Inspection · 2023-05-01
Date
2023-05-01
Complaint Related
No
Licensing Inspector
Heather Harrell
(757) 334-4329
(757) 334-4329
SHSIA monitoring inspection of an approved subsidy vendor to determine compliance with current subsidy requirements regarding the health and safety of children and to promote quality standards for the children in their care.
No
Areas Reviewed
8VAC20-780 Administration.
8VAC20-780 Staff Qualifications and Training.
8VAC20-780 Physical Plant.
8VAC20-780 Staffing and Supervision.
8VAC20-780 Programs.
8VAC20-780 Special Care Provisions and Emergencies
8VAC20-780 Special Services.
8VAC20-820 THE LICENSE.
8VAC20-820 THE LICENSING PROCESS.
8VAC20-770 Background Checks (8VAC20-770)
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced monitoring visit and facility tour was conducted on 05/01/2023. At the time of inspectors' arrival there were 69 infant to preschool aged children in care with 11 staff members and 2 administrators. Children were observed engaging with staff, outdoor play, nap, diapering, lunch and hand washing. A sample of 5 children's records and 5 staff records were reviewed. Injury reports and medications were also reviewed. A self reported incident on 4/4/23 involving staff/child interactions was also reviewed during this inspection. Areas of noncompliance are identified on the violation notice and were discussed with the director in an exit meeting at the conclusion of this inspection.
Violations
10Standard 8VAC20-780-130-E
Based on record review and interview it was determined the center did not obtain documentation of additional immunizations once every six months for children under the age of two years.
Evidence:
1. The record for child #1 (under 2 y/o) did not contain documentation of updated immunizations. The last signed immunization record was dated 8/12/22.
2. The record for child #3 (under 2 y/o) did not contain documentation of updated immunizations. The last signed immunization record was dated 4/6/22.
3. Staff confirmed updated immunization records were not available during this inspection.
Evidence:
1. The record for child #1 (under 2 y/o) did not contain documentation of updated immunizations. The last signed immunization record was dated 8/12/22.
2. The record for child #3 (under 2 y/o) did not contain documentation of updated immunizations. The last signed immunization record was dated 4/6/22.
3. Staff confirmed updated immunization records were not available during this inspection.
Plan of Correction: 1.The correct immunization updates were in the child file however, the immunization form was printed from My Chart and was current and updated as of 2/9/23. An updated form was requested with the doctor signature which was missing from the My Chart version.
2.The correct form with doctor signature will be placed in the file as soon as received (no later than 5/17).
2.The correct form with doctor signature will be placed in the file as soon as received (no later than 5/17).
Standard 8VAC20-780-270-A
Based on observation it was determined the center did not ensure that all areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition.
Evidence:
1. The door to the kitchen was open during this inspection. There was no staff person present in the kitchen when this inspector entered the room. There were several sharp kitchen knives accessible as well as the oven.
2. In the infant classroom the white shelving unit had rough broken veneer along the lower edge at floor level.
3. There was splintering wood at ground level in the "Garden of Learning" and on the shed accessible from the Infant/Toddler outdoor playground.
4. There was a two person tricycle missing peddles and splintering wooden borders along the perimeter of the PreK playground.
5. In the two year old classroom there was a broken shelf with a rough splintered edge along the backside.
6. In the boys rest room there was exposed rust and peeling paint on the partition.
7. In one of the Pre-K classrooms the bottom edge of the storage closet door was broken and splintering leaving sharp and jagged edges.
8. In another Pre-K classroom the radio was plugged in to the wall at about 3.5' off the ground and set on top of the play kitchen equipment leaving the cord dangling.
9. Peeling paint was present in multiple classrooms through out the center.
10. Staff noted that work orders had already been submitted for some of these items/areas.
Evidence:
1. The door to the kitchen was open during this inspection. There was no staff person present in the kitchen when this inspector entered the room. There were several sharp kitchen knives accessible as well as the oven.
2. In the infant classroom the white shelving unit had rough broken veneer along the lower edge at floor level.
3. There was splintering wood at ground level in the "Garden of Learning" and on the shed accessible from the Infant/Toddler outdoor playground.
4. There was a two person tricycle missing peddles and splintering wooden borders along the perimeter of the PreK playground.
