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: A preliminary notice was issued on 6/15/2023, due to current inspections do not include monitoring and enforcement for standards for all components of Emergency Preparedness and Response, standards for pediatric first aid/CPR; and preservice orientation (current inspections were missing Prevention of Child Maltreatment, Pediatric First Aid and CPR, and Child Development: Approaches to Learning. appropriate) k. Child abuse and neglect recognition and reporting [x] [x] [x] l. Child development including major domains of cognitive, social, emotional, physical development and approaches to learning. [x] [x] [x] Effective November 9, 2024, with the 2025-2027 State Plan all inspections will include all required elements including emergency preparedness and response, standards for pediatric first aid/CPR; and preservice orientation, prevention of child maltreatment, pediatric first aid and CPR, and child development: approaches to learning. 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 same monitoring approach is used for all licensed child care facilities. iv. Identify which department or agency is responsible for completing the inspections for licensed center-based providers. Mississippi State Department of Health (MSDH) 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: A preliminary notice was issued on 6/15/2023, due to current inspections do not include monitoring and enforcement for standards for all components of Emergency Preparedness and Response, standards for pediatric first aid/CPR; and preservice orientation (current inspections were missing Prevention of Child Maltreatment, Pediatric First Aid and CPR, and Child Development: Approaches to Learning. Effective November 9, 2024, with the 2025-2027 State Plan all inspections will include all required elements including emergency preparedness and response, standards for pediatric first aid/CPR; and preservice orientation, prevention of child maltreatment, pediatric first aid and CPR, and child development: approaches to learning. 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 same monitoring approach is used for all licensed child care facilities. iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. Mississippi State Department of Health (MSDH) 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? [ ] No. [x] Yes. If yes, does your pre-licensure inspection for licensed in-home providers assess compliance with health, safety, and fire standards? [x] 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: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: iii. Does the Lead Agency implement a differential monitoring approach when monitoring licensed in-home child care providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. Licensed, in-home providers receive one monitoring visit each year. [ ] No. iv. Identify which department or agency is responsible for completing the inspections for licensed in-home providers. Mississippi State Department of Health (MSDH) 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: A preliminary notice was issued on 6/15/2023, due to the Lead Agency not having evidence of enforceable standards for license exempt center and registered family child care. Effective November 9, 2024, the LA will no longer allow license-exempt programs to participate in CCDF. These programs will be required to become fully licensed and adhere to all policy and procedure requirements as well as training required of any licensed programs. There are currently no enforceable standards that apply to the license-exempt and registered family child care programs that participate in CCDF. The lead agency needs the additional time to allow the Mississippi State Department of Health to follow all state law procedures for the approval and adoption of new licensing and monitoring regulations which include license exempt providers that will be required to be newly licensed will receive at minimum two inspections per year (renewal and mid-year inspections). Providers may receive additional monitoring should complaints be lodged or the Lead Agency determines additional monitoring is necessary. 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. Mississippi State Department of Health (MSDH) 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: A preliminary notice was issued on 6/15/2023, due to the Lead Agency not having evidence of enforceable standards for license exempt center and registered family child care. Effective November 9, 2024, the LA will no longer allow license-exempt programs to participate in CCDF. These programs will be required to become fully licensed and adhere to all policy and procedure requirements as well as training required of any licensed programs. There are currently no enforceable standards that apply to the license-exempt and registered family child care programs that participate in CCDF. The lead agency needs the additional time to allow the Mississippi State Department of Health to follow all state law procedures for the approval and adoption of new licensing and monitoring regulations which include license exempt providers that will be required to be newly licensed will receive at minimum two inspections per year (renewal and mid-year inspections). Providers may receive additional monitoring should complaints be lodged or the Lead Agency determines additional monitoring is necessary. 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. Mississippi State Department of Health (MSDH) 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. A preliminary notice was issued on 6/15/2023, due to the Lead Agency not having evidence of enforceable standards for license exempt center and registered family child care. Effective October 1, 2024 with the 2025-2027 State Plan the LA will no longer allow license-exempt programs to participate in CCDF. These programs will be required to become fully licensed and adhere to all policy, procedure, and inspection requirements. 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: Mississippi State Department of Health. 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. [ ] 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.mdhs.provider.webapps.ms.gov/ccsearch.aspx A preliminary notice was issued on 6/15/2023, due to the Lead Agency not having full monitoring and inspection reports that include areas of compliance and non- compliance for all non-relative providers eligible to provide CCDF services. Currently, the inspection reports only list areas of non-compliance and does include areas of compliance. The lead the agency and the Mississippi State Department of Health are receiving TA to come into full compliance with section 5.5.4. The lead agency has submitted a waiver to request additional time to allow the Mississippi State Department of Health to complete TA and follow all state law procedures for the approval and adoption of new inspection reports that include areas of compliance and non-compliance for all non-relative providers eligible to provide CCDF services. iv. [ ] Other. Describe: 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: A table is available on MSDH and MDHS website outlining the total fatalities and serious injuries occurring monthly. iii. [x] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: The facility plan of correction is displayed on all monitoring inspection reports. iv. [x] A minimum of 3 years of results, where available. v. If any of the components above are not selected, please explain: N/A 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://www.mdhs.provider.webapps.ms.gov/ccsearch.aspx ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: MSDH inspection reports are uploaded daily, and MSDH substantiated investigation reports are uploaded within 30 days of the completed investigation. 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. The MSDH has a child care employee training plan to ensure appropriate training is received prior to beginning field work. All inspectors are required to have a minimum of a Bachelor's Degree and a minimum of 25 site inspections accompanied and evaluated by a MSDH supervisor or experienced licensing official prior to beginning field work on their own. A preliminary notice was issued on 6/15/2023, due to the Lead Agency not having evidence of this policy. Evidence of this internal policy will be submitted via email for review. 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. The MSDH has a benchmark of 50 facilities per licensed inspector. This ratio allows for every licensed facility in the state to receive at least two annual inspections as required by state law.