Green Valley United Methodist Church Christian Preschool

This Statement of Deficiencies was generated as a result of the on-site State Annual Inspection conducted at your facility on 09/112025. The facility is licensed for 69 children as a Center. The census at the time of survey was 5 children. 5 children's files and 9 staff files were reviewed. Reminders: 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: TRACY VANAKEN Title: Director Date: 09/25/2025 REPRESENTATIVE'S SIGNATURE Based on observation, the following playground hazards were noted: The playground floor padding between the wall and the play structure has holes that pose a safety hazard and require repair. Upload pictures of repairs. Answer 4 POC questions. 814 B. WING _______________________ Based on observation, the following indoor hazards were noted: Yellow Classroom: The wooden toy castle near the window is deteriorating, with chipped surfaces and splintered edges that may pose a safety risk. It requires repair or replacement to ensure it is safe for children to use. The red peelable chair covering is uneven and not smooth to the touch, posing potential safety concerns such as difficulty in cleaning and sanitizing, and a possible choking hazard if pieces become detached. Please ensure the chair is repaired, replaced or discarded to maintain a safe and sanitary environment. Up Based on record review, the facility failed to ensure all employees had documentation of Nevada Registry membership within 120 days of their hire date, as required by regulation. Please upload proof of Nevada Registry membership for the following staff: *Tracey Davis *Lisa Gayer Answer 4 POC questions. NAC 340 1. Procedures for admission must provide NAC 340 1. The father of the child filled 09/25/202 the caregiver with sufficient information and out the enrollment packet. 5 instruction from the parents to enable the 2. 09/25/25 caregiver to prepare a record and to make decisions or act on be Based on record review, the facility failed to ensure that each child had a completed admission packet, including a written authorization signed by a parent allowing for emergency medical care and a transportation permission form. Please upload the completed admission packet, signed Medical Emergency Consent form, and Transportation Permission form for Child #4 on the identifier list. Answer 4 POC questions. NRS 178 Child care facility required to maintain NRS 178 1. Parent signed and submitted 09/25/202 certain information; reporting of information NRS 432A.178 5 Based on record review, the facility failed to have signed copy of NRS178 form notifying parents of right to request complaint information. Please upload signed NRS 178 for Child # 4 listed on the identifier list. Answer 4 POC questions. NAC 360 1. The licensee of a facility shall not NAC 360 1. Documents have been 09/25/202 disclose to any person who is not a member submitted. 5 of the staff of the facility or a member of the 2. 9/23/25 licensing staff of the Health Division information pertaining to any child, unless: 3. Exclude students who do not (a) The parent has given written permissio Based on 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 the following children on the identifier list: *Child #2 *Child #4 Answer 4 POC questions. NRS 230 NRS 230 1. Received Religious 09/25/202 Certificate of immunization prerequisite to Exemption Certificate. 5 Based on interview, the facility admitted children who were not up to date with immunizations or no record was present. Please upload updated immunizations for Child # 4 listed on the identifier list. Answer 4 POC questions.

This Statement of Deficiencies was generated as a result of the on-site State Semi Annual inspection conducted at your facility on 2/24/2025. The facility is licensed for 69 children as a Center. The census at the time of survey was 13 children. 0 children's files and 0 staff files were reviewed but will be reviewed at the Annual Inspection. 13 children and 5 staff were on site at the time of the 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: TRACY VANAKEN Title: Director Date: 03/10/2025 REPRESENTATIVE'S SIGNATURE 814 B. WING _______________________ 02/24/2025 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HEN... Based on observation, the facility was found to have hazards as listed below. A broom was placed on the the playground and not properly stored. Ensure that the play area is free of hazards and the broom is stored in a location that is inaccessible to children. 814 B. WING _______ Based on interview and record review, the facility failed to maintain a daily sign-in sheet that included the times of arrival and departure for children when traveling between classrooms. To ensure times are consistently recorded, please provide instruction to staff and monitor the daily sign-in sheets. Answer 4 POC questions. NAC 302 1. A licensee of a child care facility shall not NAC 302 1. Broom was correctly stored. Locks were 02/25/202 knowingly appoint a person as director of placed on drawers and cabinets in the Red, 5 the facility or appoint or permit the Blue and Purple rooms. Cove Based on observation, the follow hazards were noted: Yellow classroom: Broom and dustpan was not properly stored and accessible to children. Ensure the broom and dustpan are stored in a location that is inaccessible to children. Please note: the broom needs to be placed bristle side up if stored on a wall hook. The blue couch and red chair are beginning to peel and the foam is exposed. Please cover, replace or repair and upload pictures of corrections. Red classroom: The cabinet under the sink was unlocked and had potentially hazardous items stored. Ensure a lock is placed on the cabinet door Based on observation, the facility failed to ensure all water bottles and cups were labeled with the child's first and last name. Ensure all water bottles and cups are properly labeled at all times. Answer 4 POC questions.

