Christ Lutheran School

This Statement of Deficiencies was generated as a result of the on-site State licensure inspection conducted at your facility on 02.20.2026. Please respond to each deficiency and attach documents as requested for the deficiency it pertains to. Sign and submit your Plan of Correction within 10 business days of receipt. Inspection consensus, the facility is licensed for 80 children as a CENTER. The census at the time of survey was 47 children. 15 children's files and 20 staff files were reviewed. Based on observation, the facility failed to recognize and eliminate the following hazards for the safety of children as evidenced by the following. Fireflies room: Surveyor observed 3 loose ceiling tiles. Please repair and upload pictures as evidence of correction. Ladybugs, Fireflies and Owls room: Hands free trashcan observed with broken metal foot pedals which may cause possible injuries to children. Please replace and upload pictures as evidence of correction. Please label pictures with classroom names for identification purposes. Answer the 4 POC questions. NAC 310 1. Every member of th Based on a review of staff files, staff members, volunteers, and/or residents of the facility did not have written evidence that they were free from communicable tuberculosis issued within the preceding 24 months. 1. Todd K. 2. David E. Please upload negative TB test results for individuals names above and answer the 4 POC questions. Based on record review and interview, the facility did not have a health statement signed by a registered nurse or physician within 30 days after admission for children listed. Please submit copy of the health statement signed by a physician or registered nurse for the children noted below: Child #5 Answer the 4 POC questions NRS 230 NRS 230 1. The action to be done is to ensure that 02/20/202 Certificate of immunization prerequisite to each child is up to date on vaccinations or 6 admission to child care facility; conditional has a medical or religious exemption on file. admission; report to Based on interview and record review, child(ren) as noted below failed to have current immunization records on file at time of inspection. Please submit a copy of the current immunization record for child(ren) noted below: Child #5: missing DPT, Varicella, Polio, MMR Answer the 4 POC questions NAC NAC 1. The action to be taken was to ensure 02/27/202 390.6 6. Furniture must be durable, safe and 390.6 that all furniture is safe for children. The 6 intended for use by children or appropriately cushions in the Owls classroom library were adapted for use by children. worn and needed replacing. 2. Based on observation all furniture is safe for children including the and interview, furniture for children was not soft chairs in the reading areas. durable/safe as evidenced by the following: 4. The person responsible is the Director, Donna S. Kent. · The two brown vinyl chairs in the Owls room was observed to have peeling material. Please replace or cover the furniture to prevent the children from peeling more of the vinyl material. Upload pictures as evidence of correction. Answer the 4 POC questions. FORM APPRO Based on observation, interview and record review, the facility failed to assess each child within three months of enrollment and every six months thereafter. Children as noted below did not have a current assessment on file during inspection. Child #5, 7, 9, 10, and 13 Please upload current and dated assessments for the children named above and answer the 4 POC questions.

The facility is licensed for 59 children as a Center. The census at the time of investigation was 52 children. 5 children's files and 0 staff files werereviewed. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER Name: Title: Date: REPRESENTATIVE'S SIGNATURE

This Statement of Deficiencies was generated as a result of the on-site complaint investigation conducted at your facility, for State license #3672, on 7/10/2025. There were no regulatory deficiencies identified at the time of the investigation. Inspection consensus, the facility is licensed for 80 children as a center. The census at the time of survey was 54 children. 1 children's files and 0 staff files were reviewed. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SU

