Inspection · 2023-04-12

Based on a review of four staff records and interview, the center did not ensure two staff had the satisfactory results of the fingerprint-based national criminal background check prior to employment.

Evidence: 1) The fingerprint-based national criminal background check in the record of Staff #1, employed on 11/12/22, was dated 01/04/23.

2) The record of Staff #3, employed on 02/01/23, did not contain the results of the fingerprint-based national criminal background check requested by the current employer.

3) During interview, a member of management confirmed the fingerprint-based national criminal background check for Staff #1 and Staff #3 were not obtained at the time of employment.

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

Evidence: 1) The record of Staff #3, employed on 02/01/23, indicated the staff had resided in another state outside of Virginia within the last five years. The record did not contain a sex offender registry check or a search of the child abuse and neglect registry. The out-of-state sex offender registry check is 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. An out-of-state criminal history record information check was not required because the state participates in the National Fingerprint File (NFF) program through the FBI.

2) During interview, a member of management confirmed the required out-of-state checks were not obtained for Staff #3 within the required timeframe.

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

Evidence: 1) The sworn statement in the record of Staff #1, employed on 11/12/22, was not signed. 2) During interview, a member of management confirmed the sworn statement for Staff #1 was not complete at the time of employment.

Based on a review of four staff records and interview on 04/25/23, the center did not ensure two 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 11/12/22, was dated 01/07/23. 2) During interview, a member of management confirmed the results of the central registry for Staff #1 were received more than 30 days after employment. The record did not contain documentation of any further contact with the Office of Background Investigations, and the staff member had been continuously employed.

3) The record of Staff #4, employed on 03/13/23, did not have a central registry finding. 4) During interview, a member of management confirmed the results of the central registry for Staff #4 had not been received to date. The record did not contain documentation of any further contact with the Office of Background Investigations, and the staff member had been continuously employed.

Based on a review of five children's records and interview, the center did not obtain documentation that one child had received the immunizations required by the State Board of Health before the child attended the center.

Evidence: 1) The immunization documentation in the record of Child #2, date of attendance 02/27/23, was dated 02/28/23. 2) During interview, a member of management confirmed the center did not obtain documentation of the child's immunizations before the child attended the center.

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

Evidence: 1) The most recent tuberculosis (TB) screening in the record of Staff #1, employed on 11/12/22, was dated 02/19/21 and expired on 02/19/23.

2) The most recent TB screening in the record of Staff #2, employed on 12/17/22, was dated 08/31/21.

3) The record of Staff #3, employed on 02/01/23, did not contain documentation of a negative tuberculosis screening.

4) The TB screening in the record of Staff #4, employed on 03/13/23, was dated 03/22/23.

5) During interview, a member of management confirmed Staff #1, Staff #2, Staff #3, and Staff #4 did not submit documentation of a negative tuberculosis screening within the required timeframe.

Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children; and 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 records, observation, and interview, the center did not ensure that there shall be at least one staff member with current certification in cardiopulmonary resuscitation (CPR) and current certification in first aid where children are present.

Evidence: 1) On 4/12/23, Staff #5 was observed providing transportation to four children that attend the program from another school. Staff #5 was the only staff member present during transportation. 2) The First Aid and CPR certificate in the record of Staff #5 expired on 11/14/22. 3) During interview, a member of management confirmed the CPR and First Aid certification of Staff #5 was expired.

Based on a review of documentation and interview, the center did not implement a monthly practice evacuation drill.

Evidence: 1) The licensing inspector observed the emergency drill log for the year 2022. An evacuation drill was not conducted for January, March, or May 2022. 2) During interview, management reported the documentation of the drills could not be located and was not able to determine if the drills were conducted.

The center shall implement a monthly practice evacuation drill.

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

Evidence: 1) The licensing inspector observed the emergency drill log for the year 2022. There was no documentation that shelter-in-place drills were practiced. 2) During interview, management reported the documentation of the drills could not be located and was not able to determine if the drills were conducted.

Shelter-in-place procedures shall be practiced a minimum of twice per year.

Based on a review of documentation and interview, the center did not practice lockdown procedures at least annually.

Evidence: 1) The licensing inspector observed the emergency drill log for the year 2022. There was no documentation that a lockdown drill was practiced. 2) During interview, management reported the documentation of the drills could not be located and was not able to determine if a lockdown drill was conducted.

Lockdown procedures shall be practiced at least annually.

Based on a review of documentation on 04/12/2023, the center did not ensure that written injury records contained the required information.

Evidence: Three out of three written injury records reviewed did not contain the date and time parents were notified of the injuries.

The center shall 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 five children's records and interview, the center did not ensure one child's record contained the required information.

Evidence: 1) The record of Child #2, enrolled on 02/27/23, did not contain documentation of two emergency contacts. 2) During interview, a member of management confirmed the center did not have documentation of two emergency contacts for Child #2.

Each child record shall contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached.

Based on staff interview and observations on 04/12/23, the center did not ensure that the required information for each staff was kept at the center.

Evidence: 1) Staff #1, Staff #2, Staff #4, Staff #5, and Staff #6 were observed at the center on 04/12/23. 2) Staff interviewed stated that an emergency contact and information about any health problems staff have were not available for review at the center.

The center should maintain at the center the name, address, and telephone number of a person to be notified in an emergency and information about any health problems that may interfere with fulfilling the job responsibilities for each staff member.