Inspection · 2021-02-24
Date
2021-02-24
Complaint Related
No
Licensing Inspector
Laura Lunceford
(571) 835-5058
(571) 835-5058
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
22VAC40-185 STAFF QUALIFICATIONS AND TRAINING.
22VAC40-185 PHYSICAL PLANT.
22VAC40-185 STAFFING AND SUPERVISION.
22VAC40-185 PROGRAMS.
22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.
22VAC40-185 SPECIAL SERVICES.
Inspector Notes
This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia.
An investigation was conducted virtually in response to a self-reported incident that was initiated jointly with a local government agency on February 24, 2021 and concluded on June 17, 2021. The report received by the department included allegations that a staff person roughly handled children.
The Center?s video recordings and staff records were reviewed, staff interviews were conducted, and the center?s policies and procedures were reviewed in response to the allegations.
The evidence gathered during the investigation did support non-compliance with standards or law. Any additional violations not related to the self-report but identified during the course of the investigation can also be found on the violation notice.
Violations
10Standard 22VAC40-185-240-A
Based on interviews, staff did not receive required training by the end of their first day of assuming job responsibilities.
Evidence:
1. Staff # 4 was hired on 02/04/21. During an interview on 03/1/21, Staff #4 admitted to not receiving the required training. Staff #4 stated ?I have not had child abuse and neglect training.?
2. Staff #5 confirmed that Staff #4 did not complete child abuse and neglect training by the end of the first day of assuming job responsibilities.
Evidence:
1. Staff # 4 was hired on 02/04/21. During an interview on 03/1/21, Staff #4 admitted to not receiving the required training. Staff #4 stated ?I have not had child abuse and neglect training.?
2. Staff #5 confirmed that Staff #4 did not complete child abuse and neglect training by the end of the first day of assuming job responsibilities.
Plan of Correction: All new hires are required to complete the VA DSS Child Abuse and Neglect Mandated Reporter Training on first day of hire.
Date to be corrected: 3/1/2021
2.Staff #4 did complete the VA DSS Child Abuse and Neglect Mandated Reporter Training on the first week of hire and before entering a classroom.
Date to be corrected: 2/9/2021
3.ChildTime New Employee Training does include Abuse & Neglect training. Staff #4 did complete training prior to entering a classroom.
Date to be corrected: 2/6/2021
Date to be corrected: 3/1/2021
2.Staff #4 did complete the VA DSS Child Abuse and Neglect Mandated Reporter Training on the first week of hire and before entering a classroom.
Date to be corrected: 2/9/2021
3.ChildTime New Employee Training does include Abuse & Neglect training. Staff #4 did complete training prior to entering a classroom.
Date to be corrected: 2/6/2021
Standard 22VAC40-185-270-A
Based on video review and staff interview, equipment was not maintained in a clean, safe and operable condition.
Evidence:
1. The bouncy chair located on the carpeted area by the rocking chair in the infant classroom was not assembled properly. The legs of the bouncy chair were attached backwards.
2. During an interview on 03/05/2021, Staff #7 confirmed that the bouncy chair was not assembled properly.
3. On 2/19/2021, Child #3 (7 months), Child #4 (3 months), and Child #5 (7 months) were observed being placed in the bouncy chair throughout the day.
Evidence:
1. The bouncy chair located on the carpeted area by the rocking chair in the infant classroom was not assembled properly. The legs of the bouncy chair were attached backwards.
2. During an interview on 03/05/2021, Staff #7 confirmed that the bouncy chair was not assembled properly.
3. On 2/19/2021, Child #3 (7 months), Child #4 (3 months), and Child #5 (7 months) were observed being placed in the bouncy chair throughout the day.
Plan of Correction: The bouncy chair was discarded from classroom and was not replaced.
Date to be corrected: 3/8/2021
Date to be corrected: 3/8/2021
Standard 22VAC40-185-340-A
Based on video review, staff did not ensure the care, protection and guidance of a child.
