Texas HHSC Child Care Regulation inspectors conduct unannounced monitoring visits across licensed centers (26 TAC Chapter 746) and child-care homes (Chapter 747). Most deficiencies come from documentation gaps, not safety failures — here is the complete inspection checklist.

In Texas, the Health and Human Services Commission (HHSC) Child Care Regulation (CCR) division inspects licensed child-care centers (governed by 26 TAC Chapter 746) and licensed or registered child-care homes (governed by 26 TAC Chapter 747).

Because routine monitoring inspections are unannounced, you cannot cram for an HHSC visit the night before. And since every cited deficiency is published publicly on the state's Search Texas Child Care portal (txchildcaresearch.org) — where prospective parents and Texas Rising Star assessors check your record — a single preventable paperwork citation carries a real business cost.

The encouraging news: public HHSC inspection data shows that the vast majority of citations at small centers and home daycares are documentation and record-keeping gaps, not physical safety hazards. This guide covers what HHSC inspectors look for, the top five deficiencies cited, and how to stay inspection-ready every day.

1. The 3 types of Texas HHSC Child Care Regulation inspections

Initial / Permit Inspections (Announced): Conducted when you apply for an initial permit or move from an initial permit to a full license.
Routine Monitoring Inspections (Unannounced): Conducted at least once every 12 months for licensed centers and licensed homes (and every 1–2 years for registered homes, depending on compliance history). The inspector arrives unannounced during operating hours and evaluates compliance across Texas Minimum Standards.
Investigation Visits (Unannounced): Triggered by a self-reported serious incident (such as an injury requiring medical treatment) or a complaint submitted to HHSC.

2. The top 5 deficiencies cited at Texas daycares (and how to prevent them)

Deficiency #1: Incomplete daily attendance and time-in / time-out records

Under 26 TAC §746.631 (centers) and §747.613 (homes), you must maintain daily attendance records showing the exact time each child arrives and departs, and which classroom or caregiver they are assigned to.

Why providers get cited: Parents forget to sign the morning clipboard, or staff move a child between classrooms during afternoon combining without recording the room transfer.
The fix: Use a digital check-in system with timestamps and classroom assignments, and keep at least 90 days (12 months recommended) of attendance logs immediately accessible.

Deficiency #2: Staff-to-child ratio and group size documentation

Texas uses a unique "specified age" (median age) system in licensed centers under 26 TAC Chapter 746 Subchapter E, alongside stricter infant/toddler rules and separate capacity caps for family homes under Chapter 747.

Why providers get cited: A room is temporarily out of ratio during morning drop-off or staff lunch breaks, or the director cannot prove classroom staffing over the past 30 days.
The fix: Track real-time classroom ratios continuously. You can check required staff counts with our free daycare ratio calculator or use Rawdly's live ratio dashboard to alert directors before a room slips out of compliance.

Deficiency #3: Expired Centralized Background Checks (CBC) or missing pediatric CPR/First Aid

Every caregiver, director, and applicable household member (for child-care homes) must have a cleared Texas HHSC Centralized Background Check before being present with children, renewed on schedule, plus current Pediatric First Aid and CPR with rescue breathing and choking training.

Why providers get cited: A newly hired assistant steps into a classroom for "just an hour" while their background check is still pending, or a teacher's 2-year CPR certification lapsed last month.
The fix: Track every staff member's CBC clearance date, CPR/First Aid expiration, and annual clock hours (24 hours/year for center caregivers, 30 hours/year for directors and home primary caregivers) with automated 30-day advance reminders.

Deficiency #4: Missing parent signatures on Incident / Illness Reports (Form 7239 equivalent)

Minor injuries must be documented in writing and signed by the parent at pickup; serious injuries requiring medical attention must also be reported to HHSC within required timeframes.

Why providers get cited: The teacher told the parent verbally at pickup, or wrote a note on paper that went home with the parent without keeping a signed copy in the center's file.
The fix: Draft incident reports digitally (Rawdly's AI incident report tool turns a 90-second voice memo into a structured report) so the director signs, the parent receives an immediate copy, and an immutable audit log remains in the center's records.

Deficiency #5: Incomplete child enrollment packets or overdue immunization records

Every enrolled child's file must include emergency contact details, parental authorization for emergency medical care, allergy/medical action plans, and an up-to-date Texas Department of State Health Services (DSHS) immunization record or valid notarized exemption affidavit.

Why providers get cited: Infant and toddler vaccine boosters fall overdue 6 months after enrollment and nobody follows up until the inspector pulls five random student folders.
The fix: Log each child's CDC/DSHS vaccination schedule at enrollment so upcoming due dates surface automatically on the director's dashboard.

3. Daily Texas HHSC inspection-readiness checklist

Run this 5-minute check each morning so an unannounced HHSC inspector never catches you off guard:

Required postings visible at the entrance: Current HHSC license/registration certificate, most recent HHSC inspection letter/report, Minimum Standards availability notice, emergency telephone numbers, and the Texas Abuse/Neglect Hotline (1-800-252-5400).
Live attendance matches headcount: Every child physically in the building is checked in with an arrival timestamp, and every staff member on the floor is clocked into their assigned room.
Allergy list posted (with privacy cover): Current food allergies are accessible in the kitchen and each classroom without exposing confidential health details to visitors.
Medication storage locked and logged: All medications are in original labeled containers inside a locked cabinet/box, with signed parent authorization and dose timestamps recorded.
Infant safe-sleep compliance: Cribs contain only a firm mattress with a tight-fitting sheet — no blankets, bumpers, pillows, or propped bottles — and signed Infant Sleep Exception forms are on file if medically required.
30-day attendance, ratio, and fire-drill logs ready to print: Monthly fire drills, quarterly severe-weather drills, and 30-day attendance records can be exported in under two minutes.

4. Stay inspection-ready automatically with Rawdly

Rawdly gives small Texas centers and child-care homes the compliance records HHSC inspectors ask for — without the binder scramble:

Timestamped digital check-in/out & live ratio monitoring across every classroom.
One-tap 30-day License Inspector PDF export ready to hand to your inspector.
AI-drafted incident reports with director sign-off and an immutable 7-year audit log.
Immunization timelines, allergy alerts, and USDA CACFP menu planning built in.

New providers get every feature 100% free for their first year (no credit card required), and small home daycares get Rawdly Freemium free forever for up to 10 children. See Rawdly's compliance toolkit or start your free year today.

HHSC Licensing Inspections in Texas: How to Prepare (and Pass)