Green Valley Lutheran Preschool

This Statement of Deficiencies was generated as a result of the on-site State licensure inspection conducted at your facility on 04/24/2026. There were no regulatory deficiencies identified at the time of the survey. The facility is licensed for 80 children as a Center. The census at the time of survey was 63 children. 0 children's files and 0 staff files were reviewed During this Semi Annual Inspection. 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: Tit

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 08/15/2025. The facility is licensed for 80 Children as a Center. The census at the time of the survey was 57 children and 10 staff. 15 children’s files were reviewed, and 17staff 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: JENETTE MANCUSO Title: Director Date: 08/18/2025 REPRESENTATIVE'S SIGNATURE STATE FOR Based on inspection walk through, hazards were observed in some of the classrooms. It was observed in room 4 that there was a trash can that had the lid broken off, please replace the lid or the trash can and upload photos of corrections and repairs to the Plan of Correction by 08/29/2025. Ensure that you answer all 4 questions in the POC box under "remarks." NAC 323 1. Except as otherwise provided in NAC NAC 323 1. The facility will be sure all required hours 08/15/202 432A.521 and NRS 432A.177, within 120 are completed and filed. 5 days after commencing his or her 2. 8/15/25 employment or position in a child care 3. We will check files to be sure all hours facility, each person who is employed in a are included in staff files. child care facility, other than a person 4. Jenette Mancuso -... Based on file review conducted during inspection, it was observed that staff Sheri R. was missing 1 hour of human growth and development/positive guidance. for her Initial trainings. Ensure that staff complete trainings and upload certificates into the Plan of Correction by 08/29/2025. Ensure that you answer all four questions in the POC box under “remarks” and fill in the “date POC submitted” box. 370.2 Based on file review conducted, it was observed that child #9 was missing immunizations or religious exemption forms for Varicella and MMR. Please refer to child identifier list for name of child. Please request that child’s parent schedule an appointment for these shots and return an updated record for your file. Upload immunizations form or exemption form to the Plan of Correction by 08/29/2025. Ensure that you answer all four questions in the POC box under “remarks” and fill in the “date POC submitted” box.

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 04/11/2025. The facility is licensed for 80 Children as a Center. The census at the time of the survey was 56 children and 10 staff. Files were not reviewed during this inspection visit but will be reviewed at the next inspection. COS - Corrected on-site 3 bikes from the playground were discarded during inspection, 2 did not have foot pedals If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of defic Based on review of NABS Roster, there was 1 staff who was not on the NABS roster. Facility provided a Memo of eligibility (12/3/25) expiration and the original C&R form. Please upload an updated NABS roster that reflects Shelly Merziotis in process/eligible status by 4/25/2025. Ensure that you answer all 4 questions in the Plan of Correction. NAC 302 1. A licensee of a child care facility shall not NAC 302 1.All hazards will be stored in locked lower 04/11/202 knowingly appoint a person as director of cabinets or upper cabinets out of reach 5 the facility or appoint or permit the 2.4/11/25 ap Based on inspection walkthrough, hazards were observed in one of the classrooms and on the playground. The classroom and play structure listed below were observed to be out of compliance. Upload photos of corrections and repairs to the Plan of Correction by 4/25/2025. Ensure that you answer all 4 questions in the Plan of Correction. Room 1 - It was observed that the cabinet under the sink did not have a lock and had toilet cleaner stored in it. Please ensure that cabinets with hazards are locked at all times or keep hazards in an area that is not accessible to children. Playground - It was ob

