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Adverse action means HHSC has taken enforcement action affecting an operation’s permit or ability to operate; see the official HHSC record for details.
State records list 16 cited deficiencies dated December 27, 2023 to November 19, 2025 (5 High, 6 Medium High, 5 Medium risk). Correction status: 3 corrected at inspection, 13 with a correction date recorded, 0 with no correction date recorded.
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.
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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 16 cited deficiencies for Doris Gardner Ratliff Ctr For Child Development in the 3 years before October 10, 2026 (5 High, 6 Medium High, 5 Medium).
Records list 6 inspections in this window. Most recent inspection: 2025-12-03.
| Risk weight | Citations |
|---|---|
| High | 5 |
| Medium High | 6 |
| Medium | 5 |
| 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.
2025-11-19 · 745.641 · High
AP Background check results - Must receive notification prior to allowing subject to be present at your operation
An individual who is apart of maintenance was observed in a toddler classroom having a conversation with another caregiver while children were present. The individual does not have an active background check in the system. This was corrected during the inspection when I observed…
Correction date recorded: 2025-11-19
2025-11-12 · 746.603(a)(2) · Medium
Children's Records - Admission Information
one out of six children did not have an admission form available for review
Correction date recorded: 2025-11-19
2025-11-12 · 746.2426(a)(1) · High
Infant May Not Sleep in a Restrictive Device
A six month infant was observed sleeping in a swing for over ten minutes. This was corrected during the inspection when I informed the two caregivers to remove the child from the swing and place the child in the crib
Correction date recorded: 2025-11-12
2025-11-19 · 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: 2025-11-19. Correction verified: 2025-12-03.
An individual who is apart of maintenance was observed in a toddler classroom having a conversation with another caregiver while children were present. The individual does not have an active background check in the system. This was corrected during the inspection when I observed the individual leave.
2025-11-12 · 746.603(a)(3) · Medium
Children's Records - Health Statement
Corrected at inspection: No. Correction date: 2025-11-19. Correction verified: 2025-11-19.
One out of six children did not have a health statement available for review
2025-11-12 · 746.1107(2) · Medium High
Additional Minimum Qualifications for Caregivers - HS Diploma, Equivalent, Certification of Completion
Corrected at inspection: No. Correction date: 2025-11-19. Correction verified: 2025-11-19.
One out of ten caregiver did not have a high school diploma or equivalent on file
2025-11-12 · 746.2426(a)(1) · High
Infant May Not Sleep in a Restrictive Device
Corrected at inspection: No. Correction date: 2025-11-12. Correction verified: 2025-11-19.
A six month infant was observed sleeping in a swing for over ten minutes. This was corrected during the inspection when I informed the two caregivers to remove the child from the swing and place the child in the crib
2025-11-12 · 746.603(a)(2) · Medium
Children's Records - Admission Information
Corrected at inspection: No. Correction date: 2025-11-19. Correction verified: 2025-11-19.
one out of six children did not have an admission form available for review
2024-12-17 · 746.5405 · Medium High
Documentation of Gas Leak Inspection
Corrected at inspection: No. Correction date: 2025-01-02. Correction verified: 2025-01-06.
The gas leak test report is not available for review
2024-12-17 · 746.2207(c)(4) · Medium
Screen Time Activities - Not Used During Eating or Rest Times
Corrected at inspection: Yes. Correction date: 2024-12-17. Correction verified: Not recorded.
Children were observed watching mickey mouse during snack time This was corrected during the inspection when I observed the caregiver turn off the tablet and closed it.
2024-12-17 · 746.2207(a) · Medium
Screen Time Activities - Not Used for Under Two
Corrected at inspection: Yes. Correction date: 2024-12-17. Correction verified: Not recorded.
Children under the age of two were observed watching mickey mouse on a tablet while eating snack. This was corrected during the inspection when I observed the caregiver turing the tablet off and closing it.
2024-12-06 · 746.2415(b) · High
AP Cribs - Only Snug Fitting Sheet and Crib Mattress Cover Allowed if Infant Younger than 12 Months of Age
Corrected at inspection: No. Correction date: 2024-12-06. Correction verified: 2024-12-17.
While in the crib, a five month old infant was observed sleeping with a blanket. This was corrected during the inspection when I observed the caregiver remove the blanket.
2024-12-06 · 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: 2024-12-20. Correction verified: 2024-12-12.
Five out of six caregivers have expired CPR First aid certificates. The CPR first aid expired August 22nd, 2024.
2024-12-06 · 746.3401(a) · Medium High
Annual Sanitation Inspection
Corrected at inspection: No. Correction date: 2024-12-27. Correction verified: 2024-12-06.
The health inspection report was not available for review.
2024-12-06 · 746.1315(b) · Medium High
Each Caregiver and the Director Must Have Current Training in pediatric CPR
Corrected at inspection: No. Correction date: 2024-12-20. Correction verified: 2024-12-12.
