Inspection · 2024-08-06
Date
2024-08-06
Complaint Related
No
Licensing Inspector
Pamela Sneed
(804) 629-2691
(804) 629-2691
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 Staffing and Supervision.
8VAC20-780 Special Care Provisions and Emergencies
22.1 Background Checks
Inspector Notes
An unannounced focused investigation was initiated on 8/6/24 and completed on 8/20/24 into a self-reported incident of a child requiring outside medical treatment. The inspector reviewed compliance in the areas listed above. The investigation included interviews and document review, both electronically and in-person. Information gathered during the investigation determined non-compliance with applicable standards or law, and violations are documented on the violation notice issued to the program.
Please complete the plan of correction (POC) and date to be corrected sections for each violation cited on the violation notice. Specify how the deficient practice will be or has been corrected. Submit your POC within five (5) business day from the date the report was sent to you, which will be close of business on 8/28/24. A POC submitted after this date will not appear on the public website.
Violations
4Standard 8VAC20-780-340-A
Based on records reviewed and staff interviewed, staff did not ensure the care and protection of a child having an allergic reaction to a known food allergen.
Evidence:
1. On 8/1/24, Staff #1 served Child #1 a known food allergen.
2. After eating the food, Staff #1 reported that Child #1 told her the "food tasted funny." Staff #2 and #3 reported that Child #1 stated his throat was hurting. Staff #2 reported in an email, dated 8/2/24, that Child #1's "tummy was upset."
3. After calling the parents of Child #1, Staff #2 administered Medication #1 to Child #1.
4. The Fairfax County Authorization for Anaphylaxis Action Plan for Child #1, signed by the physician on 8/7/23 states, (a) Regardless of whether the student is symptomatic, the epinephrine (Medication #2) will be given immediately after report of exposure to peanut; (b) Route of Exposure: Ingestion; (c) To give the pre-measured dose by injection. These instructions were not followed by SACC staff.
Evidence:
1. On 8/1/24, Staff #1 served Child #1 a known food allergen.
2. After eating the food, Staff #1 reported that Child #1 told her the "food tasted funny." Staff #2 and #3 reported that Child #1 stated his throat was hurting. Staff #2 reported in an email, dated 8/2/24, that Child #1's "tummy was upset."
3. After calling the parents of Child #1, Staff #2 administered Medication #1 to Child #1.
4. The Fairfax County Authorization for Anaphylaxis Action Plan for Child #1, signed by the physician on 8/7/23 states, (a) Regardless of whether the student is symptomatic, the epinephrine (Medication #2) will be given immediately after report of exposure to peanut; (b) Route of Exposure: Ingestion; (c) To give the pre-measured dose by injection. These instructions were not followed by SACC staff.
Plan of Correction: Staff will ensure the care and protection of children at all times. Staff must always be aware of children's allergies, especially when preparing and serving food in order to avoid cross contamination.
Staff will participate in a medication policies and procedures training to include a thorough review of all medication forms.
Immediately
Medication policies and procedures training to be held on September 11,
2024.
Although the guidance of the child's parents was followed, the guidance was not consistent with the authorization forms. Staff will review all current and incoming forms carefully with families to ensure the instructions are clear and the plan of action as outlined on the form is correct. All staff will be aware of the
procedures and follow the authorization forms as signed by the parent and physician.
Center reviews will be completed by September 4, 2024, and ongoing upon receipt.
Staff will participate in a medication policies and procedures training to include a thorough review of all medication forms.
Immediately
Medication policies and procedures training to be held on September 11,
2024.
Although the guidance of the child's parents was followed, the guidance was not consistent with the authorization forms. Staff will review all current and incoming forms carefully with families to ensure the instructions are clear and the plan of action as outlined on the form is correct. All staff will be aware of the
procedures and follow the authorization forms as signed by the parent and physician.
Center reviews will be completed by September 4, 2024, and ongoing upon receipt.
Standard 8VAC20-780-510-B
Based on records reviewed and interviews conducted, it was determined that a long-term medication was on-site and administered to a child not in accordance with SACC written medication policies and State standards.
Evidence:
1. The SACC written medication procedures state, that a physicians signature and written instructions are required for any medication administered more than 10 consecutive days, or on an as-needed basis.
2. On 6/17/24, the parent of Child #1 signed a written medication authorization form for Medication #1 (an over the counter medication) however, the physician did not sign the authorization form.
3. On 8/1/24, Medication #1 was given to Child #1 by Staff #2.
Evidence:
1. The SACC written medication procedures state, that a physicians signature and written instructions are required for any medication administered more than 10 consecutive days, or on an as-needed basis.
2. On 6/17/24, the parent of Child #1 signed a written medication authorization form for Medication #1 (an over the counter medication) however, the physician did not sign the authorization form.
3. On 8/1/24, Medication #1 was given to Child #1 by Staff #2.
Plan of Correction: All staff will participate in a medication policies and procedures training.
Centers will review all medications held at center and ensure they are in compliance with SACC policies and procedures.
Staff will ensure any new medications and authorizations submitted are in compliance with SACC and State standards.
Medication policies and procedures training to be held on September 11,
2024.
Center reviews will be completed by September 4, 2024.
Ongoing
Centers will review all medications held at center and ensure they are in compliance with SACC policies and procedures.
Staff will ensure any new medications and authorizations submitted are in compliance with SACC and State standards.
Medication policies and procedures training to be held on September 11,
2024.
Center reviews will be completed by September 4, 2024.
Ongoing
Standard 8VAC20-780-510-N
Based on records reviewed, the record of medication given to a child did not include required information. Evidence: The SACC Medication Administration Record did not include the time that medication #1 was given to Child #1 on 8/1/24.
Plan of Correction: Staff will participate in a medication policies and procedures training including the documentation requirements of medication administration .
Medication policiesand procedures training to be held on Sentember 11 2024
Medication policiesand procedures training to be held on Sentember 11 2024
Standard 8VAC20-780-560-O
Based on records reviewed and staff interviewed, staff did not ensure that food was prepared, to which a child in care is allergic, in a manner to avoid cross contamination to prevent an allergic reaction.
Evidence:
1. SACC staff prepared and served a snack they thought was "no-nuts trail mix" but it contained ingredients that had a nut based allergen.
2. SACC staff stated they served the snack to Child #1 who had a nut allergy.
3. Measures to ensure there were no nuts in the trail mix was not followed, and the child had an allergic reaction after eating the snack served.
Evidence:
1. SACC staff prepared and served a snack they thought was "no-nuts trail mix" but it contained ingredients that had a nut based allergen.
2. SACC staff stated they served the snack to Child #1 who had a nut allergy.
3. Measures to ensure there were no nuts in the trail mix was not followed, and the child had an allergic reaction after eating the snack served.
Plan of Correction: Staff will always ensure food is prepared in a manner to avoid cross contamination in order to prevent an allergic reaction. Prior to preparing and prior to serving food items, staff will review the special needs list and ensure products containing a known allergen are not served.
Staff will participate in a medication policies and procedures training which will include policies for creating, and maintaining the special needs list, as well as policies to ensure the list is reviewed by all staff upon the beginning of programs, as updates are made, and prior to preparing and serving food. Staff must always be aware of and mindful of children's allergies.
Immediately
Medication policies and procedures training to be held on September 11,
2024.
Staff will participate in a medication policies and procedures training which will include policies for creating, and maintaining the special needs list, as well as policies to ensure the list is reviewed by all staff upon the beginning of programs, as updates are made, and prior to preparing and serving food. Staff must always be aware of and mindful of children's allergies.
Immediately
Medication policies and procedures training to be held on September 11,
2024.