INSTITUTO MEXICO EN TEXAS, LLC

Three out of ten children's records reviewed are missing immunization records. One file is missing allergy plan including the symptoms and steps to take during an emergency.

Emergency practices form was reviewed: last fire drill was documented on 07/2025 and last CO detector and fire extinguisher checks on 8/2025. Per provider a fire drill was conducted last month but was not documented. Note: This was corrected at inspection when fire drill was documented and provider conducted a CO detector and fire extinguisher check during inspection.

A gas leak inspection has not been conducted.

Operation has not completed the annual children's products certification.

Last fire drill was documented on 6/14/2024 and last CO detector and fire extinguinsher checks were documented on 6/17/2024. No lock down drills were documented for the year of 2024. Per provider last fire drill was conducted on 11/2024 but was not documented. Note: CO detector and fire extinguisher checks were conducted and documented by provider during the inspection.

Ten children's records were reviewed. One file is missing emergency food allergy plan, a second file is missing immunization records and a third file is missing hearing / vision screening.

One out of ten staff files reviewed is missing copy of high school diploma or equivalent.

An infant was observed asleep with a boppy pillow in a crib. Note: This was addressed with the caregiver and the boppy pillow was removed from the crib.

Loose fill surfacing (mulch) was not maintained at the proper depth of 6 inches for a play structure in the outdoor play area. The plastic underneath the mulch was visible in different areas.

A caregiver completed pediatric CPR training online.

Several cans/bottles of disinfectant sprays were stored under a sink and on top of a sink. This posed a safety hazard as the cleaning supplies were within children reach. Note: This was CORRECTED during the inspection as the cleaning supplies were removed and stored in an area out of children's reach.

Three of ten personnel records reviewed were mising annual training in the following topics: A caregiver with DOE 6/25/2021 was missing annual trianing in: (1)Emergency preparedness, and (2)Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic. A caregiver with a DOE 3/15/2021 was missing annual training in: (1)Emergency preparedness; (2)Preventing and responding to emergencies due to food or an allergic reaction; and (3)Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?). A caregiver with a DOE 11/25/2019 was missing annual training in the following topics: (1) Emergency preparedness; (2) Preventing and controlling the spread of communicable diseases, including immunizations; (3) Preventing and responding to emergencies due to food or an allergic reaction; (4) Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?); and (1) Recognizing and preventing shaken baby syndrome and abusive head trauma; (2) Understanding and using safe sleep practices and preventing sudden infant death syndrome (SIDS); and (3) Understanding early childhood brain development.

Am emergency evacuation and relocation diagram was not posted in two classrooms that children use. Note: This was CORRECTED during the inspection as an emergency evacuation and relocation diagram was posted in both rooms.

The diaper changing mat in an infant room and a toddler room were observed torn. Note: This was CORRECTED during the inspection as both diaper changing mats were replaced with new mats.

6 of 6 cribs in the infant room were supplemented with an additional mattress. Note: This additional mattress was removed from each crib during the inspection.

The director was missing annual training on the following topics: (1) Preventing and controlling the spread of communicable diseases, including immunizations; (2) Administering medication, if applicable, including compliance with 746.3803 of this chapter (relating to What authorization must I obtain before administering a medication to a child in my care?); (3) Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; and (4) Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?). The Second director was missing annual training on the following topics: (1) Preventing and controlling the spread of communicable diseases, including immunizations; (2) Administering medication, if applicable, including compliance with 746.3803 of this chapter (relating to What authorization must I obtain before administering a medication to a child in my care?); (3) Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic;

Safety straps were not fastened for an infant using a bouncer seat in an infant room. 4 children sitting at a kidney shaped table were did not have a safety strap fastened. Chairs to the kidney shaped table were missing the safety straps in a second infant room.

4 of 6 Children's files reviewed were missing the child's immunization record.

The fire extinguisher in the transportation vehicle was not currently serviced. The service date on the tag was January 2022.