Five out of six caregivers have expired CPR First aid certificates. The CPR first aid expired August 22nd, 2024.
2024-12-06 · 746.5103 · Medium High
Documentation of Fire Inspection
Corrected at inspection: No. Correction date: 2025-02-04. Correction verified: 2025-02-06.
The fire inspection report was not available for review.
2024-12-06 · 746.4601(4) · High
Safety Requirements for Active Play Equipment - No Entanglement Protrusions or Openings
Corrected at inspection: Yes. Correction date: 2024-12-06. Correction verified: Not recorded.
The playground structure had grey nail bolts sticking out of the black barrier. This was corrected during the inspection when I observed maintenance hammering the bolts back into place.
2024-12-06 · 746.1309(e) · Medium
Documented Annual Training- Required Content
Corrected at inspection: No. Correction date: 2024-12-20. Correction verified: 2024-12-12.
Six out of Six caregivers are missing the required health and safety Audit trainings. (1) Emergency preparedness (2) Preventing and responding to emergencies due to food or an allergic reaction; (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 i).
2023-12-27 · 746.501(a)(9) · High
Written Operational Policies - Safe Sleep for Infants 12 Months and Younger
Corrected at inspection: No. Correction date: 2024-01-05. Correction verified: 2024-01-04.
The infant safe sleep policy was not written in the operational policies.
2023-01-20 · 746.605(12) · High
Required Admission Information - Emergency Medical Authorization
Corrected at inspection: No. Correction date: 2023-01-27. Correction verified: 2023-01-23.
1 child's file still does not contain the complete emergenct contact information.
2023-01-06 · 746.2426 · High
Infant May Not Sleep in a Restrictive Device
Corrected at inspection: No. Correction date: 2023-01-06. Correction verified: 2023-01-20.
During the inspection infants were observed sleeping in baby swings. Note: The caregivers removed the infants from the swing to their crib.
2023-01-06 · 746.2415(b) · High
AP Cribs - Only Snug Fitting Sheet and Crib Mattress Cover Allowed if Infant Younger than 12 Months of Age
Corrected at inspection: No. Correction date: 2023-01-06. Correction verified: 2023-01-20.
A 6 week old infant was observed in a crib with blankets and a boppy pillow during the inspection. Note: It was discussed with the provider that infants under 12 months must not have anything in their cribs but the tight fitting sheet due to the risk of SIDS. The provider removed the items from the crib during the inspection.
2023-01-06 · 746.603(a)(4) · Medium
Children's Records - Immunizations
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
1 out of 5 children's records evaluated did not contain documentation of immunizations.
2023-01-06 · 746.501(a)(18) · Medium
Written Operational Policies - Promotion of Physical Activity
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
Documentation showing the promotion of physical activities was missing from the operational policies and the following information must be included: (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 operatio (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 (F) A plan to ensure physical activity occurs on days when extreme weather conditions prohibit or limit outdoor play.
2023-01-06 · 746.2421(b) · Medium
Written Feeding Instructions - Review and Update Every 30 Days
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
The feeding instructions for 3 infants have not been updated within the last 30 days.
2023-01-06 · 746.5101(a) · High
Annual Fire Inspection - Before Initial Permit Issued and Every 12 Months
Corrected at inspection: No. Correction date: 2023-01-25. Correction verified: 2023-01-20.
An annual fire inspection has not been conducted within the past 12 months.
2023-01-06 · 746.4135(b) · Medium
Children's Products- Annual Certification
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
The annual children's product certification expired last month and has not been completed.
2023-01-06 · 746.3701(9) · Medium High
Safety - Televisions Anchored to Prevent Tip Over
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
A television was not mounted or anchored during the inspection.
2023-01-06 · 746.2419(8) · Medium High
Requirements for Feeding Infants - Other Use of Handwashing Sink
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
Bottles, spoons and bowls were observed on the hand washing sink in the infant room.
2023-01-06 · 746.801(6) · Medium
Required Records Maintained and Made Available - Liability Insurance
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
Documentation of current liability insurance was not available during the inspection.
2023-01-06 · 746.605(12) · High
Required Admission Information - Emergency Medical Authorization
Corrected at inspection: No. Correction date: 2023-01-13. Correction verified: 2023-01-20.
2 out of 5 children's records evaluated did not contain the authorization for emergency medical treatment.
2022-01-18 · 746.603(a)(3) · Medium
Children's Records - Health Statement
Corrected at inspection: No. Correction date: 2022-01-28. Correction verified: 2022-01-20.
Health statement was missing on one out of four files checked.
2022-01-18 · 746.5401 · Medium High
Requirement of Gas Leak Inspection
Corrected at inspection: No. Correction date: 2022-01-28. Correction verified: 2022-01-21.
Current gas inspection was not available duirng inspection.
Source: Texas HHSC Child Care Regulation, via data.texas.gov (CC0). See the official record: https://childcare.hhs.texas.gov/Public/InspectionAndComplianceHistory?operationId=240513
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.