5. In the two year old classroom there was a broken shelf with a rough splintered edge along the backside.
6. In the boys rest room there was exposed rust and peeling paint on the partition.
7. In one of the Pre-K classrooms the bottom edge of the storage closet door was broken and splintering leaving sharp and jagged edges.
8. In another Pre-K classroom the radio was plugged in to the wall at about 3.5' off the ground and set on top of the play kitchen equipment leaving the cord dangling.
9. Peeling paint was present in multiple classrooms through out the center.
10. Staff noted that work orders had already been submitted for some of these items/areas.
Plan of Correction: 1.Spoke with Cook (5/2/23) regarding keeping the kitchen door closed at all times and she will ensure the door remains closed moving forward. Management will also validate when monitoring the building to ensure the door remains closed.
2.Tossed out broken shelving in the Infant classroom (5/2/23)
3.Placed a work order for splintering wood (5/1/23)
4.Threw bike away (5/1/23)
5.Threw shelf away (5/2/23)
6.Work order placed (5/2/23)
7.Work order placed (5/2/23)
8.This was corrected while licensor was in the building and pointed it out (5/1/23)
9.Work order placed (5/2/23)
2.Tossed out broken shelving in the Infant classroom (5/2/23)
3.Placed a work order for splintering wood (5/1/23)
4.Threw bike away (5/1/23)
5.Threw shelf away (5/2/23)
6.Work order placed (5/2/23)
7.Work order placed (5/2/23)
8.This was corrected while licensor was in the building and pointed it out (5/1/23)
9.Work order placed (5/2/23)
Standard 8VAC20-780-330-B
Based on measurement and interview it was determined the center did not ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99.
Evidence:
1. There was 3-4" of mulch in the fall zones of the playground equipment on the Infant/Toddler and PreK playgrounds.
2. Grass and weeds were growing in the mulched areas, which negates the impact attenuation of the mulch.
3. Staff confirmed a work order was submitted for this prior to this inspection.
Evidence:
1. There was 3-4" of mulch in the fall zones of the playground equipment on the Infant/Toddler and PreK playgrounds.
2. Grass and weeds were growing in the mulched areas, which negates the impact attenuation of the mulch.
3. Staff confirmed a work order was submitted for this prior to this inspection.
Plan of Correction: A previous work order had already been placed for mulch. Another work order put in on 5/2/23. Work completed on 5/9/23
Standard 8VAC20-780-340-F
Based on observation and interview it was determined the center did not ensure children under the age of ten years were always within actual sight and sound supervision of staff.
Evidence:
1. Inspector observed:
- Child #7 (4 years old) alone filling a cup with water in the boys restroom.
- Child #7 then walked down the hallway, through the empty Preschool classroom and outside onto the playground with no staff supervision.
- Staff #1 and #7 confirmed that child #7 was inside unattended.
2. In the toddler room inspector observed:
- Two children hitting each other with the cabinet door on the changing table
- Two children standing in chairs, and
- One child pull another child that was sitting in chair over onto the floor
- One staff member was changing diapers during this time and the other was cleaning up the room.
- The staff did not acknowledge or redirect these behaviors until the children began crying.
3. On the preschool playground the inspector observed:
- Staff #7 telling children to line up to go inside from the playground.
- During this transition children were seen hitting, shoving, and pulling on each other while in line.
- These behaviors were not redirected by staff until the children were screaming or crying.
Evidence:
1. Inspector observed:
- Child #7 (4 years old) alone filling a cup with water in the boys restroom.
- Child #7 then walked down the hallway, through the empty Preschool classroom and outside onto the playground with no staff supervision.
- Staff #1 and #7 confirmed that child #7 was inside unattended.
2. In the toddler room inspector observed:
- Two children hitting each other with the cabinet door on the changing table
- Two children standing in chairs, and
- One child pull another child that was sitting in chair over onto the floor
- One staff member was changing diapers during this time and the other was cleaning up the room.
- The staff did not acknowledge or redirect these behaviors until the children began crying.
3. On the preschool playground the inspector observed:
- Staff #7 telling children to line up to go inside from the playground.
- During this transition children were seen hitting, shoving, and pulling on each other while in line.
- These behaviors were not redirected by staff until the children were screaming or crying.
