Daycare RecordChild care inspection records

Hands N Hands Childcare

4217 Clark Ave, San Antonio, TX 78223 · Bexar County
1 high-risk citation in last 12 monthsAccepts child care subsidies

Hands N Hands Childcare is a licensed child care center in San Antonio, TX, licensed for up to 88 children and serving infants through school-age children. It has held its Texas license since 2019. Since October 2021, state inspectors have visited 28 times and investigated 13 reports. Inspectors recorded 37 citations, 9 of them high-risk, most often for records & paperwork (8 of 37). 4 citations came in the last 12 months, including 1 high-risk. 16% were corrected during the inspection itself. Its last 2 inspections found no violations. Measured by risk-weighted citations per inspection, it is tied for #360 of 476 centers in San Antonio and better than 21% of licensed centers statewide.

Inspection record

Better than 21%of 9,147 Texas licensed centers, comparing risk-weighted citations per inspection. More citations than most
Tied for #360 of 476 centers in San Antonio
9High risk
17Medium High risk
8Medium risk
3Medium Low risk
0Low risk
37 citations from 28 inspections and 12 reports since Oct 1, 2021 · 4 in the last 12 months · last inspected Sep 22, 2026

Every state visit

20222023202420252026INSPECTIONS (top) · REPORTS & INVESTIGATIONS (bottom)Sep 22, 2026 · Inspection · no citationAug 22, 2026 · Report/investigation · no citationAug 20, 2026 · Inspection · no citationAug 19, 2026 · Report/investigation · citation foundAug 17, 2026 · Inspection · citation foundJun 3, 2026 · Inspection · no citationDec 3, 2025 · Inspection · no citationNov 20, 2025 · Inspection · no citationNov 13, 2025 · Inspection · no citationNov 12, 2025 · Report/investigation · citation foundOct 30, 2025 · Inspection · citation foundOct 24, 2025 · Inspection · no citationOct 17, 2025 · Inspection · no citationOct 16, 2025 · Report/investigation · no citationNov 6, 2024 · Inspection · citation foundSep 30, 2024 · Inspection · no citationSep 10, 2024 · Inspection · citation foundSep 6, 2024 · Report/investigation · citation foundJul 23, 2024 · Inspection · no citationJul 9, 2024 · Inspection · citation foundJun 14, 2024 · Report/investigation · no citationFeb 8, 2024 · Inspection · no citationJan 26, 2024 · Inspection · citation foundJan 24, 2024 · Report/investigation · no citationNov 13, 2023 · Inspection · citation foundJul 11, 2023 · Inspection · no citationJun 30, 2023 · Inspection · citation foundJun 23, 2023 · Report/investigation · no citationApr 4, 2023 · Inspection · citation foundMar 28, 2023 · Inspection · no citationMar 23, 2023 · Report/investigation · no citationFeb 15, 2023 · Report/investigation · citation foundFeb 6, 2023 · Inspection · no citationJan 28, 2023 · Report/investigation · no citationNov 2, 2022 · Inspection · citation foundAug 30, 2022 · Inspection · no citationAug 25, 2022 · Report/investigation · no citationJul 19, 2022 · Inspection · no citationJun 6, 2022 · Report/investigation · citation foundMar 10, 2022 · Inspection · citation foundMar 1, 2022 · Assessment · citation foundOct 5, 2021 · Inspection · no citation
Citation foundNo citation

What inspectors cited most

Records & paperwork8
Health & medication8
Building & playground safety7
Staff ratios4
Supervision3
Transportation2
Other standards2
Training & qualifications2
Caregiver conduct1