Evidence:
1. On 2/19/2021, at approximately 2:43pm, Child #3 (7 months) and Child #6 (16 months) were sitting in chairs at the table having snack. Child # 3 fell off their chair and hit the right side of their head and chin on the table. Child #3 then fell backwards on the tiled floor and lay on the floor crying. Staff #1 sat down on a chair next to the child for approximately 1 minute before picking Child #3 up off of the floor.
Evidence:
1. On 2/19/2021, at approximately 2:43pm, Child #3 (7 months) and Child #6 (16 months) were sitting in chairs at the table having snack. Child # 3 fell off their chair and hit the right side of their head and chin on the table. Child #3 then fell backwards on the tiled floor and lay on the floor crying. Staff #1 sat down on a chair next to the child for approximately 1 minute before picking Child #3 up off of the floor.
Plan of Correction: All staff were retrained on the appropriate handling and caring of children.
Date to be corrected: 3/1/2021
2. All new staff are trained on appropriate handling and caring of children before entering a classroom.
Date to be corrected: 3/1/2021
Date to be corrected: 3/1/2021
2. All new staff are trained on appropriate handling and caring of children before entering a classroom.
Date to be corrected: 3/1/2021
Standard 22VAC40-185-350-E-1
Based on video review, ratio requirements of one staff for every four children was not met in the infant classroom.
Evidence:
On 2/19/2021, there were five children in the infant classroom with two staff. Video recordings captured multiple incidents of one staff being left alone with five children (ages 3 months, 7 months, 9 months, 12 months and 16 months), including the following:
1. At approximately 10:25am, Staff #3 left Staff #1 alone in the classroom with five children until Staff #3 returned at approximately 10:31am.
2. At approximately 4:18pm, Staff #2 left Staff #1 alone in the classroom until Staff #2 returned at approximately 4:21pm.
3. At approximately 4:30pm, Staff #1 left Staff # 2 alone in the classroom until staff #1 returned at approximately 4:31pm.
Evidence:
On 2/19/2021, there were five children in the infant classroom with two staff. Video recordings captured multiple incidents of one staff being left alone with five children (ages 3 months, 7 months, 9 months, 12 months and 16 months), including the following:
1. At approximately 10:25am, Staff #3 left Staff #1 alone in the classroom with five children until Staff #3 returned at approximately 10:31am.
2. At approximately 4:18pm, Staff #2 left Staff #1 alone in the classroom until Staff #2 returned at approximately 4:21pm.
3. At approximately 4:30pm, Staff #1 left Staff # 2 alone in the classroom until staff #1 returned at approximately 4:31pm.
Plan of Correction: Staff have been trained on the importance of maintain classroom ratios.
Date to be corrected: 3/1/2021
2. All new staff have been trained on the importance of maintaining classroom ratios and appropriate ways to call for management while in the classroom.
Date to be corrected: 3/1/2021
3. A designated staff has been appointed as a floater for all classrooms to give appropriate breaks for staff when needing to leave the classroom for a brief period of time. When the floater is not available, management steps into classrooms.
Date to be corrected: 3/1/2021
4. All classrooms were provided with walkie-talkies to communicate with management in front office.
Date to be corrected: 3/8/2021
Date to be corrected: 3/1/2021
2. All new staff have been trained on the importance of maintaining classroom ratios and appropriate ways to call for management while in the classroom.
Date to be corrected: 3/1/2021
3. A designated staff has been appointed as a floater for all classrooms to give appropriate breaks for staff when needing to leave the classroom for a brief period of time. When the floater is not available, management steps into classrooms.
Date to be corrected: 3/1/2021
4. All classrooms were provided with walkie-talkies to communicate with management in front office.
Date to be corrected: 3/8/2021
Standard 22VAC40-185-370-5
Based on video review, staff did not provide awake infants who were not playing on the floor or ground a change in play space at least every 30 minutes.
Evidence:
1. On 2/19/2021, at approximately 9:00am, Child # 4 (3 months) was placed in a bouncy chair by Staff #3. Child #4 was removed from the bouncy chair at approximately 9:58am.
