Avance San Antonio Cdc Frank Garrett
1226 NW 18TH ST, San Antonio, TX 78207 · Bexar County
Program
- Type
- Licensed center
- Licensed capacity
- 56
- Ages
- Infant, Toddler, Pre-Kindergarten
- Hours
- 08:00 AM-04:00 PM
- Director / administrator
- Guadalupe Roh
- Phone
- (210) 734-7924
- Regulated since
- Jun 21, 1999
- HHSC IDs
- Operation 159058 · number 540916- 5052
- Official record
- HHSC Child Care Search
Violations by category
Year by year
| Year | Violations | Serious | Main categories |
|---|---|---|---|
| 2026 | 2 | 2 | Staff background & training (2) |
| 2025 | 2 | 0 | Other (2) |
| 2023 | 24 | 4 | Cleanliness & sanitation (4), Supervision & ratios (6), Safety & premises (2), Staff background & training (4), Other (8) |
| 2022 | 4 | 0 | Illness & medication (2), Staff background & training (2) |
Inspections, investigations & assessments
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Aug 27, 2026 Report · Deficiencies cited (self-report)
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Staff background & training Serious
A staff member was present at the operation, and had access to children, without a background check.
HHSC 745.621(a)(2) — AP Initial background checks submitted - At the time you hire someone
HHSC risk weight: High. Corrected 2026-09-02. Correction verified 2026-09-02.
HHSC inspection history · no longer published by HHSC; kept here
-
Staff background & training Serious
-
Aug 27, 2026 Report · Deficiencies cited (self-report)
-
Staff background & training Serious
A staff member was present at the operation, and had access to children, without a background check.
HHSC 745.621(a)(2) — AP Initial background checks submitted - At the time you hire someone
HHSC risk weight: High. Corrected 2026-09-02. Correction verified 2026-09-02.
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Staff background & training Serious
-
Jun 20, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 20, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Mar 30, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 30, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 16, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 16, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 16, 2025 Inspection · Deficiencies cited
-
Other
The health inspection was last conducted on 3.25.24.
HHSC 746.3401(a) — Annual Sanitation Inspection
HHSC risk weight: Medium High. Corrected 2025-05-07. Correction verified 2025-04-22.
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Other
-
Apr 16, 2025 Inspection · Deficiencies cited
-
Other
The health inspection was last conducted on 3.25.24.
HHSC 746.3401(a) — Annual Sanitation Inspection
HHSC risk weight: Medium High. Corrected 2025-05-07. Correction verified 2025-04-22.
HHSC inspection history · no longer published by HHSC; kept here
-
Other
-
Aug 26, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Aug 26, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 25, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 25, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
May 2, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 2, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 13, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 13, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 18, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 18, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 4, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 4, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 28, 2023 Report · Deficiencies cited
-
Other Serious
Based on the four-minute video footage the caregivers did not demonstrate good judgment by placing a weighted blue Coco Melon backpack on the back of the child over the back of their chair preventing that child from standing up. In addition to placing this weighted blue Coco Melon backpack and strapping it around the child?s waist while in centers.
HHSC 746.1201(1) — Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control
HHSC risk weight: High. Corrected 2023-11-10. Correction verified 2023-11-13.
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Other Serious
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Sep 28, 2023 Report · Deficiencies cited
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Other Serious
Based on the four-minute video footage the caregivers did not demonstrate good judgment by placing a weighted blue Coco Melon backpack on the back of the child over the back of their chair preventing that child from standing up. In addition to placing this weighted blue Coco Melon backpack and strapping it around the child?s waist while in centers.
HHSC 746.1201(1) — Responsibilities of Employees and Caregivers -Demonstrate Competency, Good Judgment, Self-control
HHSC risk weight: High. Corrected 2023-11-10. Correction verified 2023-11-13.
HHSC inspection history · no longer published by HHSC; kept here
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Other Serious
-
Sep 22, 2023 Inspection · Deficiencies cited
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Other
Based on the video footage on 9.19.23 the caregivers were observed not positively or actively interacting with the children as they we seen talking longer than an hour amongst themselves.
HHSC 746.1203(5) — Responsibilities of Caregivers - Interact positively with children
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Other
Based on the video footage on 9.19.23 the caregiver was not observed giving individual attention, holding and comforting a child that was crying after being pushed by another child.
