Inspection · 2022-11-14

Based on record review, the provider did not ensure four of six staff records had documentation of central registry results within 30 days of employment.
Evidence:
1. The record of staff #2 (employment date: 8/1/22) did not have documentation of central registry results.
2. The record of staff #4 (employment date: 5/9/22) did not have documentation of central registry results.
3. The record of staff #5 (employment date: 4/11/22) had documentation of central registry results dated 6/17/22.
4. The record of staff #6 (employment date: 8/20/19) had documentation of central registry results dated 9/30/2019.

Based on record review, the center did not ensure four of six staff records contained documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children.
Evidence:
1. The record of staff #1 (employment date: 11/14/22) did not have documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children.
2. The record of staff #2 (employment date: 8/1/22) did not have documentation of tuberculosis screening at the time of employment and prior to coming in contact with children.
3. The record of staff #4 (employment date: 5/9/22) had documentation of a negative tuberculosis screening dated 9/15/2022.
4. The record of staff #5 (employment date: 4/11/22) had documentation of a negative tuberculosis screening dated 6/8/2022.

Based on record review, the center did not ensure that the orientation training included all required topics.
Evidence:
1. The record of staff #1 (employment date: 11/14/2022) had documentation of an orientation training that did not include all of the required topics.
2. The record of staff #2 (employment date: 8/1/2022) had documentation of an orientation training that did not include all of the required topics.
3. The record of staff #4 (employment date: 5/9/2022) had documentation of an orientation training that did not include all of the required topics.
4. The record of staff #5 (employment date: 4/11/2022) had documentation of an orientation training that did not include all of the required topics.

Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, save and operable condition.
Evidence:
1. There was a water hose several feet long, sitting on the playground outside of the three year old classroom presenting an entanglement and tripping hazard.
2. The following playground structures and equipment had several rusted areas within the reach of children in care: playground fence, rake, stationary car, swing chains and seat connectors.
3. Four of the five plastic seats on the red merry-go-cycle were cracked in several places presenting a pinching hazard.
4. There was a rake laying on the ground near the backdoor of the three?s classroom presenting a tripping hazard.
5. There were two corn-hole games located on the playground with chipped paint and splintering wood within the reach of children in care.
6. There were two vinyl mats located on the playground, under the mats was several areas with mold growing on the ground.
7. Several ceiling tiles throughout the center had layers of dust built up around the vents and the wall vent located in the three and four year old classroom had several layers of dust which could affect air quality in the classrooms.

Based on observation, the center did not ensure that where play equipment is provided, resilient surfacing complied with minimum safety standards described in the American Society for Testing and Materials.
Evidence:
1. The slides located on the center's toddler playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least six inches of resilient surfacing throughout the fall zone. The center had about 2-4 inches of wooden mulch and decomposed mulch/dirt in the fall zone.
2. The yellow slide located on the center's school age playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least nine inches of resilient surfacing throughout the fall zone. The center had about 5-6 inches of wooden mulch and decomposed mulch/dirt in the fall zone.

Based on observation, the center did not ensure staff wash their hands with soap and running water before and after a diaper change.
Evidence:
1. Infant teacher #1 did not wash their hands before diapering a child. Additionally, the infant teacher stated that they do not normally wash their hands before diapering.
2. Infant teacher #2 stated that they do not regularly wash their hands before diapering.

Based on observation and record review, the center did not ensure to obtain written parent permission for prescription medication given to a child.
Evidence:
The record of child number seven (enrollment date: 9/20/2021) did not have documentation of written parent permission to administer medication. The center?s medication log indicated that the child was given the medication on several occasions.

Based on record review, the center did not ensure to maintain all required emergency information documentation as specified in 8VAC20-780-550-I and K.
Evidence:
Bus #3 did not have documentation of the following: 911 or local dial number for police, fire and emergency medical services, the number of the regional poison control, potential shelters, hospitals, evacuation routes that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools.

Based on record review, the center did not ensure to obtain documentation of a written allergy care plan for each child with a diagnosed food allergy.
Evidence:
1. The record of child # 1 (enrollment date: 7/1/2019) did not have documentation of a written allergy care plan. The child?s record and the center?s allergy list both indicated that the child had a diagnosed food allergy.
2. The record of child # 2 (enrollment date: 4/6/2020) did not have documentation of a written allergy care plan. The child?s record and the center?s allergy list both indicated that the child had a diagnosed food allergy.
3. The record of child # 3 (enrollment date: 5/30/2022) did not have documentation of a written allergy care plan. The child?s record and the center?s allergy list both indicated that the child had a diagnosed food allergy.
4. The record of child # 5 (enrollment date: 6/6/2022) did not have documentation of a written allergy care plan. The child?s record and the center?s allergy list both indicated that the child had a diagnosed food allergy.
5. The record of child # 6 (enrollment date: 2/8/2021) did not have documentation of a written allergy care plan. The child?s record and the center?s allergy list both indicated that the child had a diagnosed food allergy.