Inspection · 2023-01-24
Date
2023-01-24
Complaint Related
No
Licensing Inspector
Anita Drewry
(757) 404-5261
(757) 404-5261
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.
8VAC20-820 HEARINGS PROCEDURES.
8VAC20-770 Background Checks 20 Access to minor's records
22.1 Early Childhood Care and Education
63.2 Child Abuse & Neglect
Inspector Notes
A renewal inspection was initiated on 1/24/2023 and concluded on 1/25/2023. There were 82 children present with 18 staff supervising. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming, medication, special care and emergencies and nutrition. A total of 8 child records and 10 staff records were reviewed. The inspection started 1/24/2023 at 1:50 pm and concluded at 3:50 pm. then continued on 1/25/2023 from 10:00 am to at 12:20 pm
Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program
Violations
5Standard 22.1-289.035-B-2
Based on a review of records and interview, the licensee was unable to demonstrate that each staff person working with children in the center submitted results of a federal criminal records review prior to employment.
Evidence:
Ten staff records were reviewed.
The record for staff #1 whose date of hire was documented as 9/1/2022, contained the results of a federal criminal records review which was dated 9/8/2022 (after the initial date of employment).
The record for staff #2 whose date of hire was documented as 4/20/2022, contained the results of a federal criminal records review which was dated 4/21/2022 (after the
The record for staff #6 whose date of hire was documented as 1/3/2023, contained the results of a federal criminal records review which was dated 1/10/2023 (after the initial date of employment). initial date of employment).
The administrative staff who maintains staff records confirmed this documentation during the inspection.
Evidence:
Ten staff records were reviewed.
The record for staff #1 whose date of hire was documented as 9/1/2022, contained the results of a federal criminal records review which was dated 9/8/2022 (after the initial date of employment).
The record for staff #2 whose date of hire was documented as 4/20/2022, contained the results of a federal criminal records review which was dated 4/21/2022 (after the
The record for staff #6 whose date of hire was documented as 1/3/2023, contained the results of a federal criminal records review which was dated 1/10/2023 (after the initial date of employment). initial date of employment).
The administrative staff who maintains staff records confirmed this documentation during the inspection.
Plan of Correction: Criminal Records Checks will be requested for potential candidates for employment and Criminal Record Search results will be received and reviewed by the program director prior to the employment of any new staff.
Standard 22.1-289.036-B-2
Based on a review of records and interview, the licensee was unable to demonstrate that each corporate board member submitted results of a federal criminal records review.
Evidence:
Four corporate officer / agent records were reviewed as part of the renewal application review.
There was no documentation to demonstrate that a Federal Criminal Record Check had been conducted for officer #1 and officer #3 who were listed as current officers of the corporation on the renewal application dated 1/11/2023.
The Program Director was unable to confirm that this background check had been conducted or provide this documentation during the inspection.
Evidence:
Four corporate officer / agent records were reviewed as part of the renewal application review.
There was no documentation to demonstrate that a Federal Criminal Record Check had been conducted for officer #1 and officer #3 who were listed as current officers of the corporation on the renewal application dated 1/11/2023.
The Program Director was unable to confirm that this background check had been conducted or provide this documentation during the inspection.
Plan of Correction: The Criminal Records Checks for board members were requested by the program director and the results were received by the program and provided to the licensing inspector on 2/2/2023.
Standard 8VAC20-770-40-D-1-a
Based on a review of records and interview, the licensee was unable to demonstrate that each corporate board member submitted results of a Search of the Central Registry.
Evidence:
Four corporate officer / agent records were reviewed as part of the renewal application review.
There was no documentation to demonstrate that a Search of the Central Registry had been conducted for officer #1, officer #2 and officer #3 who were listed as current officers of the corporation on the renewal application dated 1/11/2023.
The Program Director was unable to confirm that these background checks had been conducted or provide this documentation during the inspection.
Evidence:
Four corporate officer / agent records were reviewed as part of the renewal application review.
There was no documentation to demonstrate that a Search of the Central Registry had been conducted for officer #1, officer #2 and officer #3 who were listed as current officers of the corporation on the renewal application dated 1/11/2023.
The Program Director was unable to confirm that these background checks had been conducted or provide this documentation during the inspection.
Plan of Correction: The Search of Central Registry for board members were requested by the program director and the results were received by the program and provided to the licensing inspector on 2/2/2023.
Standard 8VAC20-780-570-E
Based on observation and interview, the licensee did not ensure that each bottle of prepared infant formula brought into the center is refrigerated, dated, and labeled with the child's name.
Evidence:
There was one bottle located in the refrigerator in the infant classroom that was dated but not labeled with the owner's name.
When asked, staff were able to identify which infant the bottle belonged to based on the type of bottle and where it was located in the refrigerator.
However, staff acknowledged that the bottle was not labeled with the infant's name.
Evidence:
There was one bottle located in the refrigerator in the infant classroom that was dated but not labeled with the owner's name.
When asked, staff were able to identify which infant the bottle belonged to based on the type of bottle and where it was located in the refrigerator.
However, staff acknowledged that the bottle was not labeled with the infant's name.
Plan of Correction: Staff stated that they will remind parents to label children's bottles and if bottles arrive missing a label, staff will label the bottles at that time, before placing them in the refrigerator.
Standard 8VAC20-780-70
REPEAT VIOLATION
Based on a review of records and interview, the licensee was unable to demonstrate that two or more references as to character and reputation as well as competency were checked
before each staff member's employment or volunteering.
Evidence:
Ten staff records were reviewed during the Renewal inspection.
There was no documentation in staff #6's record to demonstrate that two or more references as to character and reputation as well as competency were checked before employment.
There was only documentation of one reference check documented in staff #4's record.
The Program Director was unable to confirm that these reference checks had been conducted or provide documentation of these reference checks during the inspection.
Based on a review of records and interview, the licensee was unable to demonstrate that two or more references as to character and reputation as well as competency were checked
before each staff member's employment or volunteering.
Evidence:
Ten staff records were reviewed during the Renewal inspection.
There was no documentation in staff #6's record to demonstrate that two or more references as to character and reputation as well as competency were checked before employment.
There was only documentation of one reference check documented in staff #4's record.
The Program Director was unable to confirm that these reference checks had been conducted or provide documentation of these reference checks during the inspection.
Plan of Correction: Reference checks will be conducted for candidates prior to employment and documented in the records for all new staff hired.