Inspection · 2022-07-06

Based on record review, the center did not ensure to obtain fingerprint-based criminal history check determination letter prior to first day of employment for one staff person.
Evidence:
1) The record for Staff #4 (hire date 03/21/2022) had a fingerprint-based criminal history check determination letter dated 03/30/2022.

Based on record review, it was determined that the provider did not ensure that Central Registry search results were obtained by the end of the 30th day of employment.
Evidence:
1) On the date of inspection, the record for Staff #4 (hire date 03/21/2022) did not contain the results of a Central Registry search request. The provider stated that a search request was sent but the record did not contain documentation that a Central Registry search had been requested and no follow up was documented in the record.

Based on record review, the provider did not obtain from each caregiver at the time of hire prior to coming into contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.
Evidence:
1) The Report of Tuberculosis Screening in the record for Staff #4 (hire date 03/21/2022) was dated 05/13/2022.

Based on record review, one caregiver did not obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities.
Evidence:
1) The record for Staff #2 documented 11.5 hours of training for the 2021 year.

Based on observation, areas and furnishings of the family day home, outside, were not maintained in a clean, safe, and operable condition.
Evidence:
1) In the backyard area, there was a gate with a broken latch so it did not lock. This gate separates the play area from a storage area with plants and gardening tools.
2) In the backyard area, there was a container of activated charcoal and a package of citronella candles on a table. The table was accessible to children.

Based on observation, potentially poisonous substances were not stored away in areas inaccessible to children.
Evidence:
1) The inspector observed a bottle of bleach, a bottle of mouthwash and a bottle of pills (medication) inside of a room that serves as storage and laundry room. The door to this area was not locked, making accessible to the children in care.

Based on observation, unused electrical outlets accessible to children under five years of age did not have child-resistant protective covers.
Evidence:
1) In the "nap room", the inspector observed two electrical outlets that were not in use and did not have protective covers. These outlets were located at a lower area of the wall within reach of children.

Based on observation, trampolines were used during the hours children are in care.
Evidence:
1) A Little Tikes trampoline was observed in the backyard area. Children had access to the trampoline and were allowed to use it.

Based on record review, children's records did not contain all required information.
Evidence:
1) The records for Child #2, Child #3 and Child #4 did not contain telephone number of each custodial parent's place of employment.

Based on observation, caregivers did not wash their hands when required.
Evidence:
1) On the date of inspection, the inspector observed Staff # 3 diapering a child. After Staff #3 finished changing the child's diaper, they placed the child on a high chair and continued with other chores without washing their hands first.

Based on observation, caregivers did not ensure that children's hands are washed with liquid soap and warm running water when required.
Evidence:
1) On the date of inspection, Staff #3 changed Child #5's diaper. After Staff #3 was finished, they placed Child #5 on a high chair without washing the child's hands first.
2) Staff instructed the children to sit down at the tables to get ready for snack. Staff served snack and children ate it without washing hands first.

Based on observation, the diapering area was not cleaned and sanitized after each use.
Evidence:
1) After changing Child's #5 diaper and returning the child to their chair, Staff #3 went on to do other chores and did not come back to clean and sanitize the diapering area.

Based on observation, medication was not kept in a locked place using a safe locking method that prevents access by children.
Evidence:
1) On the date of inspection, 2 prescription medication and 1 over the counter medication were observed being stored on a wire shelf on the care area. Although the medication was out of reach of children, it was not locked as required.

Based on observation, record review and interview with the provider, the requirements for the use of topical skin products were not met.

1) On the date of inspection, the inspector observed various containers of diaper cream and a bottle of "diaper spray" in the diapering area; and various sunscreen containers of sunscreen in the entrance area. 2) Written parent authorization for the use of these products was not available for review in the children's records. 3) The provider stated that they did not have authorization forms for these skin products.

Based on observation, children were allowed to eat while walking.
Evidence:
1) On the date of inspection, the inspector observed that Child #6 and Child #7 were eating crackers while walking around the care area.

Based on observation, interview with the provider and documentation review, requirements for the menu for the current one-week period when meals or snacks are provided by the family day home were not met.
Evidence:
1) The inspector observed some children eating pancakes and "fruit salad" (watermelon, banana pieces, mango, strawberries, cut grapes). The provider stated that they were eating breakfast. Later, the children were asked to sit down to eat snack. They served the children "fruit salad".
2) The menu listed the breakfast for the day as: cheddar cheese, croissants, bananas, milk. The substitutions were not listed on the menu. A morning snack is not contemplated on the menu.