Inspection · 2023-04-25

Based on record review, staff did not have the results of a repeat criminal record check after five years.
Evidence:
1. Staff 2's most recent criminal record check is dated 3/29/18.
2. Staff 4's most recent criminal record check was dated 3/28/2018.

Based on record review, 1 of 5 children's records reviewed did not contain documentation of the immunizations required by the State Board of Health before the child can attend the center.
Evidence:
Child 1 was allowed to attend the center without documentation that the child has received the immunizations required by the State Board of Health

Based on record review, 2 of 5 children's records reviewed did not contain documentation of a physical examination.
Evidence:
Child 1 and Child 5's record did not contain documentation of the child having received a physical examination by a physician.

Based on record review, staff members did not receive repeat Tuberculosis screenings at least every two years from the date of the first initial screening or testing, or more frequently as if recommended by a licensed physician or the local health department.
Evidence:
1. Staff 1's most recent Tuberculosis screening was conducted on 8/22/2019.
2. Staff 2's most recent Tuberculosis screening was conducted on 8/03/2020.
3. Staff 4's most recent Tuberculosis screening was conducted on 9/24/2020.

Based on medication review and staff statements, on the date of inspection staff were not capable of carrying out assigned responsibilities.
Evidence:
1. During a review of medication, Staff 5 stated that she had forgotten the combination to the medication storage box and that she was unable to access the box.
2. The medication box was not empty as determined by lifting and shaking the box.
3. Child 1 has a medication authorization form for an emergency medication and a severe food allergy.
4. Child 1's severe food allergy is not listed on the posted allergy list available to staff members.
5. In the event of a severe allergic reaction, staff may not be aware of the allergy nor have the means to access the child's emergency medication.

Equipment in the center was not maintained in a clean and operable condition.
Evidence:

Two vinyl covered children's couches and two vinyl covered chairs were observed with rips and holes exposing the foam padding.

Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children.
Evidence:
1. One bathroom in the basement contained toilet cleaner, disinfectant wipes, and aerosol air freshener on an open shelf.
2. One bathroom in the basement contained aerosol disinfectant, and disinfectant wipes on an open shelf.

Based on observation, electrical outlets did not have protective covers that are of a size that cannot be swallowed by children.

Evidence:
1. In the downstairs play room an outlet was observed without a cover.
2. In the upstairs great room a power strip was observed to be plugged in with two exposed outlets.

Based on record review, 2 of 5 children's records reviewed did not contain documentation that the center verified the child's age and identity.
Evidence:
Child 1 and Child 5's record did not contain documentation that the children's identifying documents had been reviewed.

Based on observation, the center did not maintain a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8 that was dated and kept confidential in each room or area where children are present.
Evidence:
1. The posted allergy list did not contain the information of Child 1 who has a documented severe food allergy and emergency medication to treat a reaction the the allergy.
2. The list was not dated or kept in a confidential place, it was posted directly to the wall in the center.

Based on record review, the center's medication authorization form did not contain all required documentation.
Evidence:
Child 1's prescription medication authorization form did not contain the duration the authorization would be effective or a physician's signature.

Based on record review, there was no documentation to confirm that monthly evacuation drill are practiced.
Evidence:
There was no documented evacuation drill for February or March 2023.

Based on record review, children's records did not contain all required information.
Evidence:
1. Child 1's record did not contain: documentation that the child's identity had been verified; a physical examination; a written care plan including instructions from a physician regarding the food to which the child is allergic; and an authorization to provide emergency medical care.
2. Child 2's record did not contain an authorization to provide emergency medical care.
3. Child 3's record did not contain: either parent's place of employment, or an authorization to provide emergency medical care.
4. Child 4's record did not contain: either parent's place of employment, 1 of 2 required emergency contact to include name, address, and phone number, and documentation that the child's age and identity was verified.
5. Child 5's record did not contain: one of the listed parent's place of employment, documentation of a physical.

Based on record review, parent's did not have documentation of all required written agreements in each child's record by the first day of the child's attendance.
Evidence:
Children 1, 2, and 3's record did not contain documentation that the parent has authorized the center to obtain emergency medical care for their children in care.

Based on observation, the findings of the most recent monitoring inspection were not posted.
Evidence:
The findings from the inspection conducted on 12/28/2021 were posted in the center. The most recent inspection was conducted on 12/12/2022.