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 appropriate) k. Child abuse and neglect recognition and reporting [x] [ ] [ ] l. Child development including major domains of cognitive, social, emotional, physical development and approaches to learning. [x] [x] [ ] 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. The Child Care Center Licensing Unit uses a differential monitoring checklist to ensure compliance with the health and safety requirements. The checklist form lists each of the 11 health and safety topics, Criminal Background Checks 98.43, Group Size Limits & Child:Staff Ratios, Ongoing Training/Professional Development, Fire Standards 98.42(b)(2)(i), and the associated regulations for each topic. The form includes a column for Compliant (C), Noncompliant (NC), Not Applicable (NA), and Description of NC. Licensing specialists note the checklist as the inspection is being conducted and import the checklist into the FACTS/PATH provider file cabinet upon completion of the record. If noncompliance is cited, a corrective action plan is created and sent to the provider with a Notification of Provider Regulatory Status letter. . Applicable regulations for group size limits and child:staff ratios, ongoing training, and fire standards have been added to the Differential Monitoring Checklist as follows: Group Size Limits and Child:Staff Ratios Centers 78CSR1 - 10.5.b.1. For each singe-age (sic) group at a center, the center shall maintain the staff-to-child ratio and group size described in Table A of Appendix 78-1-E of this rule; 10.5.b.2. For each mixed age group at a center, the center shall maintain the staff- to-child ratio and group size described in Table A of Appendix 78-1-E of this rule for the youngest child in the group. Out of School Time 78CSR21 ￿ 9.2.a., 9.2.a.1., 9.2.a.2., 9.2.b., 9.2.b.1., 9.2.b.2., 9.4. 9.2.a. For programs that operate with Pre-K children, the program shall ensure that: 9.2.a.1. A 1-12 staff-to-child ratio is maintained; and 9.2.a.2. Group sizes are limited to 24 for any group that mixes older children with a Pre-K child. 9.2.b. For programs that operate with school age children only, the program shall ensure that: 9.2.b.1. A 1-16 staff-to-child ratio is maintained; 9.2.b.2. The group size is determined by the activity and is limited to facilitate staff/child interaction and safe, constructive participation by children 9.4. Staff-to-child ratio and group size are always maintained based on the age of the youngest child in the group. Ongoing Training Centers 78CSR1 8.7.c. All qualified staff shall complete the approved training which is necessary to keep the credential current. 8.7.d All qualified staff shall complete at least 15 hours of approved training annually. Training hours can be applied to the hours required to keep a credential current on the West Virginia STARS Career Pathway. 8.7.e All staff in positions that are not qualified staff positions shall have training within the first three months of employment related to their responsibilities, renew child abuse and neglect recognition every three years, and keep first aid and pediatric CPR certification current. Out of School Time 78CSR21 7.8.a. Programs shall have a professional development plan for each staff member employed more than 120 calendar days that includes a minimum of 12 clock hours of professional development annually for Directors and Site Supervisors and 8 clock hours of professional development annually for other staff positions. The professional development needs to be related to school age children or providing quality programs to school age children, or both. Except in the first year of employment, the clock hours do not include the training required in subdivision 7.7.d. Fire Standards Centers 78CSR1 4.4.b.5. A positive inspection report from the State Fire Marshal following any changes to the center’s operation and premises. 8.6.d.5. Policies and procedures for safety, including prevention of injury both indoors and outdoors, fire safety, emergency response and, for programs serving infants, safe sleep practices. 19.7.b. A center shall conduct a fire drill at least two times a month during its regular hours of operation, keeping a written record of the dates and times when fire drills are conducted. 19.7.c. When a center offers evening or night time care, a center shall also conduct fire drills during the hours of operation of its evening or night time program at least once a month. 20.3.g.1. All doors close properly, and fire doors are closed at all times. Out of School Time 78CSR21 4.4.b.5. A positive inspection report from the State Fire Marshal following any changes to the program’s facility. 8.1.c. A family child care home shall conduct monthly fire evacuation drills and maintain a written record of when they are conducted. 8.1.d. A family child care home shall develop, implement, and maintain a written procedure to practice with staff and volunteers moving to a safe location within the home at least two times a year and record the dates and times when the practice sessions are conducted; 8.1.e. A family child care home shall develop, implement, and maintain a written procedure for practicing relocation with the operator and volunteers two times per year and record the dates and times when the practice sessions are conducted. 