4 of 7 caregivers records reviewed were missing annual training on the following topics. Two caregivers were missing annual training on the following topics: (1) Preventing and controlling the spread of communicable diseases, including immunizations; (2) Administering medication,; and (3) Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic. A third caregiver was missing annual training on the following topics for training year 11/01/2021 - 10/31/2022: (1) Recognizing and preventing shaken baby syndrome and abusive head trauma; (2) Understanding and using safe sleep practices and preventing sudden infant death syndrome (SIDS); and (3) Understanding early childhood brain development (4) Emergency preparedness; (5) Preventing and controlling the spread of communicable diseases, including immunizations; (6) Administering medication,; (7) Preventing and responding to emergencies due to food or an allergic reaction; (8) Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; and (9) Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?). A fourth caregiver was missing annual training on the following topics for training year 8/17/2021 - 8/16/2022: (1) Emergency preparedness; (2) Preventing and controlling the spread of communicable diseases, including immunizations; (3) Administering medication; (4) Preventing and responding to emergencies due to food or an allergic reaction; (5) Understanding building and physical premises safety, including identification and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic; and (6) Handling, storing, and disposing of hazardous materials including compliance with 746.3425 of this chapter (relating to Must caregivers wear gloves when handling blood or bodily fluids containing blood?).

Two caregivers and a staff were allowed to be present in the operation and have director contact with children in care prior to the operation receiving notice from the CBCU (Centralized Background Check Unit) regarding the person s eligibility. Note: Person left the operation during the inspection.

3 of 10 children's files reviewed were missing the children's immunization record. 2 of 10 children's files reviewed were missing the children's vision and hearing screening results.

2 of 10 employees files reviewed were missing the caregivers education documentation. 3 of 10 employees files reviewed did not have the caregivers education documentation translated into English for education received outside of the United States.

4 of 10 Personnel files reviewed were missing annual training clock hours. A caregiver with DOE 1/29/2021 was missing 5 clock hours of annual training. A caregiver with DOE 2/01/2018 was missing 1 clock hour of annual training in prevention, recognition, and reporting of child maltreatment. A caregiver with DOE 8/17/2020 was missing 6 clock hours of annual training. A caregiver with DOE 8/16/2019 was missing 5 clock hours of annual training.

The operational policies reviewed were missing the following information: The Promotion of indoor and outdoor physical activity that is consistent with Subchapter F of this chapter (relating to Developmental Activities and Activity Plan): (A) The benefits of physical activity and outdoor play; (B) The duration of physical activity at your operation, both indoor and outdoor; (C) The type of physical activity (structured and unstructured) that children may engage in at your operation; (D) Each setting in which your physical activity program will take place; (E) The recommended clothing and footwear that will allow a child to participate freely and safely in physical activities; and (F) A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play. Note: This was CORRECTED during the inspection as the missing information was added to the operational policies.

The original training certificate for a training completed was not available for review for the director and a caregiver.

An infant's written feeding instructions were not current. The date on the feeding instructions reviewed was 2/04/2022.

The diaper changing mats were observed torn in two different classrooms. Note: This was CORRECTED during the inspection as the diaper changing mats were replaced.

Screen time activity was being provided to a group of toddlers in an infant room. The children were observed sitting around a kidney shaped table watching nursery rhymes on a phone. Three of the five toddlers were under the age of 2 years. Note: This was CORRECTED during the inspection as the phone was stored away and children were provided with age appropriate toys.

There was no crib in an infant room for an infant under 12 months of age. A total of 6 infants under 12 months of age were present in the room and only 5 cribs available. Note: This was CORRECTED during the inspection as an additional crib was provided in the infant room.

Two Pre-k classrooms and the afterschool room were out of ratio. A caregiver was caring for 16 pre-k children. In a second pre-k room a caregiver was caring for 17 pre-k children. The specified age of the children in each pre-k group was 3 years of age. According to the ratio chart the maximum number of children a caregiver may supervise is 15 children. In the afterschool room a caregiver was caring for 21 children of varying ages. The specified age of the children in that group was 4 years of age. According to the ratio chart the maximum number of children one caregiver may supervise is 18 children. Note: Changes were made during the inspection and additional caregivers stepped in the rooms to meet child/caregiver ratios.

Two cribs in use were not numbered or labeled with the infant's name. Note: This was CORRECTED during the inspection as the cribs were labeled with the infant's name.