Inspection · 2023-06-15

Based on a review of ten staff records and interview, the center did not obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which one individual had resided in the preceding five years within the required timeframe.

Evidence: 1) The record of Staff #4, employed on 06/06/22, indicated the staff had resided in a state outside of Virginia within the last five years. The record did not contain the results of a criminal history record information check, a sex offender registry check, or a search of the child abuse and neglect registry or equivalent registry from the state.

2) During interview, a member of management confirmed the required out-of-state background checks were not obtained for Staff #4.

The out-of-state criminal history record information check and the sex offender registry check are required to be obtained prior to employment. The out-of-state search for founded complaints of child abuse or neglect is required to be requested within the first 30 days of employment.

Based on a review of ten staff records and interview, the center did not ensure one staff had a completed sworn statement or affirmation prior to employment.

Evidence: 1) The record of Staff #10, employed on 02/13/23, did not contain a completed sworn statement or affirmation.

2) During interview, a member of management confirmed the center did not have a completed sworn statement or affirmation on file for Staff #10.

Based on a review of ten staff records and interview, the center did not ensure seven staff members had a central registry finding within 30 days of employment.

Evidence: 1) The central registry finding in the record of Staff #1, employed on 06/01/21, was completed on 01/19/22. The record did not contain documentation that the center followed up with the Office of Background Investigation within 30 days of employment.

2) The records of Staff #4 (DOE: 06/06/22); Staff #5 (DOE: 05/04/23); Staff #7 (DOE: 08/22/22); Staff #8 (DOE: 11/01/22); Staff #9 (DOE: 11/21/22); and Staff #10 (DOE: 02/13/23) did not contain a central registry finding within 30 days of employment. 3) During interview, a member of management confirmed the results of the central registry finding for the staff were not received. The center did not have documentation of following up with the Office of Background Investigation within 30 days of employment for Staff #5, Staff #8, Staff #9, or Staff #10.

Based on a review of ten staff records and interview, the center did not ensure seven staff members submitted documentation of a negative tuberculosis (TB) screening within the required timeframe.

Evidence: 1) The record of Staff #2, employed on 04/25/22, did not contain documentation of a negative TB screening.

2) The record of Staff #3, employed on 06/12/23, did not contain documentation of a negative TB screening.

3) The record of Staff #6, employed on 06/12/23, did not contain documentation of a negative TB screening.

4) The record of Staff #7, employed on 08/22/22, did not contain documentation of a negative TB screening.

5) The record of Staff #8, employed on 11/01/22, contained a TB screening that was completed on 11/21/22.

6) The record of Staff #9, employed on 11/21/22, did not contain documentation of a negative TB screening.

7) The record of Staff #10, employed on 02/13/23, did not contain documentation of a negative TB screening.

8) During interview, a member of management confirmed the TB screenings were not obtained within the required timeframe.

Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.

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

Evidence: 1) The most recent TB screening in the record of Staff #1, employed on 06/01/21, was completed on 05/19/21 and expired on 05/19/23.

2) During interview, a member of management confirmed the center does not have documentation of a current negative TB screening on file for Staff #1.

Based on a review of ten staff records and interview, the center did not ensure five staff completed the Virginia Department of Education-sponsored (VDOE) orientation course within 90 calendar days of employment.

Evidence: 1) The following staff records did not contain documentation that the staff completed the VDOE-sponsored orientation course - Staff #2 (DOE: 04/25/22); Staff #7 (DOE: 08/22/22); Staff #8 (DOE: 11/01/22); Staff #9 (DOE: 11/21/22); and Staff #10 (DOE: 02/13/23).

2) During interview, a member of management reported the center did not have documentation that the staff completed the VDOE-sponsored orientation course.

Based on a review of ten staff records, the center did not ensure four staff completed orientation training prior to the staff members working alone with children and no later than seven days of the date of assuming job responsibilities.

Evidence: 1) The orientation training in the record of Staff #2, employed on 04/25/22, was completed on 12/29/22.

2) The orientation training in the record of Staff #8, employed on 11/01/22, was completed on 11/11/22.

3) The orientation training in the record of Staff #9, employed on 11/21/22, was completed on 06/15/23.

4) The orientation training in the record of Staff #10, employed on 02/13/23, was completed on 02/28/23.

Based on a review of ten staff records, the center did not ensure one staff completed orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care within 30 days of the first day of employment.

Evidence: Staff #2, employed on 04/25/22, completed the first and CPR orientation training on 12/29/22.

Based on a review of ten staff records, the center did not ensure two staff completed annually a minimum of 16 hours of training appropriate to the age of children in care.

Evidence: 1) The documentation of training in the record of Staff #1, employed on 06/01/21, did not contain sufficient documentation to show the staff completed 16 hours of annual training from 06/2022-06/2023.

2) The documentation of training in the record of Staff #2, employed on 04/25/22, did not contain sufficient documentation to show the staff completed 16 hours of annual training from 04/2022-04/2023.

Based on observations, the center did not ensure hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.

Evidence: 1) In the Preppers classroom, a bottle of bleach/water solution was observed in an unlocked cabinet. 2) In the PreK-1 classroom, two bottles of cleaning materials were observed in an unlocked cabinet.

Based on observation and interview, the center did not ensure purses were not accessible to children.