HHSC 746.2501(4) — Care Requirements for Toddlers - Holding and Comforting
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Supervision & ratios
Based on the video footage on 9.19.23 a child was observed being placed in a chair for a long period of time not appropriate for the child's age.
HHSC 746.2803(4)(D) — Positive Methods of Discipline and Guidance - Brief Supervised Separation
HHSC risk weight: Medium. Corrected 2023-09-22. Correction verified 2023-10-04.
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Cleanliness & sanitation
Based on the video footage on 9.19.23 a snack was being provided to the children on a bare table.
HHSC 746.3317(6) — Food Service and Preparation Requirement - Use Sanitary Holders
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Safety & premises
Based on the video footage on 9.19.23 the caregivers were not observed sanitizing tables before providing the children a snack.
HHSC 746.3407(11) — Sanitize Tables Tops, Furniture and Similar Equipment
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Cleanliness & sanitation
Based on the video footage on 9.19.23 the caregivers were not observed handwashing their hands or the children between diaper changing.
HHSC 746.3415(4) — Employee Handwashing After Diapering a Child
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Other
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Sep 22, 2023 Inspection · Deficiencies cited
-
Other
Based on the video footage on 9.19.23 the caregivers were observed not positively or actively interacting with the children as they we seen talking longer than an hour amongst themselves.
HHSC 746.1203(5) — Responsibilities of Caregivers - Interact positively with children
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
-
Other
Based on the video footage on 9.19.23 the caregiver was not observed giving individual attention, holding and comforting a child that was crying after being pushed by another child.
HHSC 746.2501(4) — Care Requirements for Toddlers - Holding and Comforting
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
-
Supervision & ratios
Based on the video footage on 9.19.23 a child was observed being placed in a chair for a long period of time not appropriate for the child's age.
HHSC 746.2803(4)(D) — Positive Methods of Discipline and Guidance - Brief Supervised Separation
HHSC risk weight: Medium. Corrected 2023-09-22. Correction verified 2023-10-04.
-
Cleanliness & sanitation
Based on the video footage on 9.19.23 a snack was being provided to the children on a bare table.
HHSC 746.3317(6) — Food Service and Preparation Requirement - Use Sanitary Holders
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
-
Safety & premises
Based on the video footage on 9.19.23 the caregivers were not observed sanitizing tables before providing the children a snack.
HHSC 746.3407(11) — Sanitize Tables Tops, Furniture and Similar Equipment
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
-
Cleanliness & sanitation
Based on the video footage on 9.19.23 the caregivers were not observed handwashing their hands or the children between diaper changing.
HHSC 746.3415(4) — Employee Handwashing After Diapering a Child
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
HHSC inspection history · no longer published by HHSC; kept here
-
Other
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Sep 21, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Sep 21, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 21, 2023 Report · Deficiencies cited
-
Other
Based on the video footage on 9.19.23 a caregiver was observed lifting a child by their forearm, pulling a child off the table by their leg when redirecting.
HHSC 746.2803(4)(C) — Positive Methods of Discipline and Guidance - Redirecting Behavior
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
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Other
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Sep 21, 2023 Report · Deficiencies cited
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Other
Based on the video footage on 9.19.23 a caregiver was observed lifting a child by their forearm, pulling a child off the table by their leg when redirecting.
HHSC 746.2803(4)(C) — Positive Methods of Discipline and Guidance - Redirecting Behavior
HHSC risk weight: Medium High. Corrected 2023-09-22. Correction verified 2023-10-04.
HHSC inspection history · no longer published by HHSC; kept here
-
Other
-
Sep 15, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 15, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 20, 2023 Inspection · Deficiencies cited
-
Staff background & training
One of the six staff files were missing 24 hours of training from May 2022-2023.
HHSC 746.1309(a) — Documented Annual Training Area - 24 Hours Required
HHSC risk weight: Medium. Corrected 2023-08-20. Correction verified 2023-07-25.
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Staff background & training
The director is missing the 30 hours of the annual training.
HHSC 746.1311(a) — Director Annual Training 30 Hours Required
HHSC risk weight: Medium. Corrected 2023-08-20. Correction verified 2023-08-03.
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Supervision & ratios
During naptime in Group 4 one caregiver was supervising nine children with the youngest being 13 months and the oldest being 21 months old. NOTE: This was corrected when another caregiver was called into the classroom.
HHSC 746.1613(a) — Reduction of child/caregiver naptime ratio by 50% allowed, If 13 or more children in care, children are 18 mo. or older and other standards met
HHSC risk weight: Medium. Corrected at inspection. Corrected 2023-07-20.
