Inspection · 2022-01-24
Date
2022-01-24
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.
8VAC20-770 Background Checks (8VAC20-770)
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
Inspector Notes
An unannounced monitoring inspection was conducted on July 20, 2022 from 2:30 p.m. to 5:15 p.m. There were 86 children present, ranging in ages from 6 weeks to 12 years with 21 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 8 child records and 8 staff records were reviewed.
Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program.
If you have any questions or concerns, please contact the Licensing Inspector at (804) 629-3923
Violations
22Standard 22.1-289.035-B-2
Based on review of records and interviews, the center failed to ensure fingerprints were completed and on file before the first day of employment.
Evidence:
1. Staff #4?s date of hire was 06/26/2022. There was no documentation on file that the National Fingerprint Criminal Background check had been completed. Staff #4 was observed working in Classroom #4.
2. Staff #9 verified the date of employment for all staff, and that there was no documentation that the fingerprints had been completed.
Evidence:
1. Staff #4?s date of hire was 06/26/2022. There was no documentation on file that the National Fingerprint Criminal Background check had been completed. Staff #4 was observed working in Classroom #4.
2. Staff #9 verified the date of employment for all staff, and that there was no documentation that the fingerprints had been completed.
Plan of Correction: Administration will information staff of documentation needed for fingerprint criminal background check and ensure all staff will have prior to employment.
Standard 8VAC20-770-40-D-6
The center failed to ensure that all criminal history background checks were dated no more than 90 days prior to the date of employment.
Evidence:
1. Staff # 3?s date of employment is 6/22/2022. The criminal history background check was completed on 1/24/2022.
2. Staff # 8?s date of employment is 3/4/2019. The criminal history background check was completed on 10/17/2018.
Evidence:
1. Staff # 3?s date of employment is 6/22/2022. The criminal history background check was completed on 1/24/2022.
2. Staff # 8?s date of employment is 3/4/2019. The criminal history background check was completed on 10/17/2018.
Plan of Correction: Administration will ensure that background checks will not be completed more than 90 prior to employment.
Standard 8VAC20-780-130-A
The center failed to obtain documentation that each child received the immunizations required by the State Board of Health before the child?s first day of attendance.
Evidence
1. Child #2 did not have an immunization record on file. The child?s first day of attendance was 7/13/2022.
2. Child #4 did not have an immunization record on file. The child?s first day of attendance was 6/22/2022.
3. Child #5 had an immunization record on file dated 5/15/2022. The child?s first day of attendance was 5/9/2022.
Evidence
1. Child #2 did not have an immunization record on file. The child?s first day of attendance was 7/13/2022.
2. Child #4 did not have an immunization record on file. The child?s first day of attendance was 6/22/2022.
3. Child #5 had an immunization record on file dated 5/15/2022. The child?s first day of attendance was 5/9/2022.
Plan of Correction: Notice was on bulletin board that staff covered. Director will ensure that it is visible.
Standard 8VAC20-780-140-A
The center failed to ensure that each child had a physical examination before the child?s first day or within 30 days after the first day of of attendance
Evidence
1. Child #2 did not have a physical examination on file. The child?s first day of attendance was 5/13/2022.
Evidence
1. Child #2 did not have a physical examination on file. The child?s first day of attendance was 5/13/2022.
Plan of Correction: Administration will make sure each child has physical examination within 30 days of first day of attendance.
Standard 8VAC20-780-160-A
Based on review of records and interviews, the center failed to ensure that each staff member had submitted documentation of a negative Tuberculosis (TB) screening prior to coming in contact with children.
Evidence
1. Staff #4 did not have documentation of a negative TB screen on file. Staff #4?s hire date is 6/26/2022. Staff #4 was observed working in Classroom #4. Staff #9 confirmed that Staff #4 did not have documentation of a negative TB screen on file.
2. Staff #1?s hire date was 4/25/2022. The TB screening on file for Staff #1 is dated 5/2/2022
Evidence
1. Staff #4 did not have documentation of a negative TB screen on file. Staff #4?s hire date is 6/26/2022. Staff #4 was observed working in Classroom #4. Staff #9 confirmed that Staff #4 did not have documentation of a negative TB screen on file.
2. Staff #1?s hire date was 4/25/2022. The TB screening on file for Staff #1 is dated 5/2/2022
Plan of Correction: Administration will have TB screening prior to coming in contact with children. TB was scheduled prior but the Health Dept. rescheduled.
