Inspection · 2023-05-08

Based on review of staff records, the center did not obtain a repeat background check every five years.

Evidence:

The record of staff #5, employed 05/18/2015, did not contain the results of a current central registry background report..

Based on review of staff records and interview, the center did not request an Out of State Child Abuse and Neglect Search by the End of 30th Day of Employment
Evidence:

1. The record of staff #7, employed 01/23/2023, indicated the staff resided outside the state of Virginia in the past five years. The record did not contain documentation of an out of state child abuse and neglect search request for the state.
2. A member of management stated they were unaware an out of state background check was required.

Based on observation and interview, the center was not equipped with a carbon monoxide detector.

Evidence:

1.The center, licensed for children ages one month through two years six months did not have a carbon monoxide detector.
2.The director stated they did not have a carbon monoxide detector installed in the center.

Based on review of seven staff records and interview, the center did not obtain the results
of the central registry background report within 30 days of employment.

Evidence:

1. The record of staff #4, employed 12/21/2021, did not contain the results of a central registry
background report.
2. The record of staff #5, employed 05/18/2015, did not contain the results of a central registry
background report.
3. The record of staff #6, employed 03/08/2023, did not contain the results of a central registry
background report.
4. The record of staff #7, employed 01/23/2023, did not contain the results of a central registry background report.

Based on review of staff records, the center did not obtain all required documentation for each staff record.
Evidence:

The record of staff #4 (employed 12/21/2021), staff #6 (employed 03/08/2023), and staff #7 (employed 01/23/2023), did not contain documentation of two or more references as to character and reputation as well as competency that were checked before employment or volunteering.

Based on review of staff records, the center did not obtain documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. The documentation must have been completed within the last 30 calendar days prior to employment.

Evidence:

1. Staff #6, employed 03/08/2023, did not have documentation of a negative tuberculosis screening on file.
2. Staff #7, employed 01/23/2023, did not have documentation of a negative tuberculosis screening on file.

Based on review of staff records, the center did not ensure staff obtained and submitted the results of a follow-up tuberculosis screening at least every two years from the date of the initial tuberculosis screening or testing.

Evidence:

1. The record of staff #1 contained documentation of a tuberculosis screening dated 04/23/2021, exceeding two years.
2. The record of staff #2 contained documentation of a tuberculosis screening dated 05/25/2019, exceeding two years.
3. Staff #5, employed 05/18/2015, did not have documentation of a negative tuberculosis screening on file. Staff #5 was observed working with children in care. I?m thinking that this should be moved to 160-C since DOH was in 2015

Based on review of staff records, the center did not ensure staff completed the Virginia Department of Education sponsored orientation course within 90 calendar days of employment.

Evidence:

1. The record of staff #4, employed 12/21/2021, did not contain documentation of completing the Virginia Department of Education sponsored orientation course within 90 days of employment.
2. The record of staff #7, employed 01/23/2023, did not contain documentation of completing the Virginia Department of Education sponsored orientation course within 90 days of employment.

Based on observation and interview, the center did not ensure within 30 days of the first day of employment, staff received orientation training in first aid and cardiopulmonary resuscitation (CPR) as appropriate to the age of children in care.

Evidence:

1. There was no documentation of staff#4 (employed 12/21/2021), staff #6 (employed 03/08/2023), and staff #7 (01/23/2023) completing orientation training in first aid and CPR.
2. The owner stated she was not aware of the updated regulations regarding staff orientation and staff had not been oriented in first aid and CPR.

Based on interview, the center did not ensure there was always at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children.

Evidence:

The director stated there were no staff with current daily health observation training.

Based on observation and interview, the care and protection of five infants was not ensured.

Evidence:

1. Eight infants were observed in the infant room with 13 daily charts posted.
2. The inspector asked if any other infants were in care. The director stated five infants were sleeping in a separate room with a staff member due to them being light sleepers.
3. Upon entering the room, five infants were observed asleep in cribs with thick blankets. The infants were alone in the room with the door closed and without staff supervision for approximately 20 minutes.

Based on observation and interview, the center did not ensure children under 10 years of age were always within actual sight and sound supervision.

Evidence:

Five infants were observed asleep in cribs in a room with the door closed. No staff were present in the room. The five infants were out of actual sight and sound supervision.

Based on observation and interview, the center did not maintain the required staff to child children ratio for children birth up to 16 months of age.

Evidence:

1. The required staff-to-children ratio for children birth up to 16 months is one staff for every four children. At the time of the inspector?s arrival, approximately 1:45 pm, there were 13 Infants in care with one staff member supervising.
2. The director stated staff were at lunch, one staff had scheduled off and the substitute had called out. The director acknowledged the infant class was out of ratio.

Based on observation and review of the license, the licensee did not ensure operational responsibilities, including compliance with the terms of the current license issued by the department.

Evidence:

During the inspection on 05/08/2023, the licensing inspector observed five infants sleeping in cribs in classroom #1. The current license stipulates: ?Room 1- A maximum of three cribs/3 children at any one time?.

Based on observation, the center did not ensure twelve inches of space was maintained between the sides and ends of occupied cribs.
Evidence:

In classroom #1, five occupied cribs were observed. The three cribs were touching end to end and did not have twelve inches of space maintained in between each crib.

Based on observation and interview, the center did not ensure medications, except those prescriptions designated otherwise by written physician?s order, were kept in a locked place using a safe locking method that prevents access by children.

Evidence:

Prescription medication for child #7 was observed in a zipper bag hanging on the wall of the kitchen. The bag did not have a locking mechanism to prevent access by children in care.
The director acknowledged the medication was in an unlocked bag.

Based on observation, the center did not maintain all required items in the first aid kit.

Evidence:

The first aid kit did not include gauze pads as required by the standard.