8.2.c. Non-flammable protective barriers, guards, or screens shall be installed around wood burning stoves, open fireplaces, and unvented heaters to protect children from burns and flames and to prevent access. 8.3.a. One working smoke detector shall be installed on every level of the home. 8.3.b. Digital carbon monoxide detectors shall be installed in all residences that use gas appliances, fireplaces, pellet or wood-burning stoves, natural gas, oil, or propane heating systems. 8.3.c. Smoke detectors and carbon monoxide detectors shall have working batteries installed at all times. 8.3.d. Detectors shall be checked frequently, and batteries replaced semi-annually to insure proper functioning. https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_Centers _78CSR_1.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_OST_78 CSR_21.pdf [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed center-based providers. The Division of Early Care and Education, Child Care Center Licensing Unit is responsible for completing the inspections for child care centers and out of school centers. 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. The Family Child Care Unit uses a differential monitoring checklist for each provider type (Facilities, Homes, and Informal/Relative Homes) to ensure compliance with the health and safety requirements. The checklist form lists each of the 11 health and safety topics, Criminal Background Checks 98.43, Group Size Limits & Child:Staff Ratios, Ongoing Training/Professional Development, Fire Standards 98.42(b)(2)(i), and the associated regulations for each topic. The form includes a column for Compliant (C), Noncompliant (NC), Not Applicable (NA), and Description of NC. Regulatory specialists note the checklist as the inspection is being conducted and import the checklist into the FACTS/PATH provider file cabinet upon completion of the record. If noncompliance is cited, a corrective action plan is created and sent to the provider with a Notification of Provider Regulatory Status letter. ii. and iii. Group Size Limits and Child:Staff Ratios FCC Facilities 78CSR18. 7.1.a. A family child care facility shall have two staff members on duty who provide care for and supervision of the children if the facility provides care to more than two children under 24 months of age or more than six children at the same time. 7.1.b. When determining the ratio between staff members and children, a family child care facility shall include all children 12 years of age and under who are present and cared for in the facility, including any child of the director, staff members, and friends of the child. FCC Homes 78CSR19 6.6.a. A family child care home shall have no more than six children in care under 13 years of age at any one time. No more than two of the children may be under 24 months of age. 6.6.b. The number of children in the family child care home includes: 6.6.b.1. Children under six years old who live in the home; and 6.6.b.2. Children under six years old who are visiting and not accompanied by a parent or a responsible adult. FCC Informal/Relative Homes 78CSR20 6.5.a. An informal family child care home shall have no more than three children under 13 years of age in care at any one time. 6.5.b. The number of children in the informal family child care home includes children under six years old who live in the home. Ongoing Training FCC Facilities 78CSR18 14.1.a.8. Complete at least 15 clock hours of approved training annually. Except for the first year of operation, training in pediatric CPR is in addition to the required 15 clock hours of approved annual training. 15.1.n. Complete at least 12 clock hours of training annually, selecting training that addresses a variety of the Core Knowledge areas listed in subsection 3.3 of this rule. FCC Homes 78CSR19 6.3.c. Thereafter, the caregiver shall complete eight hours of approved training annually, encompassing a minimum of two Core Knowledge/Core Competency areas. FCC Informal/Relative Homes 78CSR20 6.3.e. Thereafter, a caregiver shall annually complete at least one hour of self- directed study related to child development. Fire Standards FCC Facilities 78CSR18 4.4.c. Applicants shall maintain compliance with applicable rules of the Bureau for Public Health, and the State Fire Marshall, and the Department of Agricultural Pest Management at all times. 6.2.b. An emergency exit plan and a record of the required monthly fire drills for the past 12 months. 6.2.e. The most recent inspection reports from the State Fire Marshal and the Bureau for Public Health as required by this rule. 22.1. Family Child Care facilities shall meet the applicable rules of the State Fire Marshal’s Office. 22.2. A family child care facility shall request an inspection by the State Fire Marshal prior to beginning operation and annually thereafter. 