The facility is licensed for 80 children as a Center. The census at the time of investigation was 26 children. 10 children's files and 15 staff files were reviewed. Facility submitted all documents for Renewal aplication and Mandee H submitted all for Director application. Facility would like to change ages from 3-8 years to 2.5 - 8 years with Renewal. 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 State licensure survey conducted at your facility on 02/27/2024. The facility is licensed for 80 children as a center. The census at the time of survey was 46 children. 10 children's files and 17 staff files were reviewed. NAC 320 1. Except as otherwise provided in NRS NAC 320 1. We will be sure to include the orientation 03/06/202 432A.177 , within the first 2 weeks after paperwork in the employee files 4 commencing employment, newly employed 2. 3/6/2024 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: JENETTE MANCUSO Title: Office Manager Date: 04/11/2024 REPRESENTATIVE'S SIGNATUR... Based on interview and/or record review, new employees were not given a written and oral orientation and training in the policies, procedures, and programs of the facility within the first 2 weeks after commencing employment. Please upload proof of written orientation for listed on the identifier list. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. We will be sure to have all employees 03/06/202 432A.521 and NRS 432A.177, within 120 complete trainings within the specificed 4 days after commencing his or her time. employment or position in a child care 2. 3/6/24 facility, each person who is employed in a 3. We will set dates to check that all child care facility, other than a person employee trainings are completed. employed in a facility that provides care for 4. Jenette Mancuso... Based on interview and record review, the facility failed to ensure that within 120days of hire each employee completed the required hours of training in childcare. Please upload proof of trainings for staff listed on the identifier list. NAC 340 1. Procedures for admission must provide NAC 340 1. Our employees will ensure that all 03/06/202 the caregiver with sufficient information and students have all of the required paperwork 4 instruction from the parents to enable the by admission. caregiver to prepare a record and to make 2. 3/6/23 decisions or act on behalf of the child. 3. We will pe Based on interview and record review, the facility failed to ensure that each child had a written authorization signed by a parent which allows emergency and medical care. Please upload signed Medical Emergency Consent forms for children listed on the identifier list. NRS 178 Child care facility required to maintain NRS 178 1. Our employees will ensure that all 03/06/202 certain information; reporting of information students have all of the required paperwork 4 to parents and guardians; notice of right to by admission. information. 2. 3/6/23 1. A child care facility shall maintain a copy 3. W Based on observation and record review, the facility failed to have signed copy of NRS 178 form notifying parents 410 B. WING _______________________ 02/27/2024 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM PKWY, H Based on interview and record review, the facility failed to have signed Permission to Release Information form on file for children. Please upload Permission to Release forms signed by parent/guardian for children listed on the identifier list. 410 B. WING _____________________ 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. Please upload proof of health statement for children listed on the identifier list. NRS 230 NRS 230 1. Our employees will ensure that all 03/06/202 Certificate of immunization prerequisite to students have all of the required paperwork 4 admission to child care facility; conditional by admission. admission; report to Health Division. Except 2. 3/6/23 as otherwise provided in NRS 432A.235 for 3. We will periodically check all student files Based on record review and interview, the facility admitted children who were not up to date with immunizations or for whom no record was present or needed an updated. Please upload updated immunizations for children listed on the identifier list.

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 08/16/2023. The facility is licensed for 80 children as a center. The census at the time of survey was 62 children. 20 children's files and 13 staff files were reviewed. All employees including front office staff are required to get fingerprinted with 24 hours of hire and entered into the NABS system, have a negative TB upon commencing employment, and complete all initial trainings within 120 days of hire. If deficiencies are cited, an approved plan of correction must b

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility, for State license on 2/28/2023. The facility is licensed for 80 Children as an Center . The census at the time of survey was 36 children and 20 children files were reviewed and 15 staff files were reviewed. NRS 230 NRS 230 1. Parents will be contacted and asked to 03/08/202 Certificate of immunization prerequisite to supply updated vaccination records. 3 admission to child care facility; conditional 2. March 2, 2023 admission; report to Health Division. Except 3. We will Based on child files review a total of three children need updated vaccination records, please refer to the identification list to obtain names and upload the record in the plan of correction.

