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: [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 center-based providers? [x] Yes. If yes, describe how the differential monitoring approach is representative of the full complement of health and safety requirements. For the purpose of generating an annual quality rating improvement system score, monitoring visits shall consist of four (4) quarterly visits each year, three (3) announced and one unannounced, except for programs that are closed during the summer. These agencies will have three (3) quarterly visits and one (1) quarterly visit prior to or just after the three (3) month closure. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections approaches to learning. for licensed center-based providers. The Lead Agency is responsible for conducting monitoring inspections of licensed center-based providers. Licensed center-based providers receive an annual fire inspection by the Tennessee Department of Commerce and Insurance State Fire Marshal’s Office and/or local fire authority as well as an annual general health and food service (if applicable) inspection by the Tennessee Department of Health Environmental Health Program. 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: [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 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. For the purpose of generating an annual quality rating improvement system score, monitoring visits shall consist of four (4) quarterly visits each year, three (3) announced and one unannounced, except for programs that are closed during the summer. These agencies will have three (3) quarterly visits and one (1) quarterly visit prior to or just after the three (3) month closure. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. The Lead Agency is responsible for completing monitoring inspections of licensed family home and group home child care providers. Licensed family home and group home providers receive an annual fire inspection by the Tennessee Department of Commerce and Insurance State Fire Marshal’s Office and/or local fire authority as well as an annual general health and food service (if applicable) inspection by the Tennessee Department of Health Environmental Health Program. 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: The Lead Agency does not license CCDF in-home child care providers. The Lead Agency only permits relative care in circumstances when the child in care resides in the provider's home, i.e., a child or grandchild. The Lead Agency makes available in-home care for non-relatives in the child's home when the child requires special accommodations to meet individual needs. In such instances, these situations would be monitored using the protocols established for license-exempt Authorized Professionals. Please see response at 5.5.2.b.ii. 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. The Lead Agency does not license CCDF in-home child care providers. The Lead Agency only permits relative care in circumstances when the child in care resides in the provider's home, i.e., a child or grandchild. The Lead Agency makes available in-home care for non-relatives in the child's home when the child requires special accommodations to meet individual needs. In such instances, these situations would be monitored using the protocols established for license-exempt Authorized Professionals. Please see response at 5.5.2.b.iii. 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: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: 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. The Tennessee Department of Education (TDOE) is responsible for completing inspections for license-exempt center-based CCDF providers regulated by TDOE. Fire and health inspections for license-exempt center-based school-administered child care are conducted according to TDOE requirements. License-exempt center-based Boys and Girls Clubs providers participating in the Child Care Payment Assistance/Certificate Program are monitored by the Lead Agency. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. 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: [x] Annually. [ ] More than once a year. If more than once a year, describe: [ ] Other. If other, describe: 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. The Lead Agency is responsible for completing monitoring inspections of Authorized Child Care Professionals as license-exempt CCDF family child care providers. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. 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. The Lead Agency only permits relative care in circumstances when the child in care resides in the provider's home, i.e., a child or grandchild. The Lead Agency makes available in-home care for non-relatives in the child's home when the child requires special accommodations to meet individual needs. In such instances, these situations would be monitored using the protocols established for Authorized Professionals. Please see responses at 5.5.2. 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: The Lead Agency is responsible for completing monitoring inspections of Authorized Child Care Professionals as license-exempt CCDF family child care providers. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. Unannounced visits, outside of the required unannounced monitoring visit, will be based on complaints and compliance history. 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. [ ] 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: Compliance with critical health and safety indicators is prominently displayed at the beginning of each monitoring visit detail. iii. [x] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: A narrative summary of corrective action taken is included when noncompliance is observed along with a date when corrective action must be completed and a date when corrective action was completed. 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: https://onedhs.tn.gov/csp?id=tn_cc_prv_maps%20 ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: Monitoring and inspection reports are completed on-site by Lead Agency or Tennessee Department of Education (TDOE) staff. Under normal working conditions (with internet access), visit information is recorded in real-time to the Lead Agency’s eLicensing documentation system. Monitoring visits must be reviewed and approved typically within seven (7) business days by a Lead Agency supervisor or within ten (10) calendar days by a TDOE supervisor to ensure accuracy and timeliness. Once approved, visit information is immediately available at the Lead Agency’s consumer portal. The Lead Agency has requested a waiver regarding this provision to allow for report and design changes and implement technology system changes to its consumer education website related to TDOE regulated agencies that participate in the subsidy program. 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 Lead Agency consults the Tennessee Department of Human Resources Division of Classification and Compensation to develop job specifications and knowledge, skills, abilities, and competencies (KSACs) for Licensing Consultants responsible for monitoring licensed child care providers. The Lead Agency delivers a New Employee Academy (NEA) through its People Operations Learning and Organizational Development team to equip Licensing Consultants and supervisors with knowledge and resources needed to be successful. New Lead Agency licensing staff complete the three-week NEA training which includes applicable Lead Agency procedures, policies, rules, and statutes; use of Lead Agency information systems, e.g., the eLicensing documentation system; and fundamental professional skills. People Operations Learning and Organizational Development also offers ongoing and refresher trainings to meet Lead Agency needs. Additional training for The Lead Agency staff, including: • Child and Adult Care Licensing Expulsion and Suspension Policy Statement • Child Care Services CCDBG Health and Safety Training Requirements Overview • Child Care Services Cultural Competency • Child Care Services Obesity in Early Care • Developmentally Appropriate Practices • Mandated Child Abuse Reporting • Serving Families Experiencing Homelessness 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. Lead Agency staff average caseloads between 20 to 25 cases allowing Licensing Consultants to conduct quarterly monitoring visits as well as required monitoring visits based on complaints and compliance history.