Management agrees with the finding regarding health and safety requirements for timely unannounced monitoring visits. While several providers identified in the audit did receive a monitoring visit within 60 days of the annual due date, the Licensing Department experienced delays in completing some m...
Management agrees with the finding regarding health and safety requirements for timely unannounced monitoring visits. While several providers identified in the audit did receive a monitoring visit within 60 days of the annual due date, the Licensing Department experienced delays in completing some monitoring visits due to staff shortages and employee leave. To address the backlog and prioritize oversight activities, The Department has implemented a team-based prioritization approach rather than individual caseload management. This approach allows the unit to prioritize providers with the greatest need for monitoring and ensure that available resources are directed toward the highest-risk areas. The Department is actively working to increase staffing capacity within the unit. The Department is currently onboarding four new staff members to address existing vacancies and has recently received two additional FTE positions to further support monitoring activities. The unit continues to manage the impact of two staff members being out on extended medical leave with undetermined return dates; however, despite these staffing challenges, the unit has completed 423 monitoring visits since January 1, 2026. The Department will continue to monitor progress toward eliminating the backlog, strengthening system processes, and ensuring timely completion and documentation of required unannounced monitoring visits. DHS has also implemented enhanced monitoring capabilities within RISES. The system now generates automated notifications to the Licensing Department at established intervals before monitoring visits are due for both child care centers and family child care programs. These automated reminders strengthen monitoring workflows, improve oversight of upcoming monitoring requirements, and support the timely completion of unannounced visits. In addition, RISES has strengthened the Department's ability to consistently track provider compliance, document corrective actions, and identify providers requiring increased oversight. These enhanced monitoring tools have improved accountability by providing greater visibility into provider compliance and enabling licensing staff to more effectively prioritize regulatory activities based on risk. Management does not concur with the findings related to corrective action plans and inspections but has implemented various enhancements to support streamlined processes in these areas since the audit time period. As discussed during the audit, several factors affect the timing and applicability of required inspections and do not necessarily indicate provider noncompliance. For example, radon testing may only be conducted during specific times of the year. Providers may make timely efforts to schedule testing but be unable to obtain an inspection due to limited inspector availability or because the request falls outside the allowable testing window. In these circumstances, DHS does not consider the provider to be out of compliance. Similarly, fire inspections must be completed by the State Fire Marshal's Office. In recent years, staffing challenges have affected the ability to complete inspections within standard timeframes, despite providers' efforts to obtain them. When a provider has a history of compliant fire inspections, the Licensing Department accepts documentation demonstrating the provider's attempt to schedule the required inspection and may proceed with license renewal while awaiting the inspection. Additionally, lead inspections are not required for facilities constructed after the applicable regulatory date and are not required for school-age programs. During the audit process, DHS identified several providers flagged for inspection concerns that appeared to fall into one or both of these exempt categories. To strengthen compliance monitoring, RISES now generates automated notifications beginning 90 days before inspection expiration dates. DHS has already observed improved provider responsiveness in renewing required inspections and will continue to use RISES to proactively monitor inspection status and work with providers to maintain current inspection documentation. Regarding corrective action plans, under the previous licensing system, providers submitted corrective action plans and supporting documentation directly to the assigned licensor. This is typically through email. As a result, documentation was often maintained outside of the licensing system and may not have been consistently reflected in the inspection record. If the corrective action or follow-up information was not documented within the system or the inspection status was not updated, the report could continue to appear as pending, even when the provider had submitted the required information. To address this limitation, DHS intentionally designed the RISES system to centralize the corrective action process. Following an inspection, the report is issued to the provider through RISES, where the provider is required to submit a corrective action plan directly within the system. The corrective action plan is then routed to DHS for review and approval, creating a documented workflow and improving the consistency and completeness of recordkeeping. If a provider does not submit a corrective action plan, DHS is able to identify the outstanding item within RISES and determine whether a follow-up inspection is warranted to verify that the noncompliance has been addressed. Currently, DHS prioritizes follow-up for high-risk noncompliance, including issues related to facilities, background checks, staff-to-child ratios and supervision, and infant and toddler care. Anticipated Completion Date: This corrective action has since been completed through the implementation of the 2026 requirement that all regulated providers utilize RISES. Contact Person: Nicole Chiello, Associate Director, Office of Child Care, Department of Human Services nicole.chiello@dhs.ri.gov