ThisStatement of Deficiencies was generated as a result of the on-site Statelicensure inspection conducted at your facility, on 5/6/24. There were no regulatory deficienciesidentified at the time of the survey. Thefacility is licensed for #69 Children as a center . The census at the time ofsurvey was #22 children and #10 children files were reviewed and # 8 staff files werereviewed. REMINDER: email inspector annual hours( 24) for all 8 staff members by 6/30/24. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficien

The facility is licensed for 69 children as a Center. The census at the time of investigation was 12 children. 10 children's files and 8 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

Reminder: Remember to put 2 hours Wellness course back in each employee's Initial trainings section and do not remove. NAC 306 1. Every caregiver in a child care facility NAC 306 1. Uploaded NV Registry Certificates for 09/12/202 must: Jannice Oliveri and Marie Sassman. 3 (a) Be at least 16 years of age; 2. Completed on September 8, 2023 (b) Be able to summon help in an 3. Remind teachers to print certificates emergency; more timely. (c) Be emotionally and physically qualified 4. Tracy VanAken is responsible. to carry out a program which places emphasis on the development of children; and (d) Based on record review, Janice O and Marie S need to renew NV Registry. Upload NV Registry email confirmation or copy of certificate then place in employee file. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. Uploaded class certificate. 09/07/202 432A.521 and NRS 432A.177, within 120 2. September 7, 2023 3 days after commencing his or her 3. Remind employees of the classes that employment or position in a child care are required. facility, each person who is employed in a 4. Tracy VanAken is responsible. child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care 814 B. WING _______________________ 09/05/2023 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HENDERSON, NEVADA ,89... Based on record review, Christina M needs Medication training. Upload certificate then place in employee file. NAC.370 1. Evidence of each child ' s health must be NAC.370 1. Uploaded Francesca Pasoe's health 09/11/202 presented to the director of a facility, other statement. Confirmed with Carmelo 3 than an accommodation facility or a facility Leolafi's mother that his doctor's that provides care for ill children, within 30 appointment is September 15th. Confirmed days after the child ' s initial admission. The with Wes and Evan's mother that their evidence must include a written statement d Based on record review, Child #1,2,8 and 9 need Health Statements signed by Doctor. Upload Health Statements then place in child file. NRS 230 NRS 230 1. Received immunization record from 09/07/202 Certificate of immunization prerequisite to mother. 3 admission to child care facility; conditional 2. September 7, 2023 admission; report to Health Division. Except 3. Remind parents that all forms are to be as otherwise provided in NRS 432A.235 for turned in within 30 days of starting school. accommodation facilities: 4. Tracy VanAken is responsible. 1. Except as otherwise provided in subsection Based on record review, Child #10 needs updated immunizations. Upload current shot record then place in child file.

License capacity 69 Facility Type Center Total Number of Children 15 Number of child files reviewed 15 Number of staff files reviewed 9 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: TRACY VANAKEN Title: Director Date: 03/21/2023 REPRESENTATIVE'S SIGNATURE Based on record review children #2 & #3 are missing Health statements. Please gather from parent, upload into POC and keep on file for review.