Standard 8VAC20-780-160-C
The center failed to ensure that each staff record had documentation of a negative Tuberculosis (TB) screening at least every two years from the date of the previous screening.
Evidence:
1. Staff #2?s previous TB screening is dated 8/25/2019. A new TB screening was required by 08/25/2021.
2. Staff #9 confirmed that Staff #2 had not had an updated TB Screening.
Evidence:
1. Staff #2?s previous TB screening is dated 8/25/2019. A new TB screening was required by 08/25/2021.
2. Staff #9 confirmed that Staff #2 had not had an updated TB Screening.
Plan of Correction: TB was scheduled
Health Dept. rescheduled.
Administration will have TB updated every 2 years.
Health Dept. rescheduled.
Administration will have TB updated every 2 years.
Standard 8VAC20-780-260-A
Based on interview, the center failed to provide an annual fire inspection report.
Evidence:
1. The last fire inspection on record is dated 11/20/2019.
2. Staff #9 confirmed that a fire inspection had not occurred within the last year.
Evidence:
1. The last fire inspection on record is dated 11/20/2019.
2. Staff #9 confirmed that a fire inspection had not occurred within the last year.
Plan of Correction: Documentation on file each time Director call or emailed Fire Marshall.
Standard 8VAC20-780-260-B
Based on interview, the center failed to provide an annual health inspection report.
Evidence:
1. The last health inspection is dated 4/29/2019.
2. Staff #9 confirmed that a health inspection had not occurred within the last year.
Evidence:
1. The last health inspection is dated 4/29/2019.
2. Staff #9 confirmed that a health inspection had not occurred within the last year.
Plan of Correction: Documentation on file each time Director spoke to Health Dept. Inspection completed on 7/27/22.
Standard 8VAC20-780-260-C
Based on observation the notice regarding the presence and location of asbestos containing materials was not posted.
Evidence:
1. There was not a notice posted regarding the presence and location of asbestos in the building
Evidence:
1. There was not a notice posted regarding the presence and location of asbestos in the building
Plan of Correction: Notice was on bulletin board that staff covered with ocean activity. Director will ensure that staff doesn't cover notice.
Standard 8VAC20-780-270-A
Based on observation, the center failed to ensure that the areas and equipment of the center are maintained in a clean, safe and operable condition.
Evidence:
1. In Classroom #1 the tile flooring was loose and peeling.
2. Loose Baseboards were observed in Classroom #5.
3. Peeling paint was observed in Classroom #5, #7 and #8.
4. Missing outlet plate was observed in Classroom #5
5. Floors in Classroom #5 were dirty and had food and trash on the floor.
6. Splintering wood was observed on the half door in Classroom #7.
7. On the toddler playground there was a bucket of stagnant water under a chair accessible to children.
8. On the playground there were two roundabout trikes (yellow and blue), the green airplane, and the teeter totter with peeling paint and rust.
9. The chains of the swings on the playground were rusted.
10. The fence around the playground was unstable and the top railing was unattached in many places.
11. On the playground there was splintering wood on the boards over the fence.
12. On the playground there was a metal pole with rusty bolts eye level to the children.
Evidence:
1. In Classroom #1 the tile flooring was loose and peeling.
2. Loose Baseboards were observed in Classroom #5.
3. Peeling paint was observed in Classroom #5, #7 and #8.
4. Missing outlet plate was observed in Classroom #5
5. Floors in Classroom #5 were dirty and had food and trash on the floor.
6. Splintering wood was observed on the half door in Classroom #7.
7. On the toddler playground there was a bucket of stagnant water under a chair accessible to children.
8. On the playground there were two roundabout trikes (yellow and blue), the green airplane, and the teeter totter with peeling paint and rust.
9. The chains of the swings on the playground were rusted.
10. The fence around the playground was unstable and the top railing was unattached in many places.
11. On the playground there was splintering wood on the boards over the fence.
12. On the playground there was a metal pole with rusty bolts eye level to the children.
Plan of Correction: Staff was provided blank work orders to fill out when equipment needs repaired. Staff will be reminding that rooms hot be cleaned daily.
#2, #4, #5, #7, #8, #10, #9 were repaired on 7/21/22.
floors, walls, metal poles are being repaired.
Administration will do daily inspections.
#2, #4, #5, #7, #8, #10, #9 were repaired on 7/21/22.
floors, walls, metal poles are being repaired.
