Inspection · 2022-05-09
Date
2022-05-09
Complaint Related
No
Licensing Inspector
Kelly Lindsay
(540) 309-2494
(540) 309-2494
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
8VAC20-780 Administration.
8VAC20-780 Staff Qualifications and Training.
8VAC20-780 Physical Plant.
8VAC20-780 Staffing and Supervision.
8VAC20-780 Programs.
8VAC20-780 Special Care Provisions and Emergencies
8VAC20-780 Special Services.
8VAC20-820 THE LICENSE.
8VAC20-820 THE LICENSING PROCESS.
8VAC20-770 Background Checks (8VAC20-770)
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
63.2 Child Abuse & Neglect
Inspector Notes
A mandated monitoring inspection was conducted on December 16, 2022 from 9:50 A.M.-1:00 P.M. There were 37 children present, ranging in ages from four months to five years of age, with 12 staff supervising. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming, medication, special care and emergencies and nutrition. A total of five child records and eight staff records were reviewed.
Information gathered during the inspection determined non-compliance with applicable standards or law, and violations are documented on the violation notice. Additionally, the licensee has failed to comply with all requirements of the Special Order. In accordance with ?
22.1-289.022 A of the Code of Virginia, the Superintendent may revoke the license of any child day program that violates any provision of Chapter 14.1, Title 22.1 of the Code of Virginia.
If you have any questions or concerns please contact the Licensing Inspector at 540-430-9257.
Violations
13Standard 22.1-289.023-A
Based on observation, the center failed to post a copy of the notice of intent issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations.
Evidence:
1. The Notice of Intent dated May 11, 2022, was not posted anywhere in the facility.
2. Administration verified that the Notice of Intent was not posted.
Evidence:
1. The Notice of Intent dated May 11, 2022, was not posted anywhere in the facility.
2. Administration verified that the Notice of Intent was not posted.
Plan of Correction: The Notice of Intent dated May 11 was replaced by the last inspection dated May 11.
Standard 22.1-289.023-B
Based on observation, the center failed to post a copy of the special order issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations.
Evidence:
1. The Special Order dated August 31, 2022, was not posted anywhere in the facility.
2. Administration verified that the Special Order was not posted.
Evidence:
1. The Special Order dated August 31, 2022, was not posted anywhere in the facility.
2. Administration verified that the Special Order was not posted.
Plan of Correction: I thought it was posted on line. I received the email about posting it while I was away.
Standard 22.1-289.035-B-2
Based on review of staff files, the center failed to ensure that a national criminal history background check was on file prior to the first day of employment.
Evidence:
1. Staff #4?s first day of employment and orientation was 09/20/2022. The national criminal history background check on file was dated 09/22/2022.
2. Staff #6?s first day of employment and orientation was 11/02/2022. There was not a completed national criminal history background check on file for Staff #6. Staff #6 was observed to be working with a group of children by herself in Classroom #2. Staff #6 verified she started employment on 11/02/2022.
3. Staff #7?s first day of employment and orientation was 11/04/2022. The national criminal history background check on file was dated 11/16/2022.
Evidence:
1. Staff #4?s first day of employment and orientation was 09/20/2022. The national criminal history background check on file was dated 09/22/2022.
2. Staff #6?s first day of employment and orientation was 11/02/2022. There was not a completed national criminal history background check on file for Staff #6. Staff #6 was observed to be working with a group of children by herself in Classroom #2. Staff #6 verified she started employment on 11/02/2022.
3. Staff #7?s first day of employment and orientation was 11/04/2022. The national criminal history background check on file was dated 11/16/2022.
Plan of Correction: Staff #4 is the daughter of an employee it was done before employment. Staff #6 was awaiting her background. Staff #6 was awaiting her background she was with another employee or myself at all times. Staff #7 was never left alone in the babies room as there are three teachers at tall times in that classroom.
Standard 8VAC20-770-60-C-2
Based on a review of staff records, the center failed to have central registry findings within 30 days of employment.
Evidence:
1. Staff #1's date of employment was 03/04/2022. There was not a completed central registry finding on file.
2. Staff #4?s date of employment was 09/20/2022. There was not a completed central registry finding on file.
3. Staff #5?s date of employment was 02/28/2022. There was not a completed central registry finding on file.
4. Staff #6?s employment was 11/02/2022. There was not a completed central registry find on file.
5. Staff #7?s date of employment was 11/04/2022. There was not a completed central registry finding on file.
Evidence:
1. Staff #1's date of employment was 03/04/2022. There was not a completed central registry finding on file.
2. Staff #4?s date of employment was 09/20/2022. There was not a completed central registry finding on file.
3. Staff #5?s date of employment was 02/28/2022. There was not a completed central registry finding on file.
4. Staff #6?s employment was 11/02/2022. There was not a completed central registry find on file.
5. Staff #7?s date of employment was 11/04/2022. There was not a completed central registry finding on file.
Plan of Correction: See the attached communication follow-up with CRS operations for Staff #1, Staff #4 and Staff #5. Staff #7's background check is attached.
