5.5 Monitoring and Enforcement of Licensing and Health and Safety Requirements

5.5.1 Inspections for licensed CCDF providers Licensing inspectors must perform at least one annual, unannounced inspection of each licensed CCDF provider for compliance with all child care licensing standards, including an inspection for compliance with health and safety and fire standards. Lead Agencies must conduct at least one pre-licensure inspection for compliance with health, safety, and fire standards of each child care provider and facility in the State/Territory. a. Licensed CCDF center-based providers i. Does your pre-licensure inspection for licensed center-based providers assess compliance with health standards, safety standards, and fire standards? [ ] Yes. [x] No. If no, describe: Preliminary findings shared with the lead agency on July 22, 2024 showed this to be an area of non-compliance and more time is needed to come into compliance. The Kansas Department of Health and Environment is reviewing internal procedures to address this issue in the current data base and in design discussions with new system vendor. Licensing inspectors must perform at least one annual, unannounced inspection of each licensed CCDF provider for compliance with all child care licensing standards, including an inspection for compliance with health and safety and fire standards. Lead Agencies must conduct at least one pre-licensure inspection for compliance with health, safety, and fire standards of each child care provider and facility in the State/Territory. Pursuant to K.S.A. 65-504 (pg. 2 Child Care Licensing Laws) the applicant must be in full compliance with all health and safety regulations to receive a license. The initial inspection is scheduled, and the second onsite inspection is unannounced. Kansas law requires that all child care facilities comply with all applicable fire codes and rules and regulations of the state fire marshal. The lead agency does not enroll any temporarily licensed child care provider with CCDF until they have completed this unannounced inspection as required to obtain their permanent license. ii. Identify the frequency of annual unannounced inspections for licensed center- based providers addressing compliance with health, safety, and fire standards: [ ] Annually. [x] More than once a year. If more than once a year, describe: An annual inspection is conducted every 12 months and is unannounced. If compliance is not found at the first onsite survey, a second unannounced inspection is required to complete the annual survey. A complete walk through of the entire facility, both inside and outside, is to be conducted, including a count of staff and children present. [ ] Other. If other, describe: iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed center-based providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. If no, describe: The Lead Agency does not use a differential monitoring approach to access the full complement of health and safety requirements. iv. Identify which department or agency is responsible for completing the inspections for licensed center-based providers. Kansas Department of Health and Environment-Division of Public Health. b. Licensed CCDF family child care providers i. Does your pre-licensure inspection for licensed family child care homes assess compliance with health standards, safety standards, and fire standards? [ ] Yes. [x] No. If no, describe: Preliminary findings shared with the lead agency on July 22, 2024 showed this to be an area of non-compliance and we will need more time to come into compliance. The Kansas Department of Health and Environment is reviewing internal procedures to address this issue in the current data base and in design discussions with new system vendor. A prelicensure inspection requires a minimum of two onsite visits. The initial inspection is scheduled, and the second onsite inspection is unannounced. Pursuant to K.S.A. 65-504 (pg. 2 Child Care Licensing Laws) the applicant must be in full compliance with all health and safety regulations to receive a license. The initial inspection is scheduled, and the second onsite inspection is unannounced. Kansas law requires that all child care facilities comply with all applicable fire codes and rules and regulations of the state fire marshal. The lead agency does not enroll any temporarily licensed child care provider with CCDF until they have completed this unannounced inspection as required to obtain their permanent license. ii. Identify the frequency of annual unannounced inspections for licensed family child care homes addressing compliance with health, safety, and fire standards: [ ] Annually. [x] More than once a year. If more than once a year, describe: An annual inspection is conducted every 12 months and is unannounced. If compliance is not found at the first onsite survey, a second unannounced inspection is required to complete the annual survey. A complete walk through of the entire facility, both inside and outside, is to be conducted, including a count of staff and children present. Note: For a family child care home the entire premises is licensed. K.S.A. 65-512 (pg 8 Child Care Licensing Laws) grants authority to inspect all areas even if they are made inaccessible. Rooms that the licensee designates as "not used by children" should be evaluated for presence of children or hazards that present a health or safety risk. During the inspection the licensing specialist focuses on reviewing and assessing compliance with the licensing statutes and regulations, observes child care practices and asks questions to determine compliance, and provides technical assistance as needed on regulations and whatever issues are relevant to the provider. Findings of noncompliance are documented according to licensing procedures and reviewed and with the provider to establish and understanding of what was out of compliance and why. This review of non- compliance is considered the exit interview. Consultations and technical assistance provided is documented if warranted. Answering questions posed by the provider is not typically considered technical assistance or consultation. Significant non- compliance may result in an additional onsite inspection and request for a corrective action plan. Additional unannounced inspections may be required. Compliance inspections are requested to determine if compliance has been obtained or is being maintained. [ ] Other. If other, describe: iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed family child care providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. If no, describe: The Lead Agency does not use a differential monitoring approach to access the full complement of health and safety requirements. iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. Kansas Department of Health and Environment-Division of Public Health. c. Licensed in-home CCDF child care providers i. Does your Lead Agency license CCDF in-home child care (care in the child’s own home) providers? [x] No. [ ] Yes. If yes, does your pre-licensure inspection for licensed in-home providers assess compliance with health, safety, and fire standards? [ ] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed in-home child care providers for compliance with health, safety, and fire standards completed: [ ] Annually. [ ] More than once a year. If more than once a year, describe: [x] Other. If other, describe: Kansas Department of Health and Environment does not license or inspect in-home providers iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed in-home child care providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. iv. Identify which department or agency is responsible for completing the inspections for licensed in-home providers. There are no licensed in-home providers in Kansas. 5.5.2 Inspections for license-exempt providers Licensing inspectors must perform at least one annual monitoring visit of each license-exempt CCDF provider for compliance with health, safety, and fire standards. Inspections for relative providers will be addressed in subsection 5.8. Describe the policies and practices for the annual monitoring of: a. License-exempt CCDF center-based child care providers i. Identify the frequency of inspections for compliance with health, safety, and fire standards for license-exempt center-based providers: [ ] Annually. [ ] More than once a year. If more than once a year, describe: [x] Other. If other, describe: Kansas does not have license-exempt CCDF center- based providers. ii. Does the Lead Agency implement a differential monitoring approach when monitoring license-exempt center-based providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. iii. Identify which department or agency is responsible for completing the inspections for license-exempt center-based CCDF providers. Kansas does not have license- exempt CCDF center-based providers. b. License-exempt CCDF family child care providers i. Identify the frequency of the inspections of license-exempt family child care providers to determine compliance with health, safety, and fire standards: [ ] Annually. [ ] More than once a year. If more than once a year, describe: [x] Other. If other, describe: Kansas does not have license exempt CCDF family child care providers. ii. Does the Lead Agency implement a differential monitoring approach when monitoring license-exempt family child care providers? [ ] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. [x] No. iii. Identify which department or agency is responsible for completing the inspections for license-exempt family child care providers. Kansas does not have license exempt CCDF family child care providers. 5.5.3 Inspections for CCDF license-exempt in-home child care providers Lead Agencies may develop alternate monitoring requirements for care provided in the child’s home that are appropriate to the setting. This flexibility cannot be used to bypass the monitoring requirement altogether. a. Describe the requirements for the annual monitoring of CCDF license-exempt in-home child care (care in the child’s own home) providers, including if monitoring is announced or unannounced, occurs more frequently than once per year, and if differential monitoring procedures are used. Kansas does not have CCDF license-exempt in-home child care providers that are not qualifying relatives. b. List the entity(ies) in your State/Territory responsible for conducting inspections of license-exempt CCDF in-home child care (care in the child’s own home) providers: Kansas does not have CCDF license-exempt in-home child care providers that are not qualifying relatives. 5.5.4 Posting monitoring and inspection reports Lead Agencies must post monitoring and inspection reports on their consumer education website for each licensed and CCDF child care provider, except in cases where the provider is related to all the children in their care. These reports must include the results of required annual monitoring visits and visits due to major substantiated complaints about a provider’s failure to comply with health and safety requirements and child care policies. A full report covers everything in the monitoring visit, including areas of compliance and non-compliance. If the Lead Agency does not produce any reports that include areas of compliance, the website must include information about all areas covered by a monitoring visit. The reports must be in plain language or provide a plain language summary Lead Agency and be timely to ensure that the results of the reports are available and easily understood by parents when they are deciding on a child care provider. Lead Agencies must post at least 3 years of monitoring and inspection reports. a. Does the Lead Agency post: i. [x] Pre-licensing inspection reports for licensed programs. ii. [ ] Full monitoring and inspection reports that include areas of compliance and non-compliance for all non-relative providers eligible to provide CCDF services. iii. [x] Monitoring and inspection reports that include areas of non-compliance only, with information about all areas covered by a monitoring visit posted separately on the website (e.g., a blank checklist used by monitors) for all non-relative providers eligible to provide CCDF services. If checked, provide a direct URL/website link to the website where a blank checklist is posted: https://www.kdhe.ks.gov/386/Facility-Inspection-Results iv. [ ] Other. Describe: b. Check if the monitoring and inspection reports and any related plain language summaries include: i. [x] Date of inspection. ii. [ ] Health and safety violations, including those violations that resulted in fatalities or serious injuries occurring at the provider. Describe how these health and safety violations are prominently displayed: iii. [ ] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: iv. [x] A minimum of 3 years of results, where available. v. If any of the components above are not selected, please explain: This non- compliance was identified in Cycle 1 monitoring with notification sent to the lead agency on Dec. 13, 2021. Preliminary findings shared with