Inspection · 2021-09-23
Date
2021-09-23
Complaint Related
Yes
Licensing Inspector
Stephanie Reed
(540) 272-6558
(540) 272-6558
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 ADMINISTRATION.
22VAC40-185 PHYSICAL PLANT.
22VAC40-185 STAFFING AND SUPERVISION.
22VAC40-185 PROGRAMS.
22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.
Inspector Notes
The unannounced complaint inspection was completed on 09/23/2021 from 10:10 A.M.- 1:15 P.M. The inspection was in response to a complaint that was received in the Valley Licensing Office on 09/14/2021. The complaint was in regards to the licensing standards relating to staffing and supervision. Interviews with staff were conducted, review of medication and required documentation, one child record, attendance record, sign-in/sign-out, and employee handbook were reviewed. The information gathered during the investigation does not support the allegation and is determined to be "not valid". There were four non-complaint related violations cited and is noted on the violation notice.
If you have any questions or concerns contact the licensing inspector at (540)-430-9257 for further assistance.
Violations
4Standard 22VAC40-185-350-A
Based on review of documentation and interviews, the center failed to ensure the care and protection of a child at all times.
Evidence:
1. Child #1, (age 22 months) had a bottle of emergency medication on site. Child #1 was given 5 ml of the emergency medication on 6/28/2021, and 3 ml on 7/05/2021. Child #1 was given the medication due to his eyes were getting puffy, his cheeks were red, and he was scratching at his face.
2. The medication stated on the bottle children under the age of 2 do not use; children 2-5 do not use unless directed by a doctor; children ages 6-11 years of age 5 ml.
3. There was no documentation from a physician stating the dosage amount or authorizing the medication.
4. The center stated they contacted the parent before giving the child the medication. The parent verbally changed the dosage amount from 5 ml to 3ml.
Evidence:
1. Child #1, (age 22 months) had a bottle of emergency medication on site. Child #1 was given 5 ml of the emergency medication on 6/28/2021, and 3 ml on 7/05/2021. Child #1 was given the medication due to his eyes were getting puffy, his cheeks were red, and he was scratching at his face.
2. The medication stated on the bottle children under the age of 2 do not use; children 2-5 do not use unless directed by a doctor; children ages 6-11 years of age 5 ml.
3. There was no documentation from a physician stating the dosage amount or authorizing the medication.
4. The center stated they contacted the parent before giving the child the medication. The parent verbally changed the dosage amount from 5 ml to 3ml.
Plan of Correction: All staff members have been reminded about the importance of double checking age requirements for all medications (prescription and non-prescription). Age requirements will be observed and medical authorization will be obtained when necessary. Parents will be directed to MAT certified staff, as only they can administer medications.
Standard 22VAC40-185-40-E
Based on a review of policies and interviews, the licensee did not ensure operational responsibilities that the center's activities and services are maintained in compliance with the center's own policies and procedures that are required by these standards.
Evidence:
1. The center's medication policy states "that medications that are not picked up by the parent within 14 days after authorization expires will be disposed of either by dissolving down the sink or flushing down the toilet."
2. On 09/23/2021 the licensing inspector reviewed a medical authorization from for Child #1. The authorization form was signed by the parent on 06/28/2021. The authorization form expired on 07/09/2021.
3. The medication should have been disposed of by 07/23/2021.
Evidence:
1. The center's medication policy states "that medications that are not picked up by the parent within 14 days after authorization expires will be disposed of either by dissolving down the sink or flushing down the toilet."
2. On 09/23/2021 the licensing inspector reviewed a medical authorization from for Child #1. The authorization form was signed by the parent on 06/28/2021. The authorization form expired on 07/09/2021.
3. The medication should have been disposed of by 07/23/2021.
Plan of Correction: Medication was dissolved down the sink on 9/24/2021.
Standard 22VAC40-185-510-C
Based on review of the medication policy, the center failed to ensure that all required components were in the medication policy.
Evidence:
1. The medication policy did not include the statement that nonprescription medication, shall be consistent with the manufacturer's instructions for age, duration and dosage.
2. Child #1, (age 22 months), had a nonprescription emergency medication. There was no documentation of medical authorization from a physician.
3. The medication was given to Child #1 on 6/28/2021, dosage amount 5 ml, and on 07/05/2021 a dosage amount of 3 ml.
4. The medication stated on the bottle children under the age of 2 do not use; children 2-5 do not use unless directed by a doctor; children ages 6-11 years of age 5 ml.
Evidence:
1. The medication policy did not include the statement that nonprescription medication, shall be consistent with the manufacturer's instructions for age, duration and dosage.
2. Child #1, (age 22 months), had a nonprescription emergency medication. There was no documentation of medical authorization from a physician.
3. The medication was given to Child #1 on 6/28/2021, dosage amount 5 ml, and on 07/05/2021 a dosage amount of 3 ml.
4. The medication stated on the bottle children under the age of 2 do not use; children 2-5 do not use unless directed by a doctor; children ages 6-11 years of age 5 ml.
Plan of Correction: Medical authorization from child's physician will be obtained if/when child is under the age of the age requirement listed on the medication label.
Standard 22VAC40-185-510-E
Based on observation, the center failed to ensure that all medication was labeled with the dosage amount.
Evidence:
1. Child #1 had an emergency medication that was not labeled with the dosage amount. The dosage amount was recorded on the medical authorization form.
2. Staff verified that the bottle of emergency medication was not labeled with the dosage amount.
Evidence:
1. Child #1 had an emergency medication that was not labeled with the dosage amount. The dosage amount was recorded on the medical authorization form.
2. Staff verified that the bottle of emergency medication was not labeled with the dosage amount.
Plan of Correction: Staff will assure that dosage listed on the medication authorization form corresponds with dosage on medication label.