22.3. The facility shall establish and post a written plan for evacuation in the event of fire, natural disaster or other threatening situation that may pose a health or safety hazard to the children in the facility. FCC Homes 78CSR19 8.1.b. The fire evacuation plan shall include a drawing of the primary and secondary exits from all areas of the house and meeting places for the children once they have exited the home. 8.3.e. An ABC-rated multi-purpose fire extinguisher shall be available in the home at all times. FCC Informal/Relative Homes 78CSR20 8.1. One working smoke detector shall be installed on every level of the home. 8.2. An ABC-rated multi-purpose fire extinguisher shall be available in the home at all times. [ ] No. If no, describe: iv. Identify which department or agency is responsible for completing the inspections for licensed family child care providers. The Division of Early Care and Education, Family Child Care Unit is responsible for completing the inspections for Family Child Care Facilities, Family Child Care Homes, and Family Child Care Informal/Relative Homes. 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: There are no published regulations for Relative In- home care. Requirements are explained and agreed to on the following forms ECE-CC- 6E and ECE-CC-12. 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. Not aplicable 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: West Virginia has no license exempt 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. Not applicable. 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: West Virginia has no license exempt 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. Not applicable. 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. West Virginia has no license exempt providers. 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: Not applicable. 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: Monitoring Inspection Checklists https://www.wvdhhr.org/bcf/ece/cccenters/documents/Checklist_78- 1_Centers_2023-2028.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Checklist_78- 21_OST_2023-2028.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Checklist_78- 18_Facilities_2023-2028.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Checklist_78- 19_Homes_2023-2028.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Checklist_78- 20_Informal_Relative_2023-2028.pdf Differential Monitoring Checklists https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_Centers _78CSR_1.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_OST_78 CSR_21.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_Facilitie s_78CSR_18.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_Homes _78CSR_19.pdf https://www.wvdhhr.org/bcf/ece/cccenters/documents/Differential_MV_Informa l-Relative_78CSR_20.pdf Preliminary notice date 12/31/21. Current status. Blank checklists have been posted to the ECE Consumer Website. WV has met the requirement. 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: Provider noncompliance information can be accessed after clicking on Find a Child Care Provider, followed by a selection function that includes provider name, provider type, county location, and zip code. There is an option to choose View All Providers where the selection of choice can be made. When the name of a provider is selected, noncompliance Corrective Action Plans (CAP) can be viewed. CAP information includes start and end dates, regulation(s) cited, outcome code (Achieved, Not Achieved, Pending), and the date each issued noncompliance was completed. Fatalities and serious injuries occurring related to health and safety violations are included on a CAP. Any fatalities and serious injuries taking place at a provider of child care will also be reported on the monthly West Virginia Child Care Serious Occurrence, Death and Substantiated Abuse and Neglect in Child Care Report. This report can be accessed from the Reports & Data tab on the Early Care and Education website and viewed by year using the link FY 2020-2023, where data is available for a three-year timeframe, 2023-2024, 2022-2023, and 2022-2021. Preliminary notice dated 12/13/21. The reporting on the ECE website (The Locator) includes monitoring results of all types, full 2-year inspection, differential monitoring, complaint investigation, and corrective action plan (CAP) outcomes. Non-compliance is listed by start, end, non-complied regulation, outcome and completed date. The blank checklists are posted in the same location as the links to the providers. WV will require additional time to each show the regulation text with each noncompliance entry due to changes in data systems. Current status: meetings have taken place between WV Technology and the PATH system representatives to secure a solution to this non-compliance. Nothing further has taken place due the system going live on 7/22/24 and time needed to correct other system issues and defects. iii. [x] Corrective action plans taken by the Lead Agency and/or child care provider. Describe: Child Care Policy 8.9.1. designates that all provider types correct non- compliances within 30 days. If n on-critical items are cited, longer periods may be granted based on circumstance, if stronger action is not considered necessary. iv. [x] A minimum of 3 years of results, where available. v. If any of the components above are not selected, please explain: The current Locator posts monitoring results for a two-year timeframe. The new data system being implemented, Peoples Access to Help (PATH) with a go-live date of May 2024, is expected to post monitoring results for a three-year period. 