the lead agency on July 22, 2024, also showed this to be an area of non-compliance and we will need more time to come into compliance. Kansas Department of Health and Environment is in the process of upgrading the online inspection consumer website displaying inspection results with a new vendor, GL Solutions. Prominent display of health and safety violations will be a priority system enhancement, facility Corrective Actions for areas of noncompliance found and full inspection reports. Target date of implementation is approximately June 2025. c. Lead Agencies must post monitoring and inspection reports and/or any related summaries in a timely manner. i. Provide the direct URL/website link to where the reports are posted: https://khap2.kdhe.state.ks.us/OIDS/ ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: Reports are posted after the survey has been reviewed and closed out by child care licensing staff. Surveys with substantial compliance are closed within 30 business days of completion and post automatically through the Online Information Dissemination System (OIDS). Surveys with substantial non-compliance are reviewed by a program consultant within 45 days of survey completion and post automatically when review has been completed. d. Does the Lead Agency certify that the monitoring and inspection reports or the summaries are in plain language that is understandable to parents and other consumers? [x] Yes. [ ] No. If no, describe: e. Does the Lead Agency certify that there is a process for correcting inaccuracies in the monitoring and inspection reports? [x] Yes. [ ] No. If no, describe: f. Does the Lead Agency maintain monitoring and inspection reports on the consumer education website? [x] Yes. [ ] No. If no, describe: 5.5.5 Qualifications and training of licensing inspectors Lead Agencies must ensure that individuals who are hired as licensing inspectors (or qualified monitors designated by the Lead Agency) are qualified to inspect child care providers and facilities and have received health and safety training appropriate to the provider setting and age of the children served. Describe how the Lead Agency ensures that licensing inspectors (or qualified monitors designated by the Lead Agency) are qualified and have received training on health and safety requirements that are appropriate to the age of the children in care and the type of provider setting. Licensing inspectors, (referred to as licensing specialist), are qualified with the following options: Twelve credit hours in Early Childhood coursework with two years of experience in services to young children, Associates Degree in Early Childhood with two years of experience in services to young children, or a Bachelor's degree in Early Childhood or related field in nursing, early childhood or elementary education, child development, human development, social work, etc. All licensing specialists are trained one-on-one with a seasoned inspector and/or a Kansas Health and Environment, Child Care Licensing District Specialist. The initial licensing specialist training includes conducting observed initial and annual inspections, conducting an inspection during a complaint investigation, a full review of child care laws and regulations and field application, including health and safety required trainings, as well as how to determine if health and safety training and requirements are met by a child care provider. A minimum of 6 clock hours of professional development related to the work of an inspector is required annually. Licensing specialists are also required to attend 3 of 4 quarterly Kansas Department of Health and Environment Regional Meetings with ongoing regulation and procedure training. 5.5.6 Ratio of licensing inspectors Lead Agencies must ensure the ratio of licensing inspectors to child care providers and facilities in the State/Territory are maintained at a level sufficient to enable the Lead Agency to conduct effective inspections of child care providers and facilities on a timely basis in accordance with federal, State, and local laws. Provide the ratio of licensing inspectors to child care providers (i.e., number of inspectors per number of child care providers) and facilities in the State/Territory and include how the ratio is sufficient to conduct effective inspections on a timely basis. Kansas has approximately 60 licensing specialists (vacancies fluctuate) to cover approximately 4,500 child care facilities. Kansas uses a hybrid approach, as some licensing specialists are state employed, while the majority are contracted through local health departments. This is an average of 75 facilities per licensing specialist. However, the number of facilities per licensing specialist could fluctuate given the rural geography of the state of Kansas. A licensing specialist may be tasked to cover multiple counties and fewer facilities due to time and distance needed to travel to cover facilities. A licensing specialist may also be tasked to cover more facilities if covering a more densely populated geographical area, as travel times are of less concern. The Kansas Department of Health and Environment Child Care Licensing Aid to Local (ATL) process involves tracking total FTE and number of local licensing specialists for every local agency contract. Each contractor identifies staffing and Kansas Department of Health and Environment Child Care Licensing approve proposals and budgets based on need (child care facilities, child care capacity, geography/coverage area, etc.). Ratio of licensing specialists to facilities is tracked but varies for each local agency and from year to year as workloads, staffing, and available funding fluctuates. Kansas Department of Health and Environment follows HHS and NARA guidance related to ratios and strives to manage the program as effectively as possible based on capacity and funding. Kansas Department of Health and Environment continues to review the current ratios and make recommendations for increasing local licensing specialist FTE as needed. This will illustrate in 2023 with the loss of a parttime contractor replaced with full time licensing specialists in southeast Kansas. By state law, Kansas Department of Health and Environment is required to inspect facilities at least once every 12 month and has an established framework around initial, annual and complaint surveys. Kansas Department of Health and Environment internally monitors overall timeliness quarterly and works directly with contracted health departments and state staff to ensure timeliness for inspections.