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? [x] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed center- based providers addressing 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: Per ACF Preliminary Notice of Possible Non- Compliance, 01/2023: MSDE does not conduct does not conduct annual inspections for compliance with the full complement of required health and safety standards for all licensed programs (Family Child Care, Child Care Centers, Letters of Compliance, and Large Family Child Care Home providers). MSDE will need additional time to meet this requirement. MSDE is currently drafting the inspection reports for all four provider types and will send the proposed drafts to the ACF for review and approval, before implementing the new inspection reports. December 2025 is MSDEs anticipated date of compliance. iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed center-based providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. Currently, Maryland issues a license/registration for a two-year period and requires an annual unannounced inspection every 12 months. A mandatory review can be conducted during the first 12 months and the full review during the second 12 months of the two-year licensing cycle. A mandatory inspection includes the monitoring and review of selected regulations that have an immediate impact on the health and safety of children. Maryland is in the process of revising the inspection reports to ensure compliance with the ACF standards that are required to be monitored annually. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed center-based providers. The Licensing Branch is responsible for inspecting the Family Child Care, Large Family Child Care, Child Care Centers and Letter of Compliance facilities. 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? [x] Yes. [ ] No. If no, describe: ii. Identify the frequency of annual unannounced inspections for licensed family child care homes addressing 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: Per ACF Preliminary Notice of Possible Non- Compliance, 01/2023: MSDE does not conduct does not conduct annual inspections for compliance with the full complement of required health and safety standards for all licensed programs (Family Child Care, Child Care Centers, Letters of Compliance, and Large Family Child Care Home providers). MSDE will need additional time to meet this requirement. MSDE is currently drafting the inspection reports for all four provider types and will send the proposed drafts to the ACF for review and approval, before implementing the new inspection reports. December 2025 is MSDEs anticipated date of compliance. iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed family child care providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. Currently, Maryland issues a license/registration for a two-year period and requires an annual unannounced inspection every 12 months. A mandatory review can be conducted during the first 12 months and the full review during the second 12 months of the two-year licensing cycle. A mandatory inspection includes the monitoring and review of selected regulations that have an immediate impact on the health and safety of children. Maryland is in the process of revising the inspection reports to ensure compliance with the ACF standards that are required to be monitored annually. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. The Licensing Branch is responsible for inspecting the Family Child Care, Large Family Child Care, Child Care Centers and Letter of Compliance facilities. 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: N/A 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. N/A 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: N/A 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. N/A 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: N/A 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. N/A 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. Licensed-exempt/informal providers (both relative and non-relative adhere to the same requirements in Maryland). The care location must pass an annual Health and Safety Inspection. Per ACF Preliminary Notice of Possible Non-Compliance, 01/2023: MSDE does not conduct annual inspections for compliance with the full complement of required health and safety standards for license-exempt Informal Care providers. MSDE will need additional time to meet this requirement. Once the informal care electronic inspection forms have been developed and technical assistance from the ACF is received on licensed providers inspection reports, the Scholarship Branch will revise their inspection report. Please note license-exempt informal care provider inspections forms will remain the same annually, as opposed to having the two inspection type forms that licensed providers currently complete. All proposed revisions/changes to the licensed- exempt informal care provider inspection report, per TA, will be shared with the ACF for review and feedback. December 2025 is MSDEs anticipated date of compliance. 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: MSDE's Division of Early Childhood, Office of Child Care Scholarship TO Contractor inspects care locations of all licensed- Exempt providers (Relative and Non-Relative). 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. [ ] Pre-licensing inspection reports for licensed programs. ii. [x] Full monitoring and inspection reports that include areas of compliance and non-compliance for all non-relative providers eligible to provide CCDF services. iii. [ ] 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: iv. [x] Other. Describe: Licensed Programs: Per ACF Preliminary Notice of Possible Non-Compliance, 01/2023: MSDE does not post the initial inspections for Licensed Providers. MSDE will need additional time to meet this requirement. Currently, modifications to the Electronic Licensing Information System (ELIS) are being made so that the Initial inspections for child care providers will post on Checkccmd.org within thirty days of receiving their registration or license. August 2025 is MSDEs anticipated date of compliance. License-Exempt Informal Care: Per ACF Preliminary Notice of Possible Non-Compliance, 01/2023: MSDE needs to improve the process of posting monitoring and inspection reports for license- exempt Informal Care providers on the consumer education website. MSDE will need additional time to meet this requirement. MSDE is currently in the requirement phase of establishing