The facility is licensed for 80 children as a Center. The census at the time of investigation was 56 children. 20 children's files and 15 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 investigation was 40 children. 4 children'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: JENETTE MANCUSO Title: Office Manager Date: 03/01/2022 REPRESENTATIVE'S SIGNATURE Based on observation, North Playground has large hole in ground that is a safety hazard and needs to be filled and broken riding toys with sharp edges found and needs to be thrown out. 410 B. WING _______________________ 02/24/2022 Based on record review, Child #3 needs Emergency Medical form signed by parents. Upload Emergency Medical form then place in child file. NRS 178 Child care facility required to maintain NRS 178 1. The parent has be contacted and given 03/01/202 certain information; reporting of information another set of forms to complete 2 to parents and guardians; notice of right to 2. 3/1/22 information. 3. We will reguarly inspect the childrens 1. A child care facility shall maintain a copy files to be sure all forms are included of: 4. Jenette Mancuso, Office Manager (a) The license issued to the facilit Based on record review, Child #3 did not have NRS 178 form in file. Upload NRS 178 form then place in child file. 410 B. WING _______________________ 02/24/2022 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM PKWY, HE Based on record review, Child #3 did not have Permission to Release form in file. Upload Permission to Release form then place in child file. NAC.370 1. Evidence of each child ' s health must be NAC.370 1. The parent has be contacted and given 03/01/202 presented to the director of a facility, other another set of forms to complete 2 than an accommodation facility or a facility 2. 3/1/22 that provides care for ill children, within 30 3. We will reguarly inspect the childrens days after the child ' s initial admission. The files to be sure all forms are included evidence must include a written Based on record review, Child #3 did not have Health Statement in file. Upload Health Statement then place in child file. 410 B. WING _______________________ 02/24/2022 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM Based on record review, expired medication found and needs to be destroyed or returned to parents.

Based on record review, Michelle P and Nicole B need negative TB test results in file. Upload negative TB results then place in employee file. 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: JENETTE MANCUSO Title: Office Manager Date: 08/13/2021 REPRESENTATIVE'S SIGNATURE Based on observation, expired medication was found that needs to be returned to parents or disposed of.

Based on record review NV Registry was missing for the following staff: Trista H. NAC 320 1. Except as otherwise provided in NRS NAC 320 1. We will be sure to attach the orientation 02/08/202 432A.177 , within the first 2 weeks after form to each employee file 1 commencing employment, newly employed 2. 2/8/21 members of the staff of a facility must be 3. An orientation form was added to Trista given a written and oral orientation program & Emma's employee files and be trained in the policies, procedures 4. Jenette Mancuso (Office Manager) and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the f... Based on record review the facility failed to provide evidence of orientation for the following staff: Trista H. Emma M. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. Initial certifications will be completed 02/08/202 432A.521 and NRS 432A.177, within 120 within the time frame. 1 days after commencing his or her 2. 2/8/21 employment or position in a child care 3. Initial courses were completed and facility, each person who is employed in a certificates were printed. child care facility, other than a person 4. Jenette Mancuso (Office Manager). employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required by the facility in which the director serves or in which the person is employed for the purpos... Based on record review the facility failed to provide evidence of initial training for the following staff: Trista H - Signs of Illness, Child Abuse and Neglect

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 08/15/2025. The facility is licensed for 80 Children as a Center. The census at the time of the survey was 57 children and 10 staff. 15 children’s files were reviewed, and 17staff 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: JENETTE MANCUSO Title: Director Date: 08/18/2025 REPRESENTATIVE'S SIGNATURE STATE FOR Based on inspection walk through, hazards were observed in some of the classrooms. It was observed in room 4 that there was a trash can that had the lid broken off, please replace the lid or the trash can and upload photos of corrections and repairs to the Plan of Correction by 08/29/2025. Ensure that you answer all 4 questions in the POC box under "remarks." NAC 323 1. Except as otherwise provided in NAC NAC 323 1. The facility will be sure all required hours 08/15/202 432A.521 and NRS 432A.177, within 120 are completed and filed. 5 days after commencing his or her 2. 8/15/25 employment or position in a child care 3. We will check files to be sure all hours facility, each person who is employed in a are included in staff files. child care facility, other than a person 4. Jenette Mancuso -... Based on file review conducted during inspection, it was observed that staff Sheri R. was missing 1 hour of human growth and development/positive guidance. for her Initial trainings. Ensure that staff complete trainings and upload certificates into the Plan of Correction by 08/29/2025. Ensure that you answer all four questions in the POC box under “remarks” and fill in the “date POC submitted” box. 370.2 Based on file review conducted, it was observed that child #9 was missing immunizations or religious exemption forms for Varicella and MMR. Please refer to child identifier list for name of child. Please request that child’s parent schedule an appointment for these shots and return an updated record for your file. Upload immunizations form or exemption form to the Plan of Correction by 08/29/2025. Ensure that you answer all four questions in the POC box under “remarks” and fill in the “date POC submitted” box.

