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Inspection · 2021-05-06

Date

2021-05-06

Complaint Related

Licensing Inspector

Lynn Powers
(804) 840-8260

Areas Reviewed

32.1 Report by person other than physician
54.1-3408 Must be MAT Certified.
63.2 Child Abuse & Neglect
63.2(17) License & Registration Procedures
63.2 Facilities & Programs.
22VAC40-191 Background Checks for Child Welfare Agencies

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.

A code compliance inspection was initiated on 05/06/2021 and concluded on 05/06/2021. The director was contacted via video call to initiate the inspection. The inspector emailed the director a list of items required to complete the inspection. The Inspector reviewed 7 staff records submitted by the facility to ensure documentation was complete.
Information gathered during the inspection determined non-compliance(s) with applicable code sections and violations were documented on the violation notice issued to the facility.
The Licensing Inspector has reviewed with the provider COVID-19 Essential Guidance for Child Care programs.

Violations

Standard 22VAC40-191-40-D-2

Based on staff record review, the center did not ensure six of seven staff records contained documentation of central registry results within 30 days of employment and a completed sworn statement or affirmation prior to employment.
Evidence:
1. The record of staff #1 (start date: 12/15/20) did not have documentation of central registry results and a completed sworn statement or affirmation.
2. The record of staff #2 (start date: 8/19/20) did not have documentation of central registry results and a completed sworn statement or affirmation.
3. The record of staff #3 (start date: 8/24/20) did not have documentation of central registry results and a completed sworn statement or affirmation.
4. The record of staff #4 (start date: 9/12/19) did not have documentation of central registry results and a completed sworn statement or affirmation.
5. The record of staff #5 (start date: 12/14/20) did not have documentation of central registry results and a completed sworn statement or affirmation.
6. The record of staff #6 (start date: 8/24/20) did not have documentation of central registry results and a completed sworn statement or affirmation.
7. The record of staff #7 (start date: 8/4/20) did not have documentation of central registry results and a completed sworn statement or affirmation.

Plan of Correction: Cloverhill Christian Academy intends to correct the items we were recently cited on by ensuring ALL staff have completed the following documents for their personal file:

Central Registry

Standard 63.2(17)-1720.1-B-2

Based on staff record review, the center did not ensure five of seven staff records had documentation of fingerprint based national criminal history search results prior to employment.
Evidence:
1. The record of staff #2 (start date: 8/19/20) had documentation of fingerprint based national criminal history search results dated 8/24/20.
2. The record of staff #4 (start date: 9/12/19) had documentation of fingerprint based national criminal history search results dated 10/14/20.
3. The record of staff #5 (start date: 12/14/20) had documentation of fingerprint based national criminal history search results dated 1/4/21.
4. The record of staff #6 (start date: 8/24/20) did not have documentation of fingerprint based national criminal history search results.
5. The record of staff #7 (start date: 8/04/20) had documentation of fingerprint based national criminal history search results dated 9/10/20.

View original record on Virginia Department of Social Services