a fillable inspection form for Informal Providers, which will be aligned (a similar format design) with the form that is currently used for the monitoring and tracking of licensed providers. Once the PDF is accessible for use, the corrective actions for Informal Providers would also be posted through the consumer education website (checkccmd.org). January 2025 is MSDEs anticipated date of full compliance. b. Check if the monitoring and inspection reports and any related plain language summaries include: i. [x] Date of inspection. ii. [x] 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: All health and safety violations, including those violations that resulted in fatalities or serious injuries occurring at the provider are prominently displayed on checkccmd.org. Inspection reports also have a mandatory fillable field located at the top of the first page, specifically for fatalities and serious injuries, so that it stands out and is easily seen upon review. iii. [x] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: The Summary of Corrections (SOC) form was released as a new form, to be completed as part of the electronic inspection process for the Licensing Branch. The form reflects all corrections made on site/at the time of inspection or the plan of correction discussed at the time of the inspection, by both parties (Licensing specialist and child care provider), for further implementation at a required future date. The form is then displayed on the consumer education website: checkccmd.org. iv. [x] A minimum of 3 years of results, where available. v. If any of the components above are not selected, please explain: 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: Licensed Programs: https://www.checkccmd.org/ License Exempt Informal Care: https://earlychildhood.marylandpublicschools.org/informal-child-care- monitoring-inspections ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: Licensed Programs: Inspection reports are posted within 30 days of the inspection date. Supervisors monitor reports using the Summary of Findings Not Reviewed report and ensure they are reviewed and posted in accordance within the 30 day time frame unless there is an extenuating circumstance in which the supervisor is working with the provider to assess compliance with the violation, or to make a determination as to whether the violation should be overturned. License Exempt Informal Care: Inspection reports are posted manually on the website as a PDF, once every month. 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. Job qualifications are established by the Maryland Department of Budget and Management and require applicants to meet standards for education and experience. Maryland has three levels for licensing inspectors - Licensing Specialist Trainee, Licensing Specialist and Licensing Specialist Lead. The trainee position is the entry level position requiring no previous experience. A trainee must complete initial, on-going training, and a full year under supervision in conducting inspections before becoming a Licensing Specialist. Requirements for the position include: Education: Possession of a bachelor's degree in child development, education, social work or psychology from an accredited college or university. Experience: Trainee - None Licensing Specialist and Licensing Specialist Lead - One year of experience inspecting, licensing and monitoring child care centers, family child care homes and non-public nursery schools. Notes: 1. Possession of an associate's degree in early childhood development, teacher education, sociology or psychology and two years' work experience inspecting, licensing and monitoring child care centers, family (day) child care homes and non-public nursery schools may be substituted for the bachelor's degree. 2. The above requirements are set by the MSDE in accordance with Education Article, Section 2-104. All licensing staff receive initial and on-going training on all aspects of the job, including comprehensive customer service training, working with diverse populations and licensing procedures and protocols. All licensing staff are required to complete the Basic Health and Safety training and the annual updates; staff are required to print the certificate of completion as part of their personnel file. Initial training includes 10-14 days of new hire training and ongoing training includes 2 full days a year, weekly and monthly regional office training sessions, state wide licensing branch training sessions and division wide training sessions. Additionally, licensing specialists both trainee and non-trainee positions are constantly learning as they perform the duties of the job and encounter new or atypical situations and incidents that occur. The initial and ongoing training includes training of policies, procedures and guidance for all types of child care and for children ages birth through 12. Licensing Specialists are hired as trainees for a one year period. OCC requires all trainees to complete new hire training as well as on-site training in the regional offices. OCC provides ongoing training through monthly staff meetings, all staff meetings and yearly professional development days. OCC is in the process of hiring a Licensing Training Coordinator who will be responsible for creating a uniform new hire training program. Scholarship: The informal provider inspectors are provided in-service health and safety training from the Lead Agency. Monthly meetings are held which address health and safety requirements, inspections, and specific case scenarios. 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. MSDE monitors the ratio of licensing inspectors to child care providers to ensure a sufficient number of inspectors are available to conduct inspections in a timely manner. Ratios vary across Maryland based on population density and travel time considerations. The ratios of licensing specialists to child care facilities (centers and family child care homes) range from 1:62 to 1:101. The current ratio of inspectors to child care providers has been sufficient for inspectors to conduct effective inspections on a timely basis. However, the agency continues to evaluate the need to increase the number of inspectors based on fluctuations in the provider and facility populations and increased needs in other areas of licensing. Currently, OCC has 102.5 Licensing Specialists for 6,788 providers. The caseload reports in CCATS provides the breakdown of cases assigned to each Licensing Specialist. This report is reviewed on a monthly basis.