The facility is licensed for 80 children as a Center. The census at the time of inspection was 60 children. 15 child's file and 21 staff files were reviewed. Reminders: Annual and Wellness Course Hours Reminder Rylie A.: Needs updated 2hrs of Wellness If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER Name: DONNA KENT Title: Director Date: 03/20/2025 REPRESENTATIVE'S SIGNATURE 3672 B. WING _______________________ 02/19/2025 CHRIST LUTHERAN SCHOOL 1304 WYOMING STREET, BOULDER CITY, NEVADA ,89005 course and seven remaining annual hours. Bailey B.: Annual hours not needed due to staff being within her 120 days. However, her initial training was completed in the ye... Based on observation, The facility vehicle does not have fire extinguishers. Please purchase fire extinguisher for vehicle and ensure it remains in vehicle at all times. Please note that the fire extinguishers in vehicles will need to be serviced yearly like the fire extinguishers within the facility. Furthermore, the floors of the vehicle will need to be cleaned and vacuumed. Please upload a picture to provide proof of this correction. Also, Driver, Chandra S. License expired on 7/2/2024. Chandra should not be driving children until proof of her updated driver license has been provided. Plea Based on file review, Fabia T. Nevada Registry Expired on1.4.25. Upload the new Nevada Registry certificate to provide proof of this correction. NAC 308 1. Whenever a child care facility is in NAC 308 Please find attached the new CPR/First Aid 03/10/202 operation, each caregiver on duty must card for Katelyn Conrad. I was going by the 5 have completed training for the recognition month and the year for expiration date of signs and symptoms of illness and the instead of the day. In the future, I will be administration of first aid. sure to note that it is month/day/year. I will 2. The training Based on file review, Katelyn C. CPR expired on 2.9.2025.Staff will need to renew CPR and upload up-to-date CRP certification cards to provide proof of this correction. NAC 1. Every member of the staff of a facility, NAC Tara Fritch's current TB test result is 310.1 including a volunteer, and each resident of 310.1 loaded. I mistakenly believed she had until the facility shall present to the director of the end of February to redo. In the future, I the facility, to be placed in the person’s file, will mark my calendar for 30 days prior to written evidence that the person is free from expirati Based on file review, Tara F. TB test expired on 2.2.2025.Staff will need to complete a new TB test and provide negative results to return to facility. Upload TB test results to provide proof of this correction. NAC 320 1. Except as otherwise provided in NRS NAC 320 Danielle Gunny is no longer employed with 432A.177 , within the first 2 weeks after us. I believe Fabia Tregnan's Staff 3672 B. WING _______________________ 02/19/2025 CHRIST LUTHERAN SCHOOL 1304 WYOMING STREET, BOULDER CITY, NEVADA ,89005 commencing employment, newly employed Checklist may have been misfiled. I am members of the staff of a facility must be attaching the one from her initial hire and given a written and oral orientation program then the before we moved to the new and be trained in the policies, procedures facil... Based on file review Danielle G. and Fabia T. Are missing orientation checklist. Upload staff’s orientation checklist to provide proof of this correction. NAC 323 1. Except as otherwise provided in NAC NAC 323 The initial wellness trainings for Katelyn 03/10/202 432A.521 and NRS 432A.177, within 120 Conrad, Kathleen Wells, Jessica Stetson 5 days after commencing his or her and Kileigh Guffey have been uploaded as employment or position in a child care part of the POC. All initial trainings that facility, each person who is employed in a were moved to employee files have now child care facility, other than a person been moved back into the binders. employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required... Based on file review the following staff are missing initial Wellness course training: - Katelyn C. - Kathleen W. - Jessica S. - Kileigh G. Please complete and upload wellness certificate to provide proof of these corrections. NAC 340 1. Procedures for admission must provide NAC 340 Please find attached documents for child 03/10/202 the caregiver with sufficient information and #6, #14 and #15. Further documents for 5 instruction from the parents to enable the child #10 and #13 will upload 3/11/25. In caregiver to prepare a record and to make the future, I will assure that all documents decis Based on file review the following children ae missing signed emergency medical/ Admissions forms: Child #6 Child #10 Child #13 Child #14 Child#15 Please complete and upload Emergency Medical forms for the children listed above to provide proof of these corrections. Based on file review the following children are missing transportation form: Child #6 Child #10 Child #13 Child#14 Child#15 Based on file review, the following children are missing signed NRS 178 forms: Child #6 Child #10 Child #13 Child #14 Child # 15 Please complete and upload NRS 178 forms for the children listed above to provide proof of these corrections. 3672 B. WING _______________________ 0 Based on file review, the following children are missing Permission to Release Forms: Child#6 Child#10 Child#13 Child#14 Child#15 Please complete and upload Permission to Release forms for the children listed above to provide proof of these corrections. 3672 B. WING __________ Based on fil review, the following children are missing signed health statement forms: Child # 9 Child #10 Child #13 Please complete and upload signed Health Statement forms for the children listed above to provide proof of these corrections. NAC 430 1. Each facility, including, without limitation, NAC 430 Please find attached, the assessments for 03/11/202 a family home and a group home, shall child 2, child 5, child 9, child 10, child 12, 5 have an early care and education program. and child 14. In the future, I will ensure that 2. Each facility described in subsection 1 all teachers comple Based on file review, the following children are missing up-to-date assessments: Child #2 Child # 5 Child #9 Child #10 Child #12 Child #14 Please complete and upload completed assessments for the children listed above to 3672 B. WING _______________________ 02/19/2025 NAME OF