Evidence:
1. On 2/19/2021, at approximately 9:00am, Child # 4 (3 months) was placed in a bouncy chair by Staff #3. Child #4 was removed from the bouncy chair at approximately 9:58am.
Plan of Correction: 1. Staff were retrained on appropriate engagement with infants and all ages.
Date to be corrected: 3/1/2021
2. All new staff are trained on appropriate engagement with infants and all ages before entering a classroom.
Date to be corrected: 3/1/2021
Date to be corrected: 3/1/2021
2. All new staff are trained on appropriate engagement with infants and all ages before entering a classroom.
Date to be corrected: 3/1/2021
Standard 22VAC40-185-400-B
Based on staff interview, behavioral guidance was not constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behaviors.
Evidence:
1. Staff # 6 stated that on 2/19/2021, at approximately 3:30pm, ?I could hear [Staff #1] being aggressive with children. I heard [Staff #1] yelling `Be quiet. You are fine. I am not picking you up. There is nothing wrong with you [Child #1].?? When Staff #6 entered the classroom, she observed Staff #1 bending down to be directly in Child #1?s face.
Evidence:
1. Staff # 6 stated that on 2/19/2021, at approximately 3:30pm, ?I could hear [Staff #1] being aggressive with children. I heard [Staff #1] yelling `Be quiet. You are fine. I am not picking you up. There is nothing wrong with you [Child #1].?? When Staff #6 entered the classroom, she observed Staff #1 bending down to be directly in Child #1?s face.
Plan of Correction: 1. Staff #1 was terminated from company.
Date to be corrected: 2/23/21
2. Staff were retrained on positive guidance and appropriate ways to speak to children.
Date to be corrected: 3/1/2021
3. All new staff are trained on positive guidance and appropriate ways to speak to children before entering a classroom.
Date to be corrected: 3/1/2021
Date to be corrected: 2/23/21
2. Staff were retrained on positive guidance and appropriate ways to speak to children.
Date to be corrected: 3/1/2021
3. All new staff are trained on positive guidance and appropriate ways to speak to children before entering a classroom.
Date to be corrected: 3/1/2021
Standard 22VAC40-185-410-1
Based on video review, staff used the forbidden action of roughly handling children in care.
Evidence:
Video recordings of the Infant classroom on 2/19/2021 captured multiple incidents of Staff #1 and Staff #2 roughly handling children, including the following:
1. At approximately 1:57pm, Staff # 1 scooped snow onto a shovel and dumped a scoopful of snow onto the head of Child #2 (9 months) and threw snow into Child #2?s face. Child #2 started crying. Staff #1 repeatedly dumped scoopfuls of snow onto Child #2?s head approximately 12 more times. After the second time, Child #2 fell backwards from a seated position, hitting the back of their head on the tile floor. Snow was thrown directly into Child #2?s face approximately 6 more times. Child #2 continued to cry and again fell back, hitting their head on the tile floor in response to the direct hits to the face with the snow. Each time Child #2 fell backwards, Staff #1 pulled them back up to a seated position by the arms. This incident continued for approximately 2 minutes and 33 seconds.
2. At approximately 2:35pm, Child #1 (12 months) crawled towards a baby gate located in the middle of the classroom. Staff #1 lifted Child #1 up by the elbows and tossed Child #1 onto a carpeted area located approximately two feet away.
3. At approximately 3:28pm, Staff #2 grabbed Child #1 by the left wrist and picked them up about 1 foot off the ground and carried the child by their left arm over 2 feet in distance to a carpeted area located in the back of the classroom.
4. At approximately 4:39pm, Staff #2 grabbed Child #2 by the right upper arm, jerked the child towards them roughly and forcibly placed Child #2 down in a seated position on the floor. Child #2 started crying. Staff #2 threw three toys into Child #2?s lap and walked away. .
