Hands N Hands Childcare

Licensed Center

Provider details

City / County / ZIP: San Antonio / Bexar / 78223
Street address: 4217 Clark Ave
Phone: (210) 600-4116
Capacity: 88
Ages served: Infant, Toddler, Pre-Kindergarten, School
Hours / Days: 06:00 AM-06:00 PM / Mon,Tue,Wed,Thu,Fri
Permit type: Full Permit
Permit issued: April 30, 2019
Operation status:: Active
Corrective action: HHSC lists: No
Adverse action: HHSC lists: No
Temporarily closed: HHSC lists: No

Corrective action means HHSC requires steps to address compliance concerns; see the official HHSC record for details.

Adverse action means HHSC has taken enforcement action affecting an operation’s permit or ability to operate; see the official HHSC record for details.

Plain-English summary of cited deficiencies

State records list 17 cited deficiencies dated November 13, 2023 to August 19, 2026 (3 High, 10 Medium High, 4 Medium risk). Correction status: 1 corrected at inspection, 16 with a correction date recorded, 0 with no correction date recorded.

High risk · Responsibilities of Caregivers - Know children responsible for (746.1205(a)(1))
Cited November 12, 2025 (correction date recorded: November 25, 2025; correction verified December 3, 2025; technical assistance given); September 10, 2024 (correction date recorded: September 10, 2024; correction verified September 30, 2024; technical assistance given).
What the record describes: Narratives describe a daycare driver dropping a child off at the wrong elementary school and caregivers in toddler rooms not knowing the names or ages of children in their care.
High risk · Safety restraint devices for child used when vehicle is on and during all time vehicle in motion (746.5607(e))
Cited September 6, 2024 (correction date recorded: September 17, 2024; correction verified September 30, 2024; technical assistance given).
What the record describes: Vehicles used to transport children lacked appropriate restraints for the ages transported. Children ages 3 to 7 were not secured in booster seats.
Medium High risk · Infant Daily Report - Share with Parent (746.2431)
Cited August 19, 2026 (correction date recorded: September 11, 2026; correction verified September 22, 2026; technical assistance given).
What the record describes: Infant daily reports were not being shared with parents.
Medium High risk · Immunization Records, Exceptions, and Exemptions Current (746.613(b))
Cited August 17, 2026 (correction date recorded: September 17, 2026; correction verified September 14, 2026; technical assistance given).
What the record describes: Two of four children's immunization records were not updated.
Medium High risk · Floors, ceilings and Walls in Good Repair and Clean (746.3407(9))
Cited September 10, 2024 (correction date recorded: September 24, 2024; correction verified September 30, 2024; technical assistance given).
What the record describes: Five ceiling tiles were missing at the child care operation.
Medium High risk · Personal use of electronic devices, such as cell phones, MP3 players, tablets, and video games (746.1203(3)(D))
Cited July 9, 2024 (correction date recorded: July 9, 2024; correction verified July 23, 2024; technical assistance given).
What the record describes: A toddler caregiver was seen using a cell phone during nap time.
Medium High risk · Annual Sanitation Inspection (746.3401(a))
Cited January 26, 2024 (correction date recorded: March 26, 2024; correction verified March 14, 2024; technical assistance given).
What the record describes: The available posted health inspection was last conducted on 12.1.22.
Medium High risk · Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking. (746.1315(a))
Cited November 13, 2023 (correction date recorded: January 1, 2024; correction verified December 11, 2023; technical assistance given).
What the record describes: Four of eight staff files lacked first aid and CPR training documentation.
Medium High risk · Medication Authorization - Signed and Dated (746.3803(a)(1))
Cited November 13, 2023 (correction date recorded: January 5, 2024; correction verified January 8, 2024; technical assistance given).
What the record describes: A written, signed and dated medication authorization for one child was not available for review.
Medium High risk · Plan to Handle Transportation Emergencies (746.5619)
Cited November 13, 2023 (correction date recorded: November 20, 2023; correction verified November 15, 2023; technical assistance given).
What the record describes: A written procedure for handling transportation emergencies was not available for review.
Medium High risk · Required Admission Information - Special Needs Statement (746.605(13))
Cited November 13, 2023 (correction date recorded: November 20, 2023; correction verified November 15, 2023; technical assistance given).
What the record describes: Of eight children's files, six lacked special care information; one lacked food allergy information, one lacked emergency care authorization, and one lacked an emergency contact address.
Medium High risk · Transportation Safety Training -Director and Employee Complete 2 Hours Annually (746.1316(a))
Cited November 13, 2023 (correction date recorded: November 20, 2023; correction verified November 15, 2023; technical assistance given).
What the record describes: Training documentation was not available for review for one of the two staff transporting children.
Medium risk · Children's Records - Immunizations (746.603(a)(4))
Cited October 30, 2025 (correction date recorded: November 20, 2025; correction verified December 23, 2025; technical assistance given); November 13, 2023 (correction date recorded: February 1, 2024; correction verified January 23, 2024; technical assistance given).
What the record describes: Narratives describe children's files without current immunization records available for review.
Medium risk · Children's Products- Annual Certification (746.4135(b))
Cited November 6, 2024 (corrected at inspection; technical assistance given).
What the record describes: The posted Children's Products Annual Certification had expired.
Medium risk · Required Personnel Records- Meets Requirements (746.901(2))
Cited November 13, 2023 (correction date recorded: November 20, 2023; correction verified November 27, 2023; technical assistance given).
What the record describes: Of eight staff files, five lacked education qualifications and three lacked affidavits.