Administration will do daily inspections.
Standard 8VAC20-780-280-B
Based on observations and interviews, the center failed to ensure that all hazardous substances were kept in a locked place.
Evidence:
The following was observed
1. In Classroom #1 there were Clorox wipes on the counter and the wall half, and all purpose cleaner and Great Value window cleaner on the sink. Staff #5 confirmed that these items were not in a locked place.
2. In Classroom #4 there was Allene?s Gloss Finish spray in a drawer; Great Value disinfecting spray on the counter; Great Value disinfecting spray on a desk; an opened utility closet which contained bleach, Fabuloso floor cleaner, and Pinesol; unlocked lockers which contained 3 bottles of toilet bowl cleaner, soap, bleach, 9 air fresheners, 2 bottles of window cleaner, all purpose cleaner and Clorox wipes. All items were accessible to children. Staff #3 and #4 confirmed that the hazardous materials were not in a locked place.
3. In classroom #6 there were Clorox Wipes, air freshener and all-purpose cleaner on a shelf (unlocked).
Evidence:
The following was observed
1. In Classroom #1 there were Clorox wipes on the counter and the wall half, and all purpose cleaner and Great Value window cleaner on the sink. Staff #5 confirmed that these items were not in a locked place.
2. In Classroom #4 there was Allene?s Gloss Finish spray in a drawer; Great Value disinfecting spray on the counter; Great Value disinfecting spray on a desk; an opened utility closet which contained bleach, Fabuloso floor cleaner, and Pinesol; unlocked lockers which contained 3 bottles of toilet bowl cleaner, soap, bleach, 9 air fresheners, 2 bottles of window cleaner, all purpose cleaner and Clorox wipes. All items were accessible to children. Staff #3 and #4 confirmed that the hazardous materials were not in a locked place.
3. In classroom #6 there were Clorox Wipes, air freshener and all-purpose cleaner on a shelf (unlocked).
Plan of Correction: Administration reminded staff all hazardous substances must be locked. Administration will inspect room daily to make sure all hazardous substances are locked.
Standard 8VAC20-780-290-A-3
Based on observation and interview, the center failed to ensure that electrical outlets in areas that are used by children of preschool or younger had protective covers.
Evidence:
1. In Classroom #1, 2 outlets were missing covers. Staff # 5 confirmed that the covers were missing.
2. In Classroom # 3, 4 outlets were missing covers.
Evidence:
1. In Classroom #1, 2 outlets were missing covers. Staff # 5 confirmed that the covers were missing.
2. In Classroom # 3, 4 outlets were missing covers.
Plan of Correction: Administration reminded all staff to keep electrical outlets cover. Director will ensure daily each evening that they are covered.
Standard 8VAC20-780-320-B
Based on observation, the center failed to ensure that each restroom was equipped with toilet paper and paper towels.
Evidence:
1. In classroom #4, the girl?s restroom did not have toilet paper in either stall.
2. In classroom #4, no paper towels available in either the boys or the girl bathroom.
Evidence:
1. In classroom #4, the girl?s restroom did not have toilet paper in either stall.
2. In classroom #4, no paper towels available in either the boys or the girl bathroom.
Plan of Correction: Director reminded staff who is responsible for this to check restrooms daily. Was filled immediately.
Standard 8VAC20-780-330-B
Based on observation, the center failed to ensure that playground equipment is provided with resilient surfacing that complies with the minimum safety standards.
Evidence:
1. The playground was observed to have minimum amounts of mulch showing bare ground around the swing set.
2. Staff # 9 confirmed that the playground did not have the required amount of mulch.
Evidence:
1. The playground was observed to have minimum amounts of mulch showing bare ground around the swing set.
2. Staff # 9 confirmed that the playground did not have the required amount of mulch.
Plan of Correction: After rain, staff will rake mulch in place. Director will ensure enough mulch is provided.
Standard 8VAC20-780-340-D
Based on observation and review of records, the center failed to ensure that each group of children had at least one staff member that met program leader qualifications.
Evidence
1. The staff in present Classroom #1 and #4 did not qualify as a program lead.
2. Administration verified that the staff present in these classrooms did not qualify as a program lead.
Evidence
1. The staff in present Classroom #1 and #4 did not qualify as a program lead.
2. Administration verified that the staff present in these classrooms did not qualify as a program lead.
Plan of Correction: Staff #5 was 4 hrs. short to qualify, bu is now qualified. Administration will ensure each room has lead regardless of staff shortage.