5. At approximately 4:51pm, while Child #2 is lying down on the carpet crying, Staff #1 picked them up by one arm and grabbed them from under the left armpit to sit them up on the floor. Staff #1 then forcibly placed a pacifier into Child #2?s mouth. Child #2 continued to cry and would not take the pacifier. Child #2 then fell back hitting their head on the carpeted floor.
6. At approximately 5:21pm, Child #1 crawled towards a toy shelf, approximately 1 foot high by 1 foot deep by 3 feet wide, in the middle of the classroom. Child #1 propped themselves by placing two hands on the front edge of the shelf and stood up. Staff #1 walked towards Child #1 and stood on the opposite side of the furniture facing the child. Staff #1 lifted the furniture by the handles located at both ends while Child #1 was still holding on. Child #1 was lifted with their feet approximately 2 feet off the floor and the child?s right hand lost its grip. Staff #1 then turned around a full 360 degrees while still holding the furniture and with Child #1 hanging onto the edge with their left hand. Child #1 lost their grip and fell onto the floor. Child #1 started crying.
Evidence:
Video recordings of the Infant classroom on 2/19/2021 captured multiple incidents of Staff #1 and Staff #2 roughly handling children, including the following:
1. At approximately 1:57pm, Staff # 1 scooped snow onto a shovel and dumped a scoopful of snow onto the head of Child #2 (9 months) and threw snow into Child #2?s face. Child #2 started crying. Staff #1 repeatedly dumped scoopfuls of snow onto Child #2?s head approximately 12 more times. After the second time, Child #2 fell backwards from a seated position, hitting the back of their head on the tile floor. Snow was thrown directly into Child #2?s face approximately 6 more times. Child #2 continued to cry and again fell back, hitting their head on the tile floor in response to the direct hits to the face with the snow. Each time Child #2 fell backwards, Staff #1 pulled them back up to a seated position by the arms. This incident continued for approximately 2 minutes and 33 seconds.
2. At approximately 2:35pm, Child #1 (12 months) crawled towards a baby gate located in the middle of the classroom. Staff #1 lifted Child #1 up by the elbows and tossed Child #1 onto a carpeted area located approximately two feet away.
3. At approximately 3:28pm, Staff #2 grabbed Child #1 by the left wrist and picked them up about 1 foot off the ground and carried the child by their left arm over 2 feet in distance to a carpeted area located in the back of the classroom.
4. At approximately 4:39pm, Staff #2 grabbed Child #2 by the right upper arm, jerked the child towards them roughly and forcibly placed Child #2 down in a seated position on the floor. Child #2 started crying. Staff #2 threw three toys into Child #2?s lap and walked away. .
5. At approximately 4:51pm, while Child #2 is lying down on the carpet crying, Staff #1 picked them up by one arm and grabbed them from under the left armpit to sit them up on the floor. Staff #1 then forcibly placed a pacifier into Child #2?s mouth. Child #2 continued to cry and would not take the pacifier. Child #2 then fell back hitting their head on the carpeted floor.
6. At approximately 5:21pm, Child #1 crawled towards a toy shelf, approximately 1 foot high by 1 foot deep by 3 feet wide, in the middle of the classroom. Child #1 propped themselves by placing two hands on the front edge of the shelf and stood up. Staff #1 walked towards Child #1 and stood on the opposite side of the furniture facing the child. Staff #1 lifted the furniture by the handles located at both ends while Child #1 was still holding on. Child #1 was lifted with their feet approximately 2 feet off the floor and the child?s right hand lost its grip. Staff #1 then turned around a full 360 degrees while still holding the furniture and with Child #1 hanging onto the edge with their left hand. Child #1 lost their grip and fell onto the floor. Child #1 started crying.
Plan of Correction: Staff #1 & #2 were terminated from company immediately after incident was reported.
Date to be corrected: 2/23/21 & 2/24/2021
2. All staff were required to retake the VA DSS Child Abuse & Neglect Mandated Reporter Training.
Date to be corrected: 3/5/2021
3. All new staff are required to complete the VA DSS Child Abuse & Neglect Mandated Reporter Training by first day of hire.