Counts, dates, risk levels and correction status come directly from the state data. The plain-English descriptions were written automatically from the inspectors' narratives and checked against them by a second automated reviewer; they cover citations dated October 11, 2023 to October 11, 2026. They may contain errors; the official record is authoritative.

View the official state record · Report an issue with this page

Summary of the record

This summary is generated automatically from public HHSC records. It restates the official record and may lag behind it. The official state record is the authoritative source: official HHSC record.

Texas Health and Human Services records list 17 cited deficiencies for Hands N Hands Childcare in the 3 years before October 10, 2026 (3 High, 10 Medium High, 4 Medium).

Records list 18 inspections in this window. Most recent inspection: 2026-09-22.

HHSC risk weights of citations
Risk weight	Citations
High	3
Medium High	10
Medium	4
Medium Low	0
Low	0
Unknown	0

HHSC assigns each standard a risk weight from Low to High. A deficiency is a finding that a minimum standard was not met.

Recent citations in the summary window

2026-08-19 · 746.2431 · Medium High

Infant Daily Report - Share with Parent

During the course of the investigation, it was determined that infant daily reports were not being shared with parents.

Correction date recorded: 2026-09-11

2026-08-17 · 746.613(b) · Medium High

Immunization Records, Exceptions, and Exemptions Current

Two of the four children's immunizations were not updated at the time of inspection.

Correction date recorded: 2026-09-17

2025-11-12 · 746.1205(a)(1) · High

Responsibilities of Caregivers - Know children responsible for

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 date recorded: 2025-11-25

Full citation history from HHSC (37)