Evidence: 1) In the Preschool 2 classroom, two staff purses were observed on a countertop within the reach of children. 2) In the School Age classroom, a staff purse was observed in an area that was accessible to children. 3) A member of management acknowledged the purses belonged to staff members and they should have been locked to ensure cosmetics, medications, or other harmful agents were not accessible to children.

Based on observation, the center did not ensure electrical outlets shall have protective covers that are of a size that cannot be swallowed by children.

Evidence: During the inspection of the classrooms, the inspector observed the following -

1) In the Preppers classroom, one electrical outlet did not have a protective cover.
2) In the Infant B classroom, one electrical outlet did not have a protective cover.
3) In the Toddler A classroom, two electrical outlets did not have protective covers.
4) In the Toddler B classroom, three electrical outlets did not have protective covers.
5) In the Twaddlers classroom, two electrical outlets did not have protective covers.
6) In the Preschool 1 classroom, one electrical outlet did not have a protective cover.
7) In the Preschool 2 classroom, one electrical outlet did not have a protective cover.

Based on observation, and interview, the center did not ensure the diapering area in one classroom had a nonabsorbent surface for diapering or changing.

Evidence: 1) The top portion of the diaper changing pad in the Twaddler classroom had a tear on it, therefore it is no longer non-absorbent. 2) During interview, a member of management confirmed the diaper changing pad in the Twaddler classroom is torn.

Based on a review of documentation, medication review, observation, and interview, the center did not ensure when an authorization for medication expired, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization.

Evidence: 1) A medication authorization for a long-term prescription medication was observed on 06/15/23 for Child #14. The authorization was signed on 10/11/21 and expired within six months. The medication was observed on site at the time of the inspection. 2) During interview, a member of management acknowledged the authorization has not been renewed and that the medication has not been properly disposed of.

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. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

Based on observation and interview, the center did not ensure all requirements were met when diaper ointment or cream is used.

Evidence: 1) In the Preppers classroom, a diaper ointment was observed for Child #11. 2) During interview, a member of management reported the center did not have written parent authorization noting any adverse reactions.

3) Diaper ointment and creams were observed next to the changing table in the Preppers classroom. They were accessible to children and seven of them were not labeled with the child's name.

If diaper ointment or cream is used, the following requirements shall be met: 1. Written parent authorization noting any known adverse reactions shall be obtained; 2. These products shall be in the original container and labeled with the child's name; 3. These products do not need to be kept locked but shall be inaccessible to children; 4. A record shall be kept that includes the child's name, date of use, frequency of application and any adverse reactions; and 5. Staff members without medication administration training may apply diaper ointment, unless it is prescription diaper ointment, in which case the storing and application of diaper ointment must meet medication-related requirements.

Based on observation, a review of records, and interview, the center did not ensure at least one staff in each classroom or area where children are present shall have current certification in cardiopulmonary resuscitation (CPR) and first aid as appropriate to the age of the children in care.

Evidence: 1) Staff #10, employed on 02/13/23, was the only staff member present in the Preppers classroom. 2) The record did not contain documentation that the staff has current certification in CPR and first aid. 3) During interview, a member of management confirmed Staff #10 does not have current certification in CPR and first aid.

4) Staff #3, employed on 06/12/23, and Staff #8, employed on 11/01/22, were the only staff members present in the Preschool 2 classroom. 5) Their records did not contain documentation that the staff have current certification in CPR and first aid. 6) During interview, a member of management confirmed the staff do not have current certification in CPR and first aid.

Based on a review of documentation and interview, the center did not ensure shelter-in-place procedures shall be practiced a minimum of twice per year.

Evidence: 1) The center's emergency drill log for 2022 was reviewed. The most recent shelter-in-place procedures were practiced on 07/29/22. 2) During interview, a member of management reported the shelter-in-place procedures were not practiced a second time in 2022.

Based on a review of documentation and interview, the center did not maintain documentation of an emergency evacuation drill that included the required components.

Evidence: 1) The emergency evacuation drill noted for May 23, 2023, only included the date, and time of the drill, and the number of staff and children participating.

Documentation should include: 1. Identity of the person conducting the drill; 2. The date and time of the drill; 3. The method used for notification of the drill; 4. The number of staff participating; 5. The number of children participating; 6. Any special conditions simulated; 7. The time it took to complete the drill; 8. Problems encountered, if any; and 9. For emergency evacuation drills only, weather conditions.

2) During interview, a member of management confirmed the evacuation drill was not documented with the required information.

Based on a review of documentation,, the center did not ensure that written injury records contained the required information.

Evidence: Three written injury records were reviewed. The following documentation was missing - Injury record #1 did not contain documentation of the date and time when parents were notified; any future action to prevent reoccurrence of the injury; and documentation on how parent was notified.

The center should maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include the following: date and time of injury; name of injured child; type and circumstance of the injury; staff present and treatment; date and time when parents were notified; any future action to prevent reoccurrence of the injury; staff and parent signatures or two staff signatures; and documentation on how parent was notified.

Based on a review of ten staff records and interview, the center did not ensure two staff records contained the required information.

Evidence: 1) During interview, Staff #2 was identified as a program leader, but the staff record did not contain documentation that the staff possesses the education, certification, and experience required by the job position.

2) During interview, Staff #8 was identified as a program leader, but the staff record did not contain documentation that the staff possesses the education, certification, and experience required by the job position.