4. Mangement is monitoring camera and classroom frequently throughout the day.
Date to be corrected: 3/1/2021
Date to be corrected: 2/23/21 & 2/24/2021
2. All staff were required to retake the VA DSS Child Abuse & Neglect Mandated Reporter Training.
Date to be corrected: 3/5/2021
3. All new staff are required to complete the VA DSS Child Abuse & Neglect Mandated Reporter Training by first day of hire.
4. Mangement is monitoring camera and classroom frequently throughout the day.
Date to be corrected: 3/1/2021
Standard 22VAC40-185-500-A
Based on video review, children?s hands were not washed before or after eating meals or snacks.
Evidence:
1. On 2/19/2021, at approximately 2:30pm, Child #1 (12 months), Child #3 (7 months), and Child #6 (16 months) did not have their hands washed prior to being seated at the table to eat a snack.
2. At approximately 2:30pm, Staff #1 did not wash their hands with soap and running water before feeding or helping feeding children with feeding.
Evidence:
1. On 2/19/2021, at approximately 2:30pm, Child #1 (12 months), Child #3 (7 months), and Child #6 (16 months) did not have their hands washed prior to being seated at the table to eat a snack.
2. At approximately 2:30pm, Staff #1 did not wash their hands with soap and running water before feeding or helping feeding children with feeding.
Plan of Correction: Staff #1 was terminated from company.
Date to be corrected: 2/23/2021
2. Staff were retrained on importance of handwashing and when handwashing needs to be completed before giving children snacks, meals or bottles.
Date to be corrected: 3/1/2021
3. All new staff are trained on the importance of handwashing and when handwashing needs to be completed before giving children snacks, meals or bottles.
Date to be corrected: 3/1/2021
Date to be corrected: 2/23/2021
2. Staff were retrained on importance of handwashing and when handwashing needs to be completed before giving children snacks, meals or bottles.
Date to be corrected: 3/1/2021
3. All new staff are trained on the importance of handwashing and when handwashing needs to be completed before giving children snacks, meals or bottles.
Date to be corrected: 3/1/2021
Standard 22VAC40-185-570-A
Based on video review, a child was placed in an infant seat without the protective belt being fastened securely.
Evidence:
1. On 2/19/2021, at approximately 4:09pm, Child #5 (7 months) was placed into a bouncy chair by Staff #1 without the protective belt being fastened securely. Staff #1 bounced the chair vigorously up and down with the child in it.
Evidence:
1. On 2/19/2021, at approximately 4:09pm, Child #5 (7 months) was placed into a bouncy chair by Staff #1 without the protective belt being fastened securely. Staff #1 bounced the chair vigorously up and down with the child in it.
Plan of Correction: Staff #1 was terminated from company.
Date to be corrected: 2/23/2021
2. The bouncy chair was discarded from classroom and was not replaced.
Date to be corrected: 3/8/2021
Date to be corrected: 2/23/2021
2. The bouncy chair was discarded from classroom and was not replaced.
Date to be corrected: 3/8/2021
Standard 22VAC40-185-570-B
Based on video review, one bottle fed infant was not held when being fed.
Evidence:
1. On 2/19/2021, at approximately 3:25pm, Staff #2 was observed feeding Child #3 (7 months) a bottle while Child #3 was laying in a crib.
Evidence:
1. On 2/19/2021, at approximately 3:25pm, Staff #2 was observed feeding Child #3 (7 months) a bottle while Child #3 was laying in a crib.
Plan of Correction: Staff #2 was terminated from company.
Date to be corrected: 2/24/2021
2. Staff were retrained on appropriate way to feed infants.
Date to be completed: 3/1/2021
3. All new staff are trained on appropriate ways to feed infants before entering a classroom.
Date to be corrected: 3/1/2021
Date to be corrected: 2/24/2021
2. Staff were retrained on appropriate way to feed infants.
Date to be completed: 3/1/2021
3. All new staff are trained on appropriate ways to feed infants before entering a classroom.
Date to be corrected: 3/1/2021