License capacity 67 Facility Type C Total Number of Children 15 Number of child files reviewed 15 Number of staff files reviewed 9 REMINDERS 1) The following staff need additional ongoing training hours *Tracy D. - 24 hours needed *Rose G - 10 hours needed *Janice O. - 3 hours needed *Karri S. - 3 hours needed 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: TRACY VANAKEN Title: Director Date: 09/16/2022 REPRESENTATIVE'S SIGNATURE Based on observation two children were under age three, the age stated on the license. Please complete an amendment to drop the age of the license. 814 B. WING _______________________ 09/01/2022 GREEN VALLEY UNIT Based on observation a trike had a broken side panel. Please remove or repair. NAC 306 1. Every caregiver in a child care facility NAC 306 1. The Certificates were placed in the must: binder. 2. 9/15/22 3. Keep binder (a) Be at least 16 years of age; organized. 4. Tracy VanAken (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Ne Based on record review the following staff are missing current NV Registry certificates - please upload current certificate and assure they are kept in the employee binder. 1) Christina M. 2) Marie S 3) Kami S. 814 B. WING _______________________ 09/01/2022 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HENDERSON, NEVADA ,89074 NAC 320 1. Except as otherwise provided in NRS NAC 320 1. Uploaded documentation of Employee 432A.177 , within the first 2 weeks after Orientation. 2. 9/15/22 3. Will keep the commencing employment, newly employed binder more organized with necessary members of the staff of a facility must be documents. 4. Tracy VanAken given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by... Based on record review the following staff are missing New Employee Orientation - please upload and assure they are kept in the training binder. 1) Tracy V 2) Kami S. 3) Sandra A. 4) Tracy D. 5) Lisa G. 6) Rose G. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. Uploaded class certificates. 2. 9/15/22 432A.521 and NRS 432A.177, within 120 3. Will keep binder more organized. 4. days after commencing his or her Tracy VanAken employment or position in a child care facility, each person who is employed in a child care facility, other than a person 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 purposes... Based on record review the following staff are missing initial training, please upload and assure they are kept in the employee binder. 1) Marie S. missing 2 hours of Human Development or Positive Guidance 2) Tracy D. missing Signs of Illness/BBP, Child Abuse and Neglect, 3 hours of Human Development, Administration of Medication 3) Rose G. missing CPR/FA, Signs of Illness/BBP, Child Abuse and Neglect 4) Tracy V. missing 2 hours of Human Development NAC.370 1. Evidence of each child ' s health must be NAC.370 1. Uploaded Health Statements for Juliette presented to the director of a facility, Based on record review children #5 and #6 are missing Health Statements - please upload and keep in the child's file NRS 230 NRS 230 1. Uploaded Immunization Records for Eli Certificate of immunization prerequisite to G. and Mila L, Exemption for Myles L. 2. 9/15/22 3. Will conduct reviews of student Based on record review children #2, #8, & #9 are missing current immunizations - please upload and keep in the child's file.

Please email reporting child abuse and neglect certificate for Barbara S. by 9/24/2021. 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

Based on observation <!--[if !supportLists]-->2. <!--[endif]-->2. and interview, the facility had no record that April 7, 2021 a drill for natural disasters was held at least once every three months. Last disaster drill <!--[if !supportLists]-->3. <!--[endif]-->3. logged was on 11/20/2020. Assign a back-up person to conduct drills inthe Director’s absence. <!--[if !supportLists]-->4. <!--[endif]-->4. Tracy VanAken NAC 306 1. Every caregiver in a child care facility NAC 306 04/15/202 must: <!--[if !supportLists]-->1. <!--[endif]-->1. 1 (a) Be at least 16 years of age; Rose G. completed Human G Based on interview and record review, the facility failed to ensure that within 90 days of hire each employee had a completed application or renewal of Nevada Registry membership. Current Nevada Registry membership not present for staff noted below as listed on the staff identifier sheet. Please submit copy of current Nevada Registry certificate or email from Nevada Registry showing proof of applying. Staff 1 814 B. WING _______________________ 04/06/2021 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HENDERSON, NEVADA ,89074 NAC 323 1. Except as otherwise provided in NAC NAC 323 04/15/202 1. 1. Received Health Statement for 432A.521 and NRS 432A.177, within 120 1 Child #1. days after commencing his or her employment or position in a child care 2. 2. April 23, ... Based on interview and record review, the facility failed to ensure that within 120 days of hire each employee completed the required hours of training in child care. Training not on file for staff as noted below: Staff #1: Human Growth and Development/Positive Guidance and Medication Administration 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. Child #1 NRS 230 NRS 230 04/07/202 Certificate of immunization prerequisite to 1. 1. Printed Child #1 and Child 1 admission to child care facility; conditional #2 immunization records admission; report to Health Division. Except fromWebIZ; as otherwise provided in NRS 432A.235 for accommodation facilities: 2. 2. April 7, 2021 1. Except as otherwise provided in subsection 3 and unless excused because 3. 3. Audit files q Based on interview and record review, child(ren) as noted below failed to have current immunization records on file at time of inspection. Children without a current immunization 814 B. WING _______________________ 04/06/2021