Citations, newest first

Medium HighAug 19, 2026Found during an investigationRecords & paperwork
Infant Daily Report - Share with Parent §746.2431
During the course of the investigation, it was determined that infant daily reports were not being shared with parents.
Correction verified Sep 22, 2026
Medium HighAug 17, 2026InspectionHealth & medication
Immunization Records, Exceptions, and Exemptions Current §746.613(b)
Two of the four children's immunizations were not updated at the time of inspection.
Correction verified Sep 14, 2026
HighNov 12, 2025Found during an investigationSupervision
Responsibilities of Caregivers - Know children responsible for §746.1205(a)(1)
Based on the interviews conducted by the staff and parent it was determined a child was dropped off at the wrong elementary school by a daycare driver.
Correction verified Dec 3, 2025
MediumOct 30, 2025InspectionHealth & medication
Children's Records - Immunizations §746.603(a)(4)
Three out of five children's files reviewed did not have current immunization records available for review.
Correction verified Dec 23, 2025
MediumNov 6, 2024InspectionBuilding & playground safety
Children's Products- Annual Certification §746.4135(b)
The posted Children's Products Annual Certification was expired. This was corrected at inspection when the Director completed a current form.
Corrected during the visit
Medium HighSep 10, 2024InspectionBuilding & playground safety
Floors, ceilings and Walls in Good Repair and Clean §746.3407(9)
There were five ceiling tiles missing in the operation.
Correction verified Sep 30, 2024
HighSep 10, 2024InspectionSupervision
Responsibilities of Caregivers - Know children responsible for §746.1205(a)(1)
Two caregivers in the toddler rooms did not know the names of the children or ages they were responsible for.
Correction verified Sep 30, 2024
HighSep 6, 2024Found during an investigationTransportation
Safety restraint devices for child used when vehicle is on and during all time vehicle in motion §746.5607(e)
The vehicles used to transport children do not have proper restraints for the age group transporting. Children ages 3 years to 7 years were not secured in a booster seats.
Correction verified Sep 30, 2024
Medium HighJul 9, 2024InspectionOther standards
Personal use of electronic devices, such as cell phones, MP3 players, tablets, and video games §746.1203(3)(D)
The toddler caregiver was seen on her cell phone during nap time. Note, corrected at inspection after talking to the caregiver and director about no personal cell phone usage while in the classroom.
Correction verified Jul 23, 2024
Medium HighJan 26, 2024InspectionBuilding & playground safety
Annual Sanitation Inspection §746.3401(a)
The available health inspection posted was last conducted on 12.1.22.
Correction verified Mar 14, 2024
MediumNov 13, 2023InspectionHealth & medication
Children's Records - Immunizations §746.603(a)(4)
One of the eight children files didn't have a current immunization record.
Correction verified Jan 23, 2024
Medium HighNov 13, 2023InspectionHealth & medication
Medication Authorization - Signed and Dated §746.3803(a)(1)
A written, signed and dated medication authorization was not available for review for one child.
Correction verified Jan 8, 2024
MediumNov 13, 2023InspectionRecords & paperwork
Required Personnel Records- Meets Requirements §746.901(2)
Five of the eight staff files were missing education qualifications. Three of the eight staff files were missing affidavits.
Correction verified Nov 27, 2023
Medium HighNov 13, 2023InspectionTransportation
Plan to Handle Transportation Emergencies §746.5619
A written procedure on how to handle transportation emergencies was not available for review.
Correction verified Nov 15, 2023
Medium HighNov 13, 2023InspectionTraining & qualifications
Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking. §746.1315(a)
Four of the eight staff files were missing First aid and CPR training.
Correction verified Dec 11, 2023
Medium HighNov 13, 2023InspectionTraining & qualifications
Transportation Safety Training -Director and Employee Complete 2 Hours Annually §746.1316(a)
One of the two staff transporting didn't have training available for review.
Correction verified Nov 15, 2023
Medium HighNov 13, 2023InspectionRecords & paperwork
Required Admission Information - Special Needs Statement §746.605(13)
Six out of the eight children files were missing special care information. One of the eight children files were missing food allergy information. One of the eight children files were missing emergency authorization care information. One of the eight children files were missing emergency contact address.
Correction verified Nov 15, 2023
Medium HighJun 30, 2023InspectionBuilding & playground safety
Annual Sanitation Inspection §746.3401(a)
The health inspection was last conducted on 5.12.22.
Correction verified Aug 11, 2023
Medium HighJun 30, 2023InspectionSupervision
Responsibilities of Caregivers - Know children's names and ages §746.1205(a)(3)
The school age teacher was unaware of the name of the youngest and oldest of the group. NOTE: This was corrected at inspection when a name to face was conducted.
Correction verified Jul 11, 2023
HighJun 30, 2023InspectionBuilding & playground safety
Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months §746.5101(a)
The fire inspection was last conducted on 5.16.22.
Correction verified Jul 25, 2023
Medium HighJun 30, 2023InspectionStaff ratios
Child/ Caregiver Ratio - 13 or More Children §746.1601
The toddler teacher was observed with six children SAG of 12-17 months which made the teacher over by one child. NOTE: This was corrected when the youngest child was moved to the infant classroom.
Correction verified Jul 11, 2023
Medium HighApr 4, 2023InspectionBuilding & playground safety
Safety - Areas Free From Hazards §746.3701
On the changing table of the toddler classroom a Lysol spray can was observed accessible to the children. In addition to diaper cream on the changing table in the infant classroom. NOTE: This was corrected at inspection when it was removed.
Corrected during the visit
MediumApr 4, 2023InspectionHealth & medication
Children's Records - Immunizations §746.603(a)(4)
Two of the eight children did not have shot records available for review. In addition to one of the eight children missing medical authorization information. NOTE: One of the two shot records was provided.
Correction verified Apr 12, 2023
Medium HighApr 4, 2023InspectionOther standards
Electronic or Battery-Operated Carbon Monoxide Detector-Check All Detectors Monthly §746.5537(a)(2)
Documentation for the carbon monoxide, extinguisher and smoke detectors were not documented for January, February and March. NOTE: This was corrected at inspection.
Corrected during the visit
Medium HighApr 4, 2023InspectionHealth & medication
Diaper Changing Steps-Supplies Kept Out of Child's Reach §746.3501(6)
Diaper changing supplies in the toddler and two infant classrooms were observed accessible in the children cubbies. NOTE: This was corrected at inspection.
Corrected during the visit
HighApr 4, 2023InspectionHealth & medication
Required Equipment in Vehicles - Emergency Medical Information §746.5617(a)(2)
Emergency medical information for 7 children were not available for review. NOTE: This was corrected at inspection.
Corrected during the visit
HighFeb 15, 2023Found during an investigationCaregiver conduct
Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control §746.1201(1)
Based on the information gathered, and interviews conducted the operation staff did not demonstrate good judgment by not assisting in the basic care with toileting for a child who was partially toilet trained.
Correction verified Apr 4, 2023
Medium LowFeb 15, 2023Found during an investigationRecords & paperwork
Parental Notification of Infestation §746.307(e)
Based on the information gathered, and interviews conducted during this investigation parents were not notified in writing within 48 hours about the outbreak of lice.
Correction verified Apr 4, 2023
MediumNov 2, 2022InspectionRecords & paperwork
Children's Records Maintained §746.603(a)
Four out of eight children's records reviewed were missing required information including emergency contact information and healthcare provider statements.
Correction verified Nov 17, 2022
Medium LowNov 2, 2022InspectionRecords & paperwork
Required Personnel Records - Required Affidavit §746.901(4)
Three out of eight employee records reviewed were missing the required affidavit for employment.
Correction verified Nov 9, 2022
MediumJun 6, 2022Found during an investigationStaff ratios
Operation Open to Parents At All Times §746.201(7)
Based on the information received parents are not allowed to enter the operation.
Correction verified Jul 19, 2022
MediumJun 6, 2022Found during an investigationRecords & paperwork
Parental Notification of Less Serious Injuries §746.307(c)
Based on the information received, parents were not notified of less serious injuries such as scratches during pick up time.
Correction verified Jul 19, 2022
HighJun 6, 2022Found during an investigationStaff ratios
AP Background check results - Must receive notification prior to allowing subject to be present at your operation §745.641
During the investigation a caregiver in direct care of children had not received required background check eligibility notifications.
Correction verified Jul 19, 2022
Medium HighMar 10, 2022InspectionHealth & medication
Safety - Televisions Anchored to Prevent Tip Over §746.3701(9)
In the school age classroom a Tv was not anchored. This was corrected at inspection when director removed TV from the classroom.
Corrected during the visit
HighMar 10, 2022InspectionBuilding & playground safety
Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months §746.5101(a)
Annual first inspection had not been updated since 10/19/2020.
Correction verified Mar 21, 2022
Medium LowMar 1, 2022InspectionRecords & paperwork
Report Number of Employees §746.303(b)
A review of the Employees Who Left Employment in 2021 data from February 23, 2022, revealed that the center had not reported the number of employees who left employment in 2021 by February 22, 2022, as required.
Correction verified Mar 7, 2022
HighSep 24, 2021Found during an investigationStaff ratios
AP Background check results - Must receive notification prior to allowing subject to be present at your operation §745.641
A person was present at the operation without a cleared background check and responsible for children prior to the operation receiving the eligibility letter. NOTE: This has been corrected by caregiver being removed from operation.
Correction verified Oct 21, 2021