2026-08-19 · 746.2431 · Medium High
Infant Daily Report - Share with Parent
Corrected at inspection: No. Correction date: 2026-09-11. Correction verified: 2026-09-22.
During the course of the investigation, it was determined that infant daily reports were not being shared with parents.
2026-08-17 · 746.613(b) · Medium High
Immunization Records, Exceptions, and Exemptions Current
Corrected at inspection: No. Correction date: 2026-09-17. Correction verified: 2026-09-14.
Two of the four children's immunizations were not updated at the time of inspection.
2025-11-12 · 746.1205(a)(1) · High
Responsibilities of Caregivers - Know children responsible for
Corrected at inspection: No. Correction date: 2025-11-25. Correction verified: 2025-12-03.
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.
2025-10-30 · 746.603(a)(4) · Medium
Children's Records - Immunizations
Corrected at inspection: No. Correction date: 2025-11-20. Correction verified: 2025-12-23.
Three out of five children's files reviewed did not have current immunization records available for review.
2024-11-06 · 746.4135(b) · Medium
Children's Products- Annual Certification
Corrected at inspection: Yes. Correction date: 2024-11-06. Correction verified: Not recorded.
The posted Children's Products Annual Certification was expired. This was corrected at inspection when the Director completed a current form.
2024-09-10 · 746.3407(9) · Medium High
Floors, ceilings and Walls in Good Repair and Clean
Corrected at inspection: No. Correction date: 2024-09-24. Correction verified: 2024-09-30.
There were five ceiling tiles missing in the operation.
2024-09-10 · 746.1205(a)(1) · High
Responsibilities of Caregivers - Know children responsible for
Corrected at inspection: No. Correction date: 2024-09-10. Correction verified: 2024-09-30.
Two caregivers in the toddler rooms did not know the names of the children or ages they were responsible for.
2024-09-06 · 746.5607(e) · High
Safety restraint devices for child used when vehicle is on and during all time vehicle in motion
Corrected at inspection: No. Correction date: 2024-09-17. Correction verified: 2024-09-30.
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.
2024-07-09 · 746.1203(3)(D) · Medium High
Personal use of electronic devices, such as cell phones, MP3 players, tablets, and video games
Corrected at inspection: No. Correction date: 2024-07-09. Correction verified: 2024-07-23.
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.
2024-01-26 · 746.3401(a) · Medium High
Annual Sanitation Inspection
Corrected at inspection: No. Correction date: 2024-03-26. Correction verified: 2024-03-14.
The available health inspection posted was last conducted on 12.1.22.
2023-11-13 · 746.5619 · Medium High
Plan to Handle Transportation Emergencies
Corrected at inspection: No. Correction date: 2023-11-20. Correction verified: 2023-11-15.
A written procedure on how to handle transportation emergencies was not available for review.
2023-11-13 · 746.901(2) · Medium
Required Personnel Records- Meets Requirements
Corrected at inspection: No. Correction date: 2023-11-20. Correction verified: 2023-11-27.
Five of the eight staff files were missing education qualifications. Three of the eight staff files were missing affidavits.
2023-11-13 · 746.603(a)(4) · Medium
Children's Records - Immunizations
Corrected at inspection: No. Correction date: 2024-02-01. Correction verified: 2024-01-23.
One of the eight children files didn't have a current immunization record.
2023-11-13 · 746.1315(a) · Medium High
Each Caregiver and the Director Must Have Current Training in pediatric first aid with rescue breathing and choking.
Corrected at inspection: No. Correction date: 2024-01-01. Correction verified: 2023-12-11.
Four of the eight staff files were missing First aid and CPR training.
2023-11-13 · 746.1316(a) · Medium High
Transportation Safety Training -Director and Employee Complete 2 Hours Annually
Corrected at inspection: No. Correction date: 2023-11-20. Correction verified: 2023-11-15.
One of the two staff transporting didn't have training available for review.
2023-11-13 · 746.3803(a)(1) · Medium High
Medication Authorization - Signed and Dated
Corrected at inspection: No. Correction date: 2024-01-05. Correction verified: 2024-01-08.
A written, signed and dated medication authorization was not available for review for one child.
2023-11-13 · 746.605(13) · Medium High
Required Admission Information - Special Needs Statement
Corrected at inspection: No. Correction date: 2023-11-20. Correction verified: 2023-11-15.
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.
2023-06-30 · 746.1601 · Medium High
Child/ Caregiver Ratio - 13 or More Children
Corrected at inspection: No. Correction date: 2023-06-30. Correction verified: 2023-07-11.
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.
2023-06-30 · 746.3401(a) · Medium High
Annual Sanitation Inspection
Corrected at inspection: No. Correction date: 2023-07-31. Correction verified: 2023-08-11.
The health inspection was last conducted on 5.12.22.
2023-06-30 · 746.1205(a)(3) · Medium High
Responsibilities of Caregivers - Know children's names and ages