Standard 8VAC20-780-130-E
Based on review of children records, the center failed to obtain documentation of additional immunizations one every six months for children under the age of two.
Evidence:
1. The last immunizations on file for child #3 (age 19 months) were dated 04/26/2022. Documentation of additional immunizations were required in October 2022.
2. Staff verified that there were not updated immunizations in the child?s file.
Evidence:
1. The last immunizations on file for child #3 (age 19 months) were dated 04/26/2022. Documentation of additional immunizations were required in October 2022.
2. Staff verified that there were not updated immunizations in the child?s file.
Plan of Correction: parents spoke with pediatrician who said that immunizations was due in December at the child's birthday.
Standard 8VAC20-780-160-A
Based on review of staff records, the center failed to ensure that each staff member submitted documentation of a negative tuberculosis screening completed within the last 30 calendar days of the date of employment and prior to coming into contact with children.
Evidence:
1. Staff #6?s date of hire was 11/02/2022. There TB test on file was dated 07/15/2021.The TB test was more than 30 days prior to the date of hire.
2. Staff #7?s date of hire was 11/04/2022. The tuberculosis screening on file was dated 11/18/2022.
3. Administration verified that Staff #7 had began working in the classroom before the tuberculosis screening/test was on file.
Evidence:
1. Staff #6?s date of hire was 11/02/2022. There TB test on file was dated 07/15/2021.The TB test was more than 30 days prior to the date of hire.
2. Staff #7?s date of hire was 11/04/2022. The tuberculosis screening on file was dated 11/18/2022.
3. Administration verified that Staff #7 had began working in the classroom before the tuberculosis screening/test was on file.
Plan of Correction: Staff #7 had it done see attached, it was faxed; it was in her file. Staff #7 had a chest TB which was negative. We had her do the syringe TB test.
Standard 8VAC20-780-160-C
Based on review of staff records, the center failed to ensure that an updated tuberculosis screening/test was obtained at least every two years from the date of the initial screening/test.
Evidence:
1. Staff #2?s tuberculosis screening on file was dated 10/14/2020. A new tuberculosis screening/test was required by 10/14/2022.
2. Staff #3?s tuberculosis screening on file was dated 02/06/2020. A new tuberculosis screening/test was required by 02/06/2022.
3. Administration verified the dates on the tuberculosis screening on file, and verified that the staff had not obtained new tuberculosis screening/test.
Evidence:
1. Staff #2?s tuberculosis screening on file was dated 10/14/2020. A new tuberculosis screening/test was required by 10/14/2022.
2. Staff #3?s tuberculosis screening on file was dated 02/06/2020. A new tuberculosis screening/test was required by 02/06/2022.
3. Administration verified the dates on the tuberculosis screening on file, and verified that the staff had not obtained new tuberculosis screening/test.
Plan of Correction: Staff #2 got an update on 12/20/2022. Staff #2 has an appointment for 1/16/2023 they are completely backed up.
Standard 8VAC20-780-240-B
Based on review of staff records, the center failed to ensure that orientation training was completed within seven days of the date of hire.
Evidence:
1. Staff #6?s date of employment was 11/02/2022. The orientation documentation on file was dated that it was completed on 11/28/2022.
2. Administration verified that the orientation had been completed late.
Evidence:
1. Staff #6?s date of employment was 11/02/2022. The orientation documentation on file was dated that it was completed on 11/28/2022.
2. Administration verified that the orientation had been completed late.
Plan of Correction: Staff #6 worked for a couple of days and was in a car accident then had the flu. She was hardly present.
Standard 8VAC20-780-40-E
Based on review of the employee handbook and medication policy, the licensee failed to ensure that the center?s activities and services are maintained in compliance with the center?s own policy and procedures required by these standards.
Evidence:
1. In the Employee Handbook, the medication policy states, ?all medications should be in the original containers and stored in a LOCKED area?, and ?Parent?s authorizations for medications will include a duration providing an expiration date or will be renewed after 10 working days.?