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Staff background & training
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Jul 20, 2023 Inspection · Deficiencies cited
-
Staff background & training
One of the six staff files were missing 24 hours of training from May 2022-2023.
HHSC 746.1309(a) — Documented Annual Training Area - 24 Hours Required
HHSC risk weight: Medium. Corrected 2023-08-20. Correction verified 2023-07-25.
-
Staff background & training
The director is missing the 30 hours of the annual training.
HHSC 746.1311(a) — Director Annual Training 30 Hours Required
HHSC risk weight: Medium. Corrected 2023-08-20. Correction verified 2023-08-03.
-
Supervision & ratios
During naptime in Group 4 one caregiver was supervising nine children with the youngest being 13 months and the oldest being 21 months old. NOTE: This was corrected when another caregiver was called into the classroom.
HHSC 746.1613(a) — Reduction of child/caregiver naptime ratio by 50% allowed, If 13 or more children in care, children are 18 mo. or older and other standards met
HHSC risk weight: Medium. Corrected at inspection. Corrected 2023-07-20.
HHSC inspection history · no longer published by HHSC; kept here
-
Staff background & training
-
Jan 26, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 26, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jan 23, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jan 23, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 20, 2023 Report · Deficiencies cited (self-report)
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Supervision & ratios Serious
Based upon information gathered and interviews conducted supervision was determined to have occurred after a 19-month-old child was found in the classroom unsupervised.
HHSC 746.1203(4) — Responsibilities of Caregivers - Supervision of Children
HHSC risk weight: High. Corrected 2023-01-23. Correction verified 2023-01-26.
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Supervision & ratios Serious
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Jan 20, 2023 Report · Deficiencies cited (self-report)
-
Supervision & ratios Serious
Based upon information gathered and interviews conducted supervision was determined to have occurred after a 19-month-old child was found in the classroom unsupervised.
HHSC 746.1203(4) — Responsibilities of Caregivers - Supervision of Children
HHSC risk weight: High. Corrected 2023-01-23. Correction verified 2023-01-26.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios Serious
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Aug 11, 2022 Inspection · Deficiencies cited
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Staff background & training
Director did not have required training on file for the following; SID, brain development, and head trauma Handling and storing and Building grounds and premises
HHSC 746.1309(e) — Documented Annual Training- Required Content
HHSC risk weight: Medium. Corrected 2022-09-11. Correction verified 2022-09-13.
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Illness & medication
One of the six children did not have a current immunization record on file.
HHSC 746.613(b) — Immunization Records, Exceptions, and Exemptions Current
HHSC risk weight: Medium High. Corrected 2022-08-18. Correction verified 2022-08-11.
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Staff background & training
-
Aug 11, 2022 Inspection · Deficiencies cited
-
Staff background & training
Director did not have required training on file for the following; SID, brain development, and head trauma Handling and storing and Building grounds and premises
HHSC 746.1309(e) — Documented Annual Training- Required Content
HHSC risk weight: Medium. Corrected 2022-09-11. Correction verified 2022-09-13.
-
Illness & medication
One of the six children did not have a current immunization record on file.
HHSC 746.613(b) — Immunization Records, Exceptions, and Exemptions Current
HHSC risk weight: Medium High. Corrected 2022-08-18. Correction verified 2022-08-11.
HHSC inspection history · no longer published by HHSC; kept here
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Staff background & training
Get the full file
HHSC publishes inspections, investigations and assessments from October 2017 onward, with each cited deficiency and its risk weight. Investigation narratives, complaint files and older history require a public information request. The Texas Public Information Act (Texas Government Code Chapter 552) gives anyone the right to ask. You don't have to say why.
Email the request Printable letter (fax or mail)
- Send to
- HHSC Open Records Coordinator, MC-1070 · OpenRecordsRequest@hhs.texas.gov · fax 512-424-6586 · 4601 W. Guadalupe Street, Austin, Texas 78751-3146 · agency instructions
Show the letter text
If something is happening now, report a concern to HHSC Child Care Regulation. For suspected abuse, contact your county child protective services or law enforcement.
Source: Texas Health and Human Services Commission, Child Care Regulation datasets on data.texas.gov. Last read Oct 1, 2026. Violation text is HHSC's own wording. The categories are ours, added to help you scan. About this data.