Corrected at inspection: No. Correction date: 2023-06-30. Correction verified: 2023-07-11.
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.
2023-06-30 · 746.5101(a) · High
Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months
Corrected at inspection: No. Correction date: 2023-07-31. Correction verified: 2023-07-25.
The fire inspection was last conducted on 5.16.22.
2023-04-04 · 746.603(a)(4) · Medium
Children's Records - Immunizations
Corrected at inspection: No. Correction date: 2023-05-04. Correction verified: 2023-04-12.
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.
2023-04-04 · 746.5537(a)(2) · Medium High
Electronic or Battery-Operated Carbon Monoxide Detector-Check All Detectors Monthly
Corrected at inspection: Yes. Correction date: 2023-04-04. Correction verified: Not recorded.
Documentation for the carbon monoxide, extinguisher and smoke detectors were not documented for January, February and March. NOTE: This was corrected at inspection.
2023-04-04 · 746.5617(a)(2) · High
Required Equipment in Vehicles - Emergency Medical Information
Corrected at inspection: Yes. Correction date: 2023-04-04. Correction verified: Not recorded.
Emergency medical information for 7 children were not available for review. NOTE: This was corrected at inspection.
2023-04-04 · 746.3501(6) · Medium High
Diaper Changing Steps-Supplies Kept Out of Child's Reach
Corrected at inspection: Yes. Correction date: 2023-04-04. Correction verified: Not recorded.
Diaper changing supplies in the toddler and two infant classrooms were observed accessible in the children cubbies. NOTE: This was corrected at inspection.
2023-04-04 · 746.3701 · Medium High
Safety - Areas Free From Hazards
Corrected at inspection: Yes. Correction date: 2023-04-04. Correction verified: Not recorded.
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.
2023-02-15 · 746.1201(1) · High
Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control
Corrected at inspection: No. Correction date: 2023-03-28. Correction verified: 2023-04-04.
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.
2023-02-15 · 746.307(e) · Medium Low
Parental Notification of Infestation
Corrected at inspection: No. Correction date: 2023-03-28. Correction verified: 2023-04-04.
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.
2022-11-02 · 746.603(a) · Medium
Children's Records Maintained
Corrected at inspection: No. Correction date: 2022-11-16. Correction verified: 2022-11-17.
Four out of eight children's records reviewed were missing required information including emergency contact information and healthcare provider statements.
2022-11-02 · 746.901(4) · Medium Low
Required Personnel Records - Required Affidavit
Corrected at inspection: No. Correction date: 2022-11-09. Correction verified: 2022-11-09.
Three out of eight employee records reviewed were missing the required affidavit for employment.
2022-06-06 · 746.307(c) · Medium
Parental Notification of Less Serious Injuries
Corrected at inspection: No. Correction date: 2022-07-14. Correction verified: 2022-07-19.
Based on the information received, parents were not notified of less serious injuries such as scratches during pick up time.
2022-06-06 · 745.641 · High
AP Background check results - Must receive notification prior to allowing subject to be present at your operation
Corrected at inspection: No. Correction date: 2022-07-14. Correction verified: 2022-07-19.
During the investigation a caregiver in direct care of children had not received required background check eligibility notifications.
2022-06-06 · 746.201(7) · Medium
Operation Open to Parents At All Times
Corrected at inspection: No. Correction date: 2022-07-14. Correction verified: 2022-07-19.
Based on the information received parents are not allowed to enter the operation.
2022-03-10 · 746.5101(a) · High
Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months
Corrected at inspection: No. Correction date: 2022-03-10. Correction verified: 2022-03-21.
Annual first inspection had not been updated since 10/19/2020.
2022-03-10 · 746.3701(9) · Medium High
Safety - Televisions Anchored to Prevent Tip Over
Corrected at inspection: Yes. Correction date: 2022-03-10. Correction verified: Not recorded.
In the school age classroom a Tv was not anchored. This was corrected at inspection when director removed TV from the classroom.
2022-03-01 · 746.303(b) · Medium Low
Report Number of Employees
Corrected at inspection: No. Correction date: 2022-03-04. Correction verified: 2022-03-07.
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.
2021-09-24 · 745.641 · High
AP Background check results - Must receive notification prior to allowing subject to be present at your operation
Corrected at inspection: No. Correction date: 2021-10-21. Correction verified: 2021-10-21.
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.

Source: Texas HHSC Child Care Regulation, via data.texas.gov (CC0). See the official record: https://childcare.hhs.texas.gov/Public/InspectionAndComplianceHistory?operationId=1318541

Records reflect only deficiencies published by the state after due process. This page does not rate or rank providers. Check the official record for the latest information.

Provider data fetched: October 10, 2026.