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://dhhr.wv.gov/bfa/ece/pages/providersearch.aspx ii. Identify the Lead Agency’s established timeline for posting monitoring reports and describe how it is timely: The Child Care Licensing Unit, regulating Centers and Out of School Time programs must issue a written report of the inspection to the director within ten (10) working days of the on-site inspection (Child Care Policy 9.8.3.) The Family Child Care Unit, regulating Facilities, Homes, and Informal/Relative Homes must issue a written report of the inspection to the operator/caregiver within five (5) business days of the on-site inspection (Child Care Policy 2.6.3). Monitoring reports are pulled from the FACTS/PATH data system and posted to the Locator every 24 hours. 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? [ ] Yes. [x] No. If no, describe: 5.5.4e. Process for correcting inaccuracies in monitoring and inspection reports Comments • WV has an outstanding non-compliance (12/13/21). Provide the OCC Regional Office with documentation or other evidence of the process for correcting inaccuracies in the monitoring and inspection reports. WV has an outstanding non-compliance dated 12/31/21 that will be addressed through a revision to Child Care Policy to include the process for correcting inaccuracies in the monitoring and inspection reports. Revision: An inaccurate checklist and corrective action plan will be deleted in the PATH system with a contact entered in the provider record to verify the deletion. A new corrective action plan will be created and posted in the PATH system which will link to the ECE Locator signifying the correction. A contact will be added in the provider record to verify the creation of a new corrective action plan. The policy revision will be applicable for all provider types, Child Care Centers, Out of School Time Centers, Family Child Care Facilities, Family Child Care Homes, and Family Child Care Informal/Relative Homes. 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 (Regulation Unit Specialists), at a minimum must have a bachelor's degree and defined years of experience. All regulation unit staff are required upon hire to complete the National Association of Regulatory Agencies (NARA) Module training for licensing inspectors. In addition, a plan has been developed with onsite review of policies and procedures along with shadowing seasoned staff. During at least the first 90 days of employment, a regulation unit specialist is not assigned a caseload. A caseload is assigned gradually and formal meetings between the specialist and their supervisor are held to discuss cases and participate in training related to the position. DoHS specifies a bachelor's degree as criteria for an HHR (Health & Human Resource) Specialist. All regulation specialists are trained on Health and Safety topics upon hire when WV Code and regulation study begins. In addition, the family child care unit continues discussions during unit meetings on the emergency plan requirements and how it applies to individual providers caring for children in their homes and simultaneously maintaining residence. The Regulation Unit Program Managers are in the process of developing a training program for inspecting providers for health and safety compliance in the 11 topic areas set forth in 98.41(a)(1). The trainings will be based on the differential monitoring checklists that were developed for each provider type incorporating child care regulations 78CSR1, 78CSR18, 78CSR19, 78CSR20, and 78CSR 21 to assist regulatory specialists in monitoring the health and safety topics. Preliminary notice date 12/13/21. WV has implemented a training plan for new inspectors and is developing on-going training for all staff, tenured or new. 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. West Virginia is comprised of 55 counties. The child care licensing unit caseloads consist of child care center and out of school time providers. The family child care unit caseloads consist of facilities, homes, and informal/relative home providers. When fully staffed, caseloads average 50-55 per specialist in each unit. Factors including staff location, travel time, number of providers per county, and provider size are the primary determinants for assigning caseload numbers. The process of assigning caseloads is similar in both regulatory units. The Program Manager will divide the state into two teams (north/south) and assign specialists to each team based on office location. Then, the Program Manager will assign each team a total number of counties based on the number of providers located in each county. The teams then meet to determine which staff will regulate each of the counties while maintaining an equal balance between providers and staff travel. Staff turnover, leave of absence, and/or unforeseen situations result in adjustments to team and individual caseload assignments to ensure effective inspections on a timely basis.