Inspection · 2025-07-18
Date
2025-07-18
Complaint Related
No
Licensing Inspector
Brandie Viscayda
(757) 636-3427
(757) 636-3427
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
8VAC20-770 Background Checks (8VAC20-770)
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced, on-site renewal inspection was initiated on July 18, 2025 and completed on July 18, 2025. The on-site inspection began at 10:20am and ended at 1:16pm. The inspector reviewed compliance in the areas listed above. There were 34 children present and 5 staff. The inspector reviewed 5 children?s records and 5 staff records on-site. This inspection included document review, tour of the facility, interviews, observations. 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. Please complete the plan of correction (POC) and date to be corrected sections for each violation cited on the violation notice. Specify how the violation will be or has been corrected. Submit your POC within five (5) business days from today, which will be the close of business on (8/21/2025). A POC submitted after this date will not appear on the public website.
Violations
10Standard 22.1-289.035-B-3
REPEAT VIOLATION
The center must request a search of the central registry prior to the employee's first day of employment. Staff #2 who has been employed for approximately two months had a central registry request after employment.
The center must request a search of the central registry prior to the employee's first day of employment. Staff #2 who has been employed for approximately two months had a central registry request after employment.
Plan of Correction: Staff #2 central registry has been submitted and proof of submission will be placed in our personnel files. Effective immediately, no staff will be permitted to begin employment until the central registry has been submitted.
Standard 8VAC20-770-70-A
REPEAT VIOLATION
Documentation of at least two references to character, reputation, and competency are to be checked prior to employment. Staff #1 and Staff #2, who have been actively working at the center for at least two months, did not have any completed reference verifications on file.
Documentation of at least two references to character, reputation, and competency are to be checked prior to employment. Staff #1 and Staff #2, who have been actively working at the center for at least two months, did not have any completed reference verifications on file.
Plan of Correction: References for staff #1 and Staff #2 have been contacted and documentation will placed in a personal file within 5 business days. Effective immediately no employee will be permitted to start work until two reference checks are documented and verified. A pre-employment checklist has been created to ensure references are verified prior to the employee's first day.
Standard 8VAC20-780-140-A
REPEAT VIOLATION
Each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. The record for child #3 did not have documentation of a completed physical.
Each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. The record for child #3 did not have documentation of a completed physical.
Plan of Correction: The familied of children that are affected have been contacted immediately upon notice of violation. Completed physical has been requested withing 10 days of notice. A checklist will be used to ensure that all required documents include the physicals are collected within 30 days. Staff will not consider file complete unless all documentation is verified in law. The center will review all new enrollment files weekly for compliance. A monthly audit of 10% of the children 's records will be conducted by administrative staff. Staff will receive training on documentation requirements.
Standard 8VAC20-780-160-C
REPEAT VIOLATION
At least every two years from the date of the initial screening or testing staff members shall obtain and submit the results of a follow-up tuberculosis screening. The last tuberculosis screening documented for staff #3 was completed in 2022 and the last tuberculosis screening was completed for staff #4 in 2023.
At least every two years from the date of the initial screening or testing staff members shall obtain and submit the results of a follow-up tuberculosis screening. The last tuberculosis screening documented for staff #3 was completed in 2022 and the last tuberculosis screening was completed for staff #4 in 2023.
Plan of Correction: TB screening appointments have been scheduled immediately and the results will be submitted within 10 business days. A health compliance tracker will be implemented to log TB date and flag staff 30 days prior to expiration. Staff will not be scheduled in ratio if TB compliance is not met.
Standard 8VAC20-780-210-A
REPEAT VIOLATION
Program leaders shall have fulfilled a high school program completion or the equivalent. The record for staff #1 and staff #2 did not have documentation of a high school completion program or the equivalent.
Program leaders shall have fulfilled a high school program completion or the equivalent. The record for staff #1 and staff #2 did not have documentation of a high school completion program or the equivalent.
Plan of Correction: The staff member file was reviewed and updated documentation of high school completion was obtained and placed int he file. If documentation was not available this staff member was removed from their leadership role. A qualification verification form will be added to the hiring checklist. No program leader will be gin work. Education documentation is reviewed and approved by center director.
Standard 8VAC20-780-240-B
Staff shall complete orientation training prior to working alone with children and no later than seven days of the date of assuming job responsibilities. Staff #1 has been actively working in