Plan of Correction: 1.Speak with teachers about the importance of always making sure that the children are within sight and sound. Retrain teachers on supervision standards using KinderCare policy. The child observed was a teacher?s child- redirection provided to teacher on the importance of maintaining the same standards for every child in the center, regardless of relationship.
2.Speak with teachers about the importance of delegating tasks within the classroom so that there are always eyes on the children. If one person is changing diapers, the other should be engaged with the children and incorporating them in clean-up time. Also, retrain staff on the importance of monitoring children at all times in order to avoid them hurting each other. This is also connected to KinderCare?s supervision policy.
3.Speak with staff about proper transitions from the playground to the classroom. Retrain staff on CSR usage for transitions. Proper usage of the CSR will allow a smoother transition from the playground to the classroom, avoiding children pushing and hitting each other. Also, retrain teachers on conflict resolution with children and how to provide positive redirection.
4. Management will utilize classroom observations weekly through KinderCare?s Standards of Excellence In Teaching to validate the training is being implemented in the classroom.
2.Speak with teachers about the importance of delegating tasks within the classroom so that there are always eyes on the children. If one person is changing diapers, the other should be engaged with the children and incorporating them in clean-up time. Also, retrain staff on the importance of monitoring children at all times in order to avoid them hurting each other. This is also connected to KinderCare?s supervision policy.
3.Speak with staff about proper transitions from the playground to the classroom. Retrain staff on CSR usage for transitions. Proper usage of the CSR will allow a smoother transition from the playground to the classroom, avoiding children pushing and hitting each other. Also, retrain teachers on conflict resolution with children and how to provide positive redirection.
4. Management will utilize classroom observations weekly through KinderCare?s Standards of Excellence In Teaching to validate the training is being implemented in the classroom.
Standard 8VAC20-780-400-B
Based on observation it was determined the behavioral guidance was not constructive in nature and did not redirect children to appropriate behaviors.
Evidence:
1. Inspector heard staff from outside the preschool classroom using a harsh tone and reprimanding children in the class.
2. Staff were heard saying to the children in care:
- "you can't get off your cots"
- "you won't be able to use the restroom during nap time"
- "we will say no if you ask to go to the bathroom"
3. Staff #7 was heard saying in a harsh tone to child #8 5 y/o:
- "you're going to do it now or never, I'm not waiting" regarding going to the bathroom
- "you're going to the office"
- "we are not going to take it today"
- "lay down, head down, stop crying",
- "I don't care"
4. Staff was also heard saying:
- "lunch is over, do you understand me?
- "you are all done" to a child who was not done eating their lunch.
5. Child #8 was observed crying after their interactions with staff #7.
Evidence:
1. Inspector heard staff from outside the preschool classroom using a harsh tone and reprimanding children in the class.
2. Staff were heard saying to the children in care:
- "you can't get off your cots"
- "you won't be able to use the restroom during nap time"
- "we will say no if you ask to go to the bathroom"
3. Staff #7 was heard saying in a harsh tone to child #8 5 y/o:
- "you're going to do it now or never, I'm not waiting" regarding going to the bathroom
- "you're going to the office"
- "we are not going to take it today"
- "lay down, head down, stop crying",
- "I don't care"
4. Staff was also heard saying:
- "lunch is over, do you understand me?
- "you are all done" to a child who was not done eating their lunch.
5. Child #8 was observed crying after their interactions with staff #7.
Plan of Correction: Re-train teachers on constructive positive behavioral guidance and redirection. We will have this training on Tuesday, May 16th during our monthly staff meeting. Staff #1 and #7 will receive written documentation addressing concerns observed during the visit.
Management will utilize classroom observations weekly through KinderCare?s Standards of Excellence In Teaching to validate the training is being implemented in the classroom.
Management will utilize classroom observations weekly through KinderCare?s Standards of Excellence In Teaching to validate the training is being implemented in the classroom.
Standard 8VAC20-780-510-B
Based on medication and record review as well as interview it was determined the center did not ensure medication was only given to a child with written authorization from the parent.
Evidence:
1. Child #10 was administered Albuterol twice on 8/15/22 and once on 8/16/22. There was no written permission from the parent.
2. Staff confirmed that there was no written authorization from the parent available during this inspection and medication was administered to child #10 three times in August 2022.