Standard 8VAC20-780-350-B-1
Based on observation and interview, the center failed to ensure that required staff-to-child ratios were maintained.
Evidence:
1. In Classroom # 2, there was 1 staff member and 6 infants present. The required ratio for children birth-16 months is 1:4.
2. Staff #11 confirmed that there were 6 infants present with one staff member.
Evidence:
1. In Classroom # 2, there was 1 staff member and 6 infants present. The required ratio for children birth-16 months is 1:4.
2. Staff #11 confirmed that there were 6 infants present with one staff member.
Plan of Correction: Director reminded staff not to walk children to parents unless ratio is maintained.
Standard 8VAC20-780-40-D
Based on observation and interview the center failed to ensure that the license was posted in a place conspicuous to the public.
Evidence:
1. The current license effective September 8, 2021- September 7, 2023 was not posted in a place conspicuous to the public.
2. Administration confirmed that the license was not posted in a conspicuous place.
Evidence:
1. The current license effective September 8, 2021- September 7, 2023 was not posted in a place conspicuous to the public.
2. Administration confirmed that the license was not posted in a conspicuous place.
Plan of Correction: Not available online. Contact Inspector for more information.
Standard 8VAC20-780-40-K
Based on interviews, the center failed to develop a written procedure for prevention of shaken baby syndrome or abusive head trauma and sudden infant death syndrome awareness.
Evidence:
1. Staff #9 confirmed that the center did not have written procedures for the prevention of shaken baby syndrome or abusive head trauma and sudden infant death syndrome awareness.
Evidence:
1. Staff #9 confirmed that the center did not have written procedures for the prevention of shaken baby syndrome or abusive head trauma and sudden infant death syndrome awareness.
Plan of Correction: Administration was not aware of policy. Policy was added to handbook.
Standard 8VAC20-780-450-C
Based on interview, the center failed to ensure that crib sheets are cleaned and washed daily.
Evidence:
1. Interview with Staff #10 revealed that the sheets in the infant room are washed weekly.
2. Staff #10 confirmed that crib sheets are not cleaned and washed daily.
Evidence:
1. Interview with Staff #10 revealed that the sheets in the infant room are washed weekly.
2. Staff #10 confirmed that crib sheets are not cleaned and washed daily.
Plan of Correction: Staff was reminded that sheets must be changed daily.
Standard 8VAC20-780-530-A-1
Based on review of records and interviews, the center failed to ensure that each classroom had at least one staff member with current First Aid certification.
Evidence:
1. Classroom #4 did not have a staff member in the classroom that was First Aid Certified.
2. Staff #9 confirmed that there was not a staff member in that classrooms that had current First Aid Certification.
Evidence:
1. Classroom #4 did not have a staff member in the classroom that was First Aid Certified.
2. Staff #9 confirmed that there was not a staff member in that classrooms that had current First Aid Certification.
Plan of Correction: 4 staff members quit on 7/15/22. First aid/CPR was already scheduled for 8/8/2022. Soonest Director could schedule.
Standard 8VAC20-780-560-G
Based on observation and interview, the center failed to ensure that food brought from home was clearly dated and labeled in a way that identifies the owner.
Evidence:
1. In Classroom #1 a bottle of milk was observed in the fridge with neither a date nor name. Staff # 5 confirmed that the bottle had no name or date.
2. In Classroom #5 there were 2 lunchboxes without names and dates and 2 additional lunch boxes without dates.
Evidence:
1. In Classroom #1 a bottle of milk was observed in the fridge with neither a date nor name. Staff # 5 confirmed that the bottle had no name or date.
2. In Classroom #5 there were 2 lunchboxes without names and dates and 2 additional lunch boxes without dates.
Plan of Correction: Administration reminded staff that food brought from home must be labeled and dated. Administration send a note home asking parents to label and date.
Standard 8VAC20-820-120-E-2
Based on observation, the center failed to post the findings of the most recent inspection of the facility.
Evidence:
1. The most recent inspection of the facility was the renewal inspection that concluded on 10/12/2021.
2. The inspection findings were not posted.
Evidence:
1. The most recent inspection of the facility was the renewal inspection that concluded on 10/12/2021.
2. The inspection findings were not posted.
Plan of Correction: Notice was on bulletin board that staff covered with ocean theme. Director will ensure staff doesn't cover notice.