Inspection · 2023-07-19

Repeat Violation
Based on a review of three staff records and interview, the center did not obtain the satisfactory results of a national fingerprint-based criminal record search for one staff prior to employment.

Evidence: 1) The record of Staff #3, employed on 06/14/22, did not contain the results of a national fingerprint-based criminal record search.

2) During interview, a member of management reported the center did not have a fingerprint-based criminal record search for Staff #3.

Based on a review of three staff records, the center did not ensure one staff had a completed sworn statement or affirmation prior to employment.

Evidence: The sworn statement in the record of Staff #2, employed on 08/01/22, was completed on 08/02/22.

Repeat Violation
Based on a review of three staff records and interviews, the center did not have a central registry finding for one staff within 30 days of employment.

Evidence: 1) The record of Staff #3, employed on 06/14/22, did not contain a central registry finding. 2) During interview, a member of management reported the center did not have a central registry finding for Staff #3.

Based on a review of a child?s record and interview, the center did not ensure one child had a physical examination by or under the direction of a physician before the child?s attendance or within 30 days of the child?s first day of attendance.

Evidence: 1) The record of Child #1, date of attendance 04/17/23, did not contain documentation of a physical examination. 2) During interview, a member of management acknowledged a physical examination was not on file for Child #1.

Repeat Violation
Based on a review of three staff records and interview, the center did not ensure one staff member submitted documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children.

Evidence: 1) The TB screening in the record of Staff #3, employed on 06/14/22, was completed on 06/28/23. 2) During interview, a member of management reported this was the only TB screening on file for Staff #3.

Based on a review of three staff records and interview, the center did not ensure one staff was at least 16 years of age.

Evidence: 1) The record of Staff #3, employed on 06/14/22 as an aide, indicates the staff member is 15 years of age. Aides shall be at least 16 years of age. 2) During interview, a member of management reported she was unaware an aide had to be 16 years of age. The staff is never alone with children but has been counted in ratio in the past.

Repeat Violation
Based on a review of three staff records and interview, the center did not ensure two staff members completed the Virginia Department of Education-sponsored orientation course within 90 calendar days of employment.

Evidence:
1) According to the certificate for Virginia Department of Education-sponsored orientation course in the record of Staff #2, employed on 08/01/22, the training was completed on 12/31/22.

2) The record of Staff #3, employed on 06/14/22, did not contain a training certificate for the Virginia Department of Education-sponsored orientation course. During interview, a member of management reported the center does not have documentation that Staff #3 has completed the course.

Based on a review of documentation and interviews, the center did not maintain the required staff-child ratio for children birth up to 16 months.

Evidence:
1) During an interview with a collateral witness, it was reported that on 06/14/23 at approximately 7:55am, Staff #1 and Staff #3 were the only two staff members in the Fish Class (Infant 1) with nine children.

2) A review of the center?s Rollcall Sheet for the Fish Class (Infant 1) and the Turtles Class (Infant 2) for 06/14/23 showed there were a total of nine children present by approximately 7:25am. The ages of the children ranged from 3 months to 17 months. A member of management reported the Fish Class (Infant 1) and the Turtles Class (Infant 2) are typically combined in the mornings and were combined on 06/14/23.

The staff-child ratio applied to the group is one staff member to four children based on the age of the youngest child present.

Based on a review of documentation, observations, and interviews, the center did not ensure to follow the center's own policies and procedures that are required by these standards.

Evidence: During the inspection on 07/24/23, the inspector observed three infants, under 12 months of age, sleeping in cribs. Two out of the three infants had blankets in the cribs. A staff member in the classroom reported she did not know infants could not have blankets in the crib.

The center?s policy on safe sleeping practices state: ?Use a wearable blanket to keep baby warm without blankets in the sleep area. Make sure baby?s head and face stay uncovered during sleep.?

Based on interviews and a review of documentation, the center did not ensure cribs shall be used for children under 12 months of age.

Evidence: 1) During interviews, it was reported that on several occasions, Child #1 (6-months-old) has fallen asleep in a bouncy chair but was not transitioned to their assigned crib. When staff were asked why the child was not moved, they reported ?she was already asleep, and we didn?t want to wake her.? 2) A daily report reviewed for Child #1 dated 05/26/23 shows a picture of Child #1 asleep in a bouncy chair with a blanket. The report was labeled ?Naptime.?

Based on a review of documentation and interviews, the center did not ensure that when children at the center have been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the parents shall be notified within 24 hours or the next business day of the center's having been informed unless forbidden by law, except for life threatening diseases, which must be reported to parents immediately.

Evidence: 1) During interviews, it was reported that on 07/10/23, a communicable disease was reported to the center for a child in the Fish Class (Infant 1). The parents of the children in the classroom did not receive a notification from the center to let them know their children had been exposed to a communicable disease.

2) Documentation reviewed showed the last notification sent to families regarding a communicable disease was on 05/09/23. A member of management reported a notification was not sent to families about the communicable disease reported on 07/10/23 because the information was given to another member of management that is no longer at the center.

Based on observation, interviews, and a review of documentation, the center did not follow the requirement to obtain written parent authorization noting any known adverse reactions when diaper ointment or cream is used for three out of six children.

Evidence: 1) Diaper ointment was observed on-site on 07/24/23 for Child #3, Child #5, and Child #6. The center did not have written parent authorization noting any known adverse reactions for the diaper ointment on site for each child. 2) During interview, staff reported the ointments have been applied to Child #3, Child #5, and Child #6.

Based on observation and interviews on 07/24/23, the center did not ensure prepared infant formula was dated and labeled with the child's name.

Evidence: 1) In the refrigerator in the Fish Class (Infant 1), the inspector observed 13 prepared infant bottles that were not dated and two bottles that did not have a child?s name or the date.

2) During interview, staff reported all the prepared bottles contain formula and acknowledged they were not dated and two were also missing the child?s name.