Evidence:
1. Child #10 was administered Albuterol twice on 8/15/22 and once on 8/16/22. There was no written permission from the parent.
2. Staff confirmed that there was no written authorization from the parent available during this inspection and medication was administered to child #10 three times in August 2022.
Plan of Correction: Parent signed form at pickup on 5/1/23. Moving forward, I will double check to make sure parent signatures are on all paperwork.
Standard 8VAC20-780-550-B
Based on record review and interview it was determined that the emergency preparedness plan did not include plan review and update.
Evidence:
1. The emergency preparedness plan did not include current evacuation location and contact information.
2. Staff confirmed that the information on the plan was not current.
Evidence:
1. The emergency preparedness plan did not include current evacuation location and contact information.
2. Staff confirmed that the information on the plan was not current.
Plan of Correction: Emergency preparedness plan updated with correct information (5/2/23)
Standard 8VAC20-780-550-D
Based on record review and interview it was determined the center did not implement a monthly practice evacuation drill.
Evidence:
1. There was no evacuation drill completed the month of April 2023.
2. Staff confirmed that this was not completed, as they thought a monthly evacuation drill wasn't needed if they did a shelter-in-place drill in April 2023.
Evidence:
1. There was no evacuation drill completed the month of April 2023.
2. Staff confirmed that this was not completed, as they thought a monthly evacuation drill wasn't needed if they did a shelter-in-place drill in April 2023.
Plan of Correction: Moving forward, we are making sure the evacuation drill is conducted monthly and documented
Standard 8VAC20-780-550-P
Based on record review and interview it was determined the center did not ensure the written record of children's serious and minor injuries contained all of the required information.
Evidence:
1. The Injury report dated 3/23/23 for child #11 did not contain the date, time, and method of parental notification and future action to prevent recurrence.
2. The Injury report dated 3/24/23 for child #9 did not contain the date, time, and method of parental notification.
3. Staff confirmed this information was not on the injury reports.
Evidence:
1. The Injury report dated 3/23/23 for child #11 did not contain the date, time, and method of parental notification and future action to prevent recurrence.
2. The Injury report dated 3/24/23 for child #9 did not contain the date, time, and method of parental notification.
3. Staff confirmed this information was not on the injury reports.
Plan of Correction: 1.Retrain staff on how to properly fill out an incident/accident report.
2.Make parents aware by highlighting the areas they need to complete on the incident report.
3. Ensure that management is checking incident/accident reports when signing to validate there is not missing information prior to having the parent sign. The Health and Safety Coordinator will also check reports when completing monthly filing to also validate forms are completed correctly.
2.Make parents aware by highlighting the areas they need to complete on the incident report.
3. Ensure that management is checking incident/accident reports when signing to validate there is not missing information prior to having the parent sign. The Health and Safety Coordinator will also check reports when completing monthly filing to also validate forms are completed correctly.
Standard 8VAC20-780-60-A
Based on record review and interview it was determined the center did not ensure each record contained all of the required information
Evidence:
1. The record for child #1 (enrolled 1/3/22) did not contain the work phone number for one of the two listed parents and previous child care and previous and concurrent schools and programs attended.
2. The record for child #3 (enrolled 2/15/22) did not contain the work phone number for one of the two listed parents.
3. The record for child #4 (enrolled 2/15/22) did not contain the work phone number for one of the two listed parents.
4. Staff confirmed this information was not available during this inspection.
Evidence:
1. The record for child #1 (enrolled 1/3/22) did not contain the work phone number for one of the two listed parents and previous child care and previous and concurrent schools and programs attended.
2. The record for child #3 (enrolled 2/15/22) did not contain the work phone number for one of the two listed parents.
3. The record for child #4 (enrolled 2/15/22) did not contain the work phone number for one of the two listed parents.
4. Staff confirmed this information was not available during this inspection.
Plan of Correction: 1.Paperwork updated with second parent's work number. (5/2/23) Child did not attend a previous daycare. Child started with us at about 6-8 weeks of age. We were this child's first daycare.
2.Paperwork updated with second parent's work number.(5/2/23)
3.Paperwork updated with second parent's work number. (5/2/23)
2.Paperwork updated with second parent's work number.(5/2/23)
3.Paperwork updated with second parent's work number. (5/2/23)