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 04/11/2025. The facility is licensed for 80 Children as a Center. The census at the time of the survey was 56 children and 10 staff. Files were not reviewed during this inspection visit but will be reviewed at the next inspection. COS - Corrected on-site 3 bikes from the playground were discarded during inspection, 2 did not have foot pedals If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of defic Based on review of NABS Roster, there was 1 staff who was not on the NABS roster. Facility provided a Memo of eligibility (12/3/25) expiration and the original C&R form. Please upload an updated NABS roster that reflects Shelly Merziotis in process/eligible status by 4/25/2025. Ensure that you answer all 4 questions in the Plan of Correction. NAC 302 1. A licensee of a child care facility shall not NAC 302 1.All hazards will be stored in locked lower 04/11/202 knowingly appoint a person as director of cabinets or upper cabinets out of reach 5 the facility or appoint or permit the 2.4/11/25 ap Based on inspection walkthrough, hazards were observed in one of the classrooms and on the playground. The classroom and play structure listed below were observed to be out of compliance. Upload photos of corrections and repairs to the Plan of Correction by 4/25/2025. Ensure that you answer all 4 questions in the Plan of Correction. Room 1 - It was observed that the cabinet under the sink did not have a lock and had toilet cleaner stored in it. Please ensure that cabinets with hazards are locked at all times or keep hazards in an area that is not accessible to children. Playground - It was ob

The facility is licensed for 80 children as a Center. The census at the time of investigation was 26 children. 10 children's files and 15 staff files were reviewed. Facility submitted all documents for Renewal aplication and Mandee H submitted all for Director application. Facility would like to change ages from 3-8 years to 2.5 - 8 years with Renewal. 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 State licensure survey conducted at your facility on 02/27/2024. The facility is licensed for 80 children as a center. The census at the time of survey was 46 children. 10 children's files and 17 staff files were reviewed. NAC 320 1. Except as otherwise provided in NRS NAC 320 1. We will be sure to include the orientation 03/06/202 432A.177 , within the first 2 weeks after paperwork in the employee files 4 commencing employment, newly employed 2. 3/6/2024 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: JENETTE MANCUSO Title: Office Manager Date: 04/11/2024 REPRESENTATIVE'S SIGNATUR... Based on interview and/or record review, new employees were not given a written and oral orientation and training in the policies, procedures, and programs of the facility within the first 2 weeks after commencing employment. Please upload proof of written orientation for listed on the identifier list. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. We will be sure to have all employees 03/06/202 432A.521 and NRS 432A.177, within 120 complete trainings within the specificed 4 days after commencing his or her time. employment or position in a child care 2. 3/6/24 facility, each person who is employed in a 3. We will set dates to check that all child care facility, other than a person employee trainings are completed. employed in a facility that provides care for 4. Jenette Mancuso... Based on interview and record review, the facility failed to ensure that within 120days of hire each employee completed the required hours of training in childcare. Please upload proof of trainings for staff listed on the identifier list. NAC 340 1. Procedures for admission must provide NAC 340 1. Our employees will ensure that all 03/06/202 the caregiver with sufficient information and students have all of the required paperwork 4 instruction from the parents to enable the by admission. caregiver to prepare a record and to make 2. 3/6/23 decisions or act on behalf of the child. 3. We will pe Based on interview and record review, the facility failed to ensure that each child had a written authorization signed by a parent which allows emergency and medical care. Please upload signed Medical Emergency Consent forms for children listed on the identifier list. NRS 178 Child care facility required to maintain NRS 178 1. Our employees will ensure that all 03/06/202 certain information; reporting of information students have all of the required paperwork 4 to parents and guardians; notice of right to by admission. information. 2. 3/6/23 1. A child care facility shall maintain a copy 3. W Based on observation and record review, the facility failed to have signed copy of NRS 178 form notifying parents 410 B. WING _______________________ 02/27/2024 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM PKWY, H Based on interview and record review, the facility failed to have signed Permission to Release Information form on file for children. Please upload Permission to Release forms signed by parent/guardian for children listed on the identifier list. 410 B. WING _____________________ 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. Please upload proof of health statement for children listed on the identifier list. NRS 230 NRS 230 1. Our employees will ensure that all 03/06/202 Certificate of immunization prerequisite to students have all of the required paperwork 4 admission to child care facility; conditional by admission. admission; report to Health Division. Except 2. 3/6/23 as otherwise provided in NRS 432A.235 for 3. We will periodically check all student files Based on record review and interview, the facility admitted children who were not up to date with immunizations or for whom no record was present or needed an updated. Please upload updated immunizations for children listed on the identifier list.