2. In Classroom #1 there was a prescription diaper ointment, (Triamcinolone Cream), in a container on the shelf with the rest of the over-the counter skin products. The container was not locked or in a locked area.
3. Child#1 had a prescription diaper ointment, (Triamcinolone Cream) on site on 12/16/2022. The parent authorization form was completed on 05/09/2022 and expired on 05/23/2022. The authorization was not renewed after 10 working days.
Evidence:
1. In the Employee Handbook, the medication policy states, ?all medications should be in the original containers and stored in a LOCKED area?, and ?Parent?s authorizations for medications will include a duration providing an expiration date or will be renewed after 10 working days.?
2. In Classroom #1 there was a prescription diaper ointment, (Triamcinolone Cream), in a container on the shelf with the rest of the over-the counter skin products. The container was not locked or in a locked area.
3. Child#1 had a prescription diaper ointment, (Triamcinolone Cream) on site on 12/16/2022. The parent authorization form was completed on 05/09/2022 and expired on 05/23/2022. The authorization was not renewed after 10 working days.
Plan of Correction: The shelf is five feet high and unreachable to children, however I have explained that we are still mandated to lock it. We have spoken to the parent. They kept forgetting to bring the form. Ointment was returned to the parents.
Standard 8VAC20-780-500-A
Based on observation, the center failed to ensure that children?s and staff?s hands were washed at all the required time.
Evidence:
1. On December 16, 2022, the Licensing Inspector observed a routine diaper changing time in Classroom #1.
2. Three children were observed during the process. Staff #1 did not wash her hands before or after changing each child.
3. All three children that were observed during diaper changing time did not wash their hands after having their diapers changed.
Evidence:
1. On December 16, 2022, the Licensing Inspector observed a routine diaper changing time in Classroom #1.
2. Three children were observed during the process. Staff #1 did not wash her hands before or after changing each child.
3. All three children that were observed during diaper changing time did not wash their hands after having their diapers changed.
Plan of Correction: Staff #1 was retrained. She explained she was nervous and just removed the gloves. See attached training.
Standard 8VAC20-780-500-B
Based on observation of the diapering routine, the facility failed to ensure that the diapering surface was cleaned and sanitized, and diapers were disposed of as required.
Evidence:
1. Staff #1 was observed changing three children?s diapers. Staff #1 did not use the foot pedal 2 out of 3 times to dispose of the soiled diaper. She lifted the lid of the trashcan with her hand and placed the soiled diaper inside the trash can.
2. Staff #1 was observed changing three children?s diapers. Staff #1 sprayed the surface with the bleach spray disinfectant, and immediately wiped it off of the surface. She did not first clean the surface with soap and water, nor did she allow the bleach spray disinfectant to air dry.
Evidence:
1. Staff #1 was observed changing three children?s diapers. Staff #1 did not use the foot pedal 2 out of 3 times to dispose of the soiled diaper. She lifted the lid of the trashcan with her hand and placed the soiled diaper inside the trash can.
2. Staff #1 was observed changing three children?s diapers. Staff #1 sprayed the surface with the bleach spray disinfectant, and immediately wiped it off of the surface. She did not first clean the surface with soap and water, nor did she allow the bleach spray disinfectant to air dry.
Plan of Correction: Staff were retrained. Please see attached training signed by Staff #1.
Standard 8VAC20-780-510-L
Based on observation, the center failed to ensure that all prescription medication was kept in a locked location.
Evidence:
In Classroom #1 there was a jar of prescription diaper ointment, Triamcinolone Cream, in an open storage container on the shelf with the rest of the diaper ointments. The container was not in a locked location.
Evidence:
In Classroom #1 there was a jar of prescription diaper ointment, Triamcinolone Cream, in an open storage container on the shelf with the rest of the diaper ointments. The container was not in a locked location.
Plan of Correction: Medication was sent home with the parent.
Standard 8VAC20-780-510-P
Based on review of medication, the center failed to ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization.
Evidence:
In Classroom #1 on 12/16/2022, Child #1 had a prescription diaper ointment (Triamcinolone Cream). The medication authorization form signed by the parent dated 05/09/2022 was only current for 10 business days and expired on 05/23/2022. A new medication authorization form had not been completed.
Evidence:
In Classroom #1 on 12/16/2022, Child #1 had a prescription diaper ointment (Triamcinolone Cream). The medication authorization form signed by the parent dated 05/09/2022 was only current for 10 business days and expired on 05/23/2022. A new medication authorization form had not been completed.
Plan of Correction: Medication sent home with the parent.