This Statement of Deficiencies was generated as a result of the on-site State licensure survey conducted at your facility on 02/21/2020. There were no regulatory deficiencies identified at the time of the survey. 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 Semi Annual inspection conducted at your facility on 2/24/2025. The facility is licensed for 69 children as a Center. The census at the time of survey was 13 children. 0 children's files and 0 staff files were reviewed but will be reviewed at the Annual Inspection. 13 children and 5 staff were on site at the time of the 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: TRACY VANAKEN Title: Director Date: 03/10/2025 REPRESENTATIVE'S SIGNATURE 814 B. WING _______________________ 02/24/2025 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HEN... Based on observation, the facility was found to have hazards as listed below. A broom was placed on the the playground and not properly stored. Ensure that the play area is free of hazards and the broom is stored in a location that is inaccessible to children. 814 B. WING _______ Based on interview and record review, the facility failed to maintain a daily sign-in sheet that included the times of arrival and departure for children when traveling between classrooms. To ensure times are consistently recorded, please provide instruction to staff and monitor the daily sign-in sheets. Answer 4 POC questions. NAC 302 1. A licensee of a child care facility shall not NAC 302 1. Broom was correctly stored. Locks were 02/25/202 knowingly appoint a person as director of placed on drawers and cabinets in the Red, 5 the facility or appoint or permit the Blue and Purple rooms. Cove Based on observation, the follow hazards were noted: Yellow classroom: Broom and dustpan was not properly stored and accessible to children. Ensure the broom and dustpan are stored in a location that is inaccessible to children. Please note: the broom needs to be placed bristle side up if stored on a wall hook. The blue couch and red chair are beginning to peel and the foam is exposed. Please cover, replace or repair and upload pictures of corrections. Red classroom: The cabinet under the sink was unlocked and had potentially hazardous items stored. Ensure a lock is placed on the cabinet door Based on observation, the facility failed to ensure all water bottles and cups were labeled with the child's first and last name. Ensure all water bottles and cups are properly labeled at all times. Answer 4 POC questions.

The facility is licensed for 69 children as a Center. The census at the time of investigation was 12 children. 10 children's files and 8 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

ThisStatement of Deficiencies was generated as a result of the on-site Statelicensure inspection conducted at your facility, on 5/6/24. There were no regulatory deficienciesidentified at the time of the survey. Thefacility is licensed for #69 Children as a center . The census at the time ofsurvey was #22 children and #10 children files were reviewed and # 8 staff files werereviewed. REMINDER: email inspector annual hours( 24) for all 8 staff members by 6/30/24. If deficiencies are cited, an approved plan of correction must be returned within 10 days after receipt of this statement of deficien

Reminder: Remember to put 2 hours Wellness course back in each employee's Initial trainings section and do not remove. NAC 306 1. Every caregiver in a child care facility NAC 306 1. Uploaded NV Registry Certificates for 09/12/202 must: Jannice Oliveri and Marie Sassman. 3 (a) Be at least 16 years of age; 2. Completed on September 8, 2023 (b) Be able to summon help in an 3. Remind teachers to print certificates emergency; more timely. (c) Be emotionally and physically qualified 4. Tracy VanAken is responsible. to carry out a program which places emphasis on the development of children; and (d) Based on record review, Janice O and Marie S need to renew NV Registry. Upload NV Registry email confirmation or copy of certificate then place in employee file. NAC 323 1. Except as otherwise provided in NAC NAC 323 1. Uploaded class certificate. 09/07/202 432A.521 and NRS 432A.177, within 120 2. September 7, 2023 3 days after commencing his or her 3. Remind employees of the classes that employment or position in a child care are required. facility, each person who is employed in a 4. Tracy VanAken is responsible. child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care 814 B. WING _______________________ 09/05/2023 GREEN VALLEY UNITED METHODIST CHURCH CHRISTIAN PRESCHOOL 2200 ROBINDALE RD, HENDERSON, NEVADA ,89... Based on record review, Christina M needs Medication training. Upload certificate then place in employee file. NAC.370 1. Evidence of each child ' s health must be NAC.370 1. Uploaded Francesca Pasoe's health 09/11/202 presented to the director of a facility, other statement. Confirmed with Carmelo 3 than an accommodation facility or a facility Leolafi's mother that his doctor's that provides care for ill children, within 30 appointment is September 15th. Confirmed days after the child ' s initial admission. The with Wes and Evan's mother that their evidence must include a written statement d Based on record review, Child #1,2,8 and 9 need Health Statements signed by Doctor. Upload Health Statements then place in child file. NRS 230 NRS 230 1. Received immunization record from 09/07/202 Certificate of immunization prerequisite to mother. 3 admission to child care facility; conditional 2. September 7, 2023 admission; report to Health Division. Except 3. Remind parents that all forms are to be as otherwise provided in NRS 432A.235 for turned in within 30 days of starting school. accommodation facilities: 4. Tracy VanAken is responsible. 1. Except as otherwise provided in subsection Based on record review, Child #10 needs updated immunizations. Upload current shot record then place in child file.

License capacity 69 Facility Type Center Total Number of Children 15 Number of child files reviewed 15 Number of staff files reviewed 9 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: TRACY VANAKEN Title: Director Date: 03/21/2023 REPRESENTATIVE'S SIGNATURE Based on record review children #2 & #3 are missing Health statements. Please gather from parent, upload into POC and keep on file for review.