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 08/16/2023. The facility is licensed for 80 children as a center. The census at the time of survey was 62 children. 20 children's files and 13 staff files were reviewed. All employees including front office staff are required to get fingerprinted with 24 hours of hire and entered into the NABS system, have a negative TB upon commencing employment, and complete all initial trainings within 120 days of hire. If deficiencies are cited, an approved plan of correction must b

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility, for State license on 2/28/2023. The facility is licensed for 80 Children as an Center . The census at the time of survey was 36 children and 20 children files were reviewed and 15 staff files were reviewed. NRS 230 NRS 230 1. Parents will be contacted and asked to 03/08/202 Certificate of immunization prerequisite to supply updated vaccination records. 3 admission to child care facility; conditional 2. March 2, 2023 admission; report to Health Division. Except 3. We will Based on child files review a total of three children need updated vaccination records, please refer to the identification list to obtain names and upload the record in the plan of correction.

The facility is licensed for 80 children as a Center. The census at the time of investigation was 56 children. 20 children's files and 15 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 investigation was 40 children. 4 children'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: JENETTE MANCUSO Title: Office Manager Date: 03/01/2022 REPRESENTATIVE'S SIGNATURE Based on observation, North Playground has large hole in ground that is a safety hazard and needs to be filled and broken riding toys with sharp edges found and needs to be thrown out. 410 B. WING _______________________ 02/24/2022 Based on record review, Child #3 needs Emergency Medical form signed by parents. Upload Emergency Medical form then place in child file. NRS 178 Child care facility required to maintain NRS 178 1. The parent has be contacted and given 03/01/202 certain information; reporting of information another set of forms to complete 2 to parents and guardians; notice of right to 2. 3/1/22 information. 3. We will reguarly inspect the childrens 1. A child care facility shall maintain a copy files to be sure all forms are included of: 4. Jenette Mancuso, Office Manager (a) The license issued to the facilit Based on record review, Child #3 did not have NRS 178 form in file. Upload NRS 178 form then place in child file. 410 B. WING _______________________ 02/24/2022 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM PKWY, HE Based on record review, Child #3 did not have Permission to Release form in file. Upload Permission to Release form then place in child file. NAC.370 1. Evidence of each child ' s health must be NAC.370 1. The parent has be contacted and given 03/01/202 presented to the director of a facility, other another set of forms to complete 2 than an accommodation facility or a facility 2. 3/1/22 that provides care for ill children, within 30 3. We will reguarly inspect the childrens days after the child ' s initial admission. The files to be sure all forms are included evidence must include a written Based on record review, Child #3 did not have Health Statement in file. Upload Health Statement then place in child file. 410 B. WING _______________________ 02/24/2022 GREEN VALLEY LUTHERAN PRESCHOOL 1799 WIGWAM Based on record review, expired medication found and needs to be destroyed or returned to parents.

Based on record review, Michelle P and Nicole B need negative TB test results in file. Upload negative TB results then place in employee file. 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: JENETTE MANCUSO Title: Office Manager Date: 08/13/2021 REPRESENTATIVE'S SIGNATURE Based on observation, expired medication was found that needs to be returned to parents or disposed of.