Ranked by how often the rule shows up on real inspections. Rule #1 is the rule that gets the most facilities written up. Plain-language summary, official text, and the kind of evidence that satisfies it — pulled from Chapter 746 — Minimum Standards for Child-Care Centers (TX Health and Human Services Commission (HHSC)).
| Rank | Rule | Plain summary | Severity |
|---|---|---|---|
| #1 |
745.641
|
Staff must have a cleared, active, eligible background check before being present at the operation. | high |
| #2 |
746.1205(a)(4)
|
Caregivers must directly supervise each child with physical proximity and visual or auditory awareness. | high |
| #3 |
746.5101(a)
|
Annual fire inspection required from local authority before initial permit and every 12 months thereafter. | high |
| #4 |
746.3407
|
Daily safety checks of building, grounds, and equipment to identify and address hazards. | medium-high |
| #5 |
746.1201(1)
|
Caregivers must demonstrate competency, good judgment, and self-control with children at all times. | high |
| #6 |
746.1601
|
Maintain required child-to-caregiver ratio at all times — including during transitions and breaks. | medium-high |
| #7 |
746.603(a)(4)
|
Each child record must include current immunization documentation, with exemptions properly documented. | medium |
| #8 |
746.303(b)
|
Annually report to CCR by January 15 the number of employees who left in the prior calendar year. | medium-low |
| #9 |
746.1203(4)
|
Caregivers must not leave children unattended at any time, including during transitions, naps, or routines. | high |
| #10 |
746.3701
|
Indoor and outdoor areas must be safe and free from hazards, including damaged or unsafe equipment. | medium-high |
| #11 |
746.2421(b)
|
Written feeding instructions for infants must be reviewed and updated by parents every 30 days. | medium |
| #12 |
746.3401(a)
|
Annual sanitation inspection required from local health authority. | medium-high |
| #13 |
746.1309(e)
|
Caregivers must complete required annual training on specific topics within mandated timeframes; documentation maintained. | medium |
| #14 |
746.3819
|
Food allergy emergency plan required; caregivers must be aware of each child individual allergies. | medium-high |
| #15 |
746.603(a)(3)
|
Each child record must include a current statement of health from a health-care professional. | medium |