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 10/30/2024. The facility is licensed for 80 children as a Center. The census at the time of survey was 64 children and 10 staff. 0 child files and 0 staff files were reviewed. Reminders: • Ensure that staff beverages stored in Infant classroom fridge are labeled with If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER Name: DONNA KENT Title: Based on observation, there were personal items and cleaning supplies that were not properly stored. It was observed in the Ladybug room that there was a black crossbody/fannypack and a large tote bag out. The Fours room had a grey and purple bookbag out near the classroom entrance door. In the Fireflies room, there were two cleaning supplies on top of the cubbies behind the water pitcher. Ensure to store personal belongings in an area that is not accessible to children. Also, store cleaning supplies in an area that is not accessible to children. Please upload photos to show proof of these corrections. 3672 B. WING _______________________ 10/30/2024 CHRIST LUTHERAN SCHOOL 1304 WYOMING STREET, BOULDER CITY, NEVADA ,89005 NAC 520 1. A licensee of a child care facility shall NAC 520 Immediate... 3672 B. WING _______________________ 10/30/2024 CHRIST LUTHERAN SCHOOL 1304 WYOMING STREET, BOULDER CITY, NEVADA ,89005 ID (EACH DEFICI

The facility is licensed for 80 children as a Center. The census at the time of inspection was 46 children. 15 child's files and 17 staff files were reviewed. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER Name: Title: Date: REPRESENTATIVE'S SIGNATURE

The facility is licensed for 80 children as a Center. Thecensus at the time of inspection was 39 children. 20 children's files and 18 stafffiles were reviewed. NAC 323 1. Except as otherwise provided in NAC NAC 323 Director will ensure that all staff take the 432A.521 and NRS 432A.177, within 120 Transportation and Field Trip Safety in Early days after commencing his or her Childhood Environment course as part of employment or position in a child care their initial trainings and require all staff facility, each person who is employed in a working in the infants room take the child care facility, other than a person Reducing the Risks of SIDS course as part employed in a facility that provides care for of their initial trainings. Please find ill children, and each director of a child care u... The following staff did not have initial trainings on file, have the staff obtain their cert and upload a copy of the cert in the Plan of Correction (POC) by 11/10/23: Kileigh G. - SIDS Kathleen W. - Transportation Fabia T. - Transportation NAC 340 1. Procedures for admission must provide NAC 340 The Director will provide parents with the caregiver with sufficient information and admissions packet and will require the instruction from the parents to enable the parent or guardian to complete an intake caregiver to prepare a record and to make form that has the child's information on it decisio Child #9 needs the following information on file, have the parent complete the forms, and upload a copy in the Plan of Correction by 11/10/23: Permission to release info, Emergency medical consent, general admission packet, 3672 B. WING _______________________ 10/20/2023 NAME OF Child #9 needs the following information on file, have the parent complete the form, and upload a copy in the Plan of Correction (POC) by 11/10/23: NRS178 Complaint review NAC.370 1. Evidence of each child ' s health must be NAC.370 In the future, I or Center Director will presented to the director of a facility, other immediately file all paperwork regarding the than an accommodation facility or a facility child/student including but not limited to that provides care for ill children, within 30 their health statement. days after the child ' s initial admission. The evidence must include a wr Child #9 and #19 need a signed Health Statement on file, once the child receives it from their doctor, upload a copy in the Plan of Correction (POC) by 11/17/23.

This is currently a pending facility, no census was taken as the facility is not open yet. 1 staff file, for the Director Donna Kent, was reviewed. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficiencies. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER Name: Title: Date: REPRESENTATIVE'S SIGNATURE