About this center

Licensed capacity88 children
Ages servedInfant, Toddler, Pre-Kindergarten, School
Hours06:00 AM-06:00 PM
DaysMon, Tue, Wed, Thu, Fri
Licensed sinceApr 30, 2019
DirectorCassandra Estrada
Phone2106004116
State operation #1682546

Common questions

Does Hands N Hands Childcare take infants?

Yes. Texas licenses it to care for infants through school-age children.

What are Hands N Hands Childcare’s hours?

6 AM to 6 PM, Monday through Friday, according to its state licensing record. Confirm holiday and summer hours with the center.

Does Hands N Hands Childcare accept child care subsidies?

Yes, according to its state licensing record.

How much does Hands N Hands Childcare cost?

Texas does not publish individual centers’ prices, so ask Hands N Hands Childcare for its current tuition. For comparison, the median full-day price at licensed centers in the Alamo area, which includes San Antonio, is $42.00 a day for infants, $40.40 a day for toddlers and $39.20 a day for 3-year-olds (2025 Texas Child Care Market Rate Survey).

Has Hands N Hands Childcare had any serious violations?

Inspectors recorded 9 high-risk citations since 2021. The most recent was on Nov 12, 2025: “Responsibilities of Caregivers - Know children responsible for.” Each one is listed in full above.

How does Hands N Hands Childcare compare with other daycares in San Antonio?

It is tied for #360 of 476 centers in San Antonio by risk-weighted citations per inspection, and is better than 21% of licensed centers statewide (out of 9,147 Texas centers with enough inspection history).

When was Hands N Hands Childcare last inspected?

Sep 22, 2026. No violations were found during that visit.

Licensed centers nearby

Citations are quoted from Texas HHS inspection records. Many are corrected the same day, and a citation is a finding about one rule, not a judgment about a center overall.

To see the official record, search operation 1682546 on Search Texas Child Care. Data refreshed Sep 30, 2026.