Inspection · 2023-08-09
Date
2023-08-09
Complaint Related
No
Licensing Inspector
Nicole Scott
(804) 588-2372
(804) 588-2372
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 LICENSE PROCESS
8VAC20-820 HEARING PROCEDURES
8VAC20-770 BACKGROUND CHECKS
20 ACCESS TO MINOR?S RECORDS
22.1 BACKGROUND CHECKS, CODE, CARBON MONOXIDE
63.2 CHILD ABUSE AND NEGLECT
Inspector Notes
An unannounced renewal inspection was initiated and completed on 8/9/2023. The inspector was on site from 10:30am until 1:00pm.
There were 24 children, ages 3 months to 5years old under the supervision of six staff. Children were observed during indoor free play, outdoor play, lunchtime and nap time. Three children's records, one medical record and three 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 issued to the program.
If you have any questions about this inspection, please contact
Nicole Scott, Licensing Inspector
Phone-804.588.2372
Email- nicole.scott@doe.virginia.gov.
Violations
7Standard 22.1-289.035-B-4
Based on record review, the center failed to obtain a copy of a criminal record check and a child abuse and neglect registry check from any state in which the individual has resided in the preceding five years.
Evidence:
1.The record for Staff 2 contained documentation that Staff 2 has resided outside of the state within the preceding five years. There was not a child abuse and neglect search registry check from the state in which Staff 2 resided within the preceding five years available for review.
2.The record for Staff 2 contained documentation that Staff 2 has resided outside of the state within the preceding five years. There was not a Out of state Sex Offender Registry completed for each state an individual has resided in the past 5 years.
Evidence:
1.The record for Staff 2 contained documentation that Staff 2 has resided outside of the state within the preceding five years. There was not a child abuse and neglect search registry check from the state in which Staff 2 resided within the preceding five years available for review.
2.The record for Staff 2 contained documentation that Staff 2 has resided outside of the state within the preceding five years. There was not a Out of state Sex Offender Registry completed for each state an individual has resided in the past 5 years.
Plan of Correction: Staff CRS out state was sent on 5-15 and has been followed up on each month and will continue until the record comes back. ( These e-mails were at our HR office and has now put in the staff file)
Standard 8VAC20-780-200-A
Based on observation and interview, the center failed to ensure the center shall have a qualified program director or a qualified back-up program director who meets one of the director qualifications who shall regularly be on the site at least 50% of the center?s hours of operation.
Evidence:
Staff #4 stated the current Director has been out since June on leave and the employees have been in charge of running the center. Staff stated they have access to the previous Director if need be by phone. Also stated there is no specific person in charge.
Staff #5 stated the staff have been running the center since current Director has been out. If they need access to someone they can all the previous Director for help. Stated the previous Director only comes by ?if? once a week to the location and sometimes not even that.
Evidence:
Staff #4 stated the current Director has been out since June on leave and the employees have been in charge of running the center. Staff stated they have access to the previous Director if need be by phone. Also stated there is no specific person in charge.
Staff #5 stated the staff have been running the center since current Director has been out. If they need access to someone they can all the previous Director for help. Stated the previous Director only comes by ?if? once a week to the location and sometimes not even that.
Plan of Correction: The PD has been on vacation, and we did have someone in charge and the Director from another location has been there several times weekly. The Director will return September 5th.
Standard 8VAC20-780-260-A
Based on observation, the center failed to provide an annual fire inspection report.
Evidence: Upon review of annual reports, the last inspection on record was dated for 6/8/2022.
Evidence: Upon review of annual reports, the last inspection on record was dated for 6/8/2022.
Plan of Correction: This has been done, due to PD out they did not knw where it was. We will ensure a copy gets in their licensing book.
Standard 8VAC20-780-270-A
REPEAT VIOLATION
Based on observation, the center failed to maintain areas and equipment of the center in a clean, safe operable condition.
Evidence:
1.The wooden boarder on the playground has split apart at the corner causing a three-inch gap. This causes an entrapment hazard for children. Children were observed playing in this area.
2. In the afterschool room the cabinet door under the sink is broken on one side. The wood is splintered and jagged. This is a snagging hazard to children.
Based on observation, the center failed to maintain areas and equipment of the center in a clean, safe operable condition.
Evidence:
1.The wooden boarder on the playground has split apart at the corner causing a three-inch gap. This causes an entrapment hazard for children. Children were observed playing in this area.
2. In the afterschool room the cabinet door under the sink is broken on one side. The wood is splintered and jagged. This is a snagging hazard to children.
Plan of Correction: These items have been reported for maintenance and will be complete by 8/28/2023.
Standard 8VAC20-780-330-B
Based on observation, the center failed to ensure that all climbable playground equipment had the required resilient surfacing.
Evidence: Observed non-measurable amount of resilient surfacing under the required fall
zone. The required amount is 6 inches of resilient surfacing.
Evidence: Observed non-measurable amount of resilient surfacing under the required fall
zone. The required amount is 6 inches of resilient surfacing.
Plan of Correction: Will contact maintenance and schedule mulch to be added by 8/28/2023.
Standard 8VAC20-780-510-P
Based on medication review, the center failed to notify the parent of expired medication for pick-up within 14 days or the parent to renew the authorization .
Evidence: Child #4 had medication authorization that expired on 07/30/2023 on site during the inspection on 08/09/2023
Evidence: Child #4 had medication authorization that expired on 07/30/2023 on site during the inspection on 08/09/2023
Plan of Correction: The PD will ensure that all expired medication is sent home.
Standard 8VAC20-780-60-A
Based record review, the center failed to ensure that the separate record for each enrolled child shall contain name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached.
Evidence:
1.Child #1 had no address for emergency contacts on record.
2.Child #2 had no address for emergency contacts on record.
Evidence:
1.Child #1 had no address for emergency contacts on record.
2.Child #2 had no address for emergency contacts on record.
Plan of Correction: The PD will get the information from the parents nd put in the file. PD will ensure that this is completed before a family starts 8/21/2023.