Inspection · 2024-04-01
Date
2024-04-01
Complaint Related
No
Licensing Inspector
Sydney Emory
(804) 807-3277
(804) 807-3277
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
8VAC20-800 Administration
8VAC20-800 Personnel
8VAC20-800 Household Members
8VAC20-800 Physical Health of Caregivers and Household members
8VAC20-800 Caregiver Training
8VAC20-800 Physical Equipment and Environment
8VAC20-800 Care of Children
8VAC20-800 Preventing the Spread of Disease
8VAC20-800 Medication Administration
8VAC20-800 Emergencies
8VAC20-800 Nutrition
8VAC20-820 THE LICENSE
8VAC20-770 Background Checks
Inspector Notes
An unannounced monitoring inspection was initiated on 04/01/2024 (12:15 pm) and completed on 04/01/2024 at 1:50pm. At the time of entrance there were 9 children in care with 4 caregivers. The provider arrived at 12:23 pm with a 10th child. The children in care counted for a total of 20 points.
Children were observed playing games in the child care room, working on arts & crafts in the dining room and napping. Records were reviewed for 9 children and 5 caregivers.
Information gathered during the inspection determined non-compliance with applicable standards and violations were documented on the violation notice issued to the FDH. These violations were reviewed with the provider at the conclusion of the inspection.
Violations
8Standard 8VAC20-800-100-A
Based on record review and interview, the provider failed to obtain, for children in care, documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance.
Evidence:
1. Child 4, enrollment date 01/03/2023, lacks documentation of a physical exam.
2. Child 7, enrollment date 01/03/2023, lacks documentation of a physical exam.
2. The provider verified that a physical exam was not on file for child 4 and child 7.
Evidence:
1. Child 4, enrollment date 01/03/2023, lacks documentation of a physical exam.
2. Child 7, enrollment date 01/03/2023, lacks documentation of a physical exam.
2. The provider verified that a physical exam was not on file for child 4 and child 7.
Plan of Correction: The provider stated that each parent will be asked to provide documentation of a physical exam.
Standard 8VAC20-800-240-A
Based on observation, the provider failed to ensure that areas of the home shall be maintained in a safe condition.
Evidence:
1. Approximately 8 dangling cords were observed in the area beside the dining room table.
a. These cords were accessible to the children in care who were observed in the dining room area during the inspection.
Evidence:
1. Approximately 8 dangling cords were observed in the area beside the dining room table.
a. These cords were accessible to the children in care who were observed in the dining room area during the inspection.
Plan of Correction: The dangling cords were put away during the inspection.
Standard 8VAC20-800-70-A
Based on record review, the provider failed to ensure that parents shall be provided with the written parent agreement.
Evidence:
1. The enrollment record for child 1 and child 2 lacked a complete parent agreement.
2. The provider confirmed that a written parent agreement was not on file for child 1 and child 2.
Evidence:
1. The enrollment record for child 1 and child 2 lacked a complete parent agreement.
2. The provider confirmed that a written parent agreement was not on file for child 1 and child 2.
Plan of Correction: The provider stated that the written parent agreement will be provided to the parent of child 1 and child 2.
Standard 8VAC20-800-780-B
Based on record review, the provider failed to ensure that annually children's records will be reviewed with the parent to ensure that emergency contact information is correct and obtain the parent's signed acknowledgment of the review.
Evidence:
1. The following children's records lacked documentation of annual review by the parent:
a. The enrollment record for child 7 was last reviewed by the parent on 01/03/2023;
b. The enrollment record for child 4 was last reviewed by the parent on 01/03/2023;
c. The enrollment record for child 5 was last reviewed by the parent on 12/2019;
d. The enrollment record for child 6 was last reviewed by the parent on 01/04/2021.
2. The provider confirmed that the above records had not been reviewed annually by each parent.
Evidence:
1. The following children's records lacked documentation of annual review by the parent:
a. The enrollment record for child 7 was last reviewed by the parent on 01/03/2023;
b. The enrollment record for child 4 was last reviewed by the parent on 01/03/2023;
c. The enrollment record for child 5 was last reviewed by the parent on 12/2019;
d. The enrollment record for child 6 was last reviewed by the parent on 01/04/2021.
2. The provider confirmed that the above records had not been reviewed annually by each parent.
Plan of Correction: The provider stated the each parent will be asked to review and update children's records as needed.
Standard 8VAC20-800-790
Based on observation, the provider failed to ensure that the telephone number for the responsible person for emergency backup care shall be posted in a visible area close to the telephone.
Evidence:
1. The telephone number for the provider's emergency backup caregiver was not posted.
a. The provider confirmed that this information was not posted.
Evidence:
1. The telephone number for the provider's emergency backup caregiver was not posted.
a. The provider confirmed that this information was not posted.
Plan of Correction: The provider stated the the phone number and name of emergency back-up caregiver will be posted.
Standard 8VAC20-800-830-B
Based on record review and interview, the provider failed to ensure that shelter-in-place procedures shall be practiced a minimum of twice per year.
Evidence:
1. The written emergency log for the FDH indicated that only one shelter-in-place practice drill had been conducted.
2. The provider confirmed that a second shelter drill had not been conducted.
Evidence:
1. The written emergency log for the FDH indicated that only one shelter-in-place practice drill had been conducted.
2. The provider confirmed that a second shelter drill had not been conducted.
Plan of Correction: The provider stated that 2 shelter drills will be conducted in 2024.
Standard 8VAC20-800-90-C
Based on record review, the provider failed to obtain documentation of additional immunizations for children in care.
Evidence:
1. Child 5, age 8 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday.
a. The most recent immunizations on file were administered on 09/13/2016.
2. Child 6, age 5 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday.
a. The most recent immunizations on file were administered on 10/12/2020.
3. Child 3, age 20 months, lacked documentation of having received updated immunizations once every six months for children under the age of two years.
a. The most recent immunizations on file were administered on 01/23/2023.
4. The provider confirmed that updated immunization records had not been obtained for these children who were all in care during the inspection.
Evidence:
1. Child 5, age 8 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday.
a. The most recent immunizations on file were administered on 09/13/2016.
2. Child 6, age 5 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday.
a. The most recent immunizations on file were administered on 10/12/2020.
3. Child 3, age 20 months, lacked documentation of having received updated immunizations once every six months for children under the age of two years.
a. The most recent immunizations on file were administered on 01/23/2023.
4. The provider confirmed that updated immunization records had not been obtained for these children who were all in care during the inspection.
Plan of Correction: The provider stated that each parent will be asked to provided documentation of updated immunizations.
Standard 8VAC20-800-900-B
Based on observation, the provider failed to ensure that children shall not be allowed to eat or drink while lying down.
Evidence:
1. At approximately 12:20 pm child 1 and child 2 were put down for nap with a bottle of formula. Both children were observed drinking from their bottles while lying down.
2. Child 3 was placed in his crib with a sippy cup which he was drinking from while lying down in his crib.
Evidence:
1. At approximately 12:20 pm child 1 and child 2 were put down for nap with a bottle of formula. Both children were observed drinking from their bottles while lying down.
2. Child 3 was placed in his crib with a sippy cup which he was drinking from while lying down in his crib.
Plan of Correction: The provider stated that children will no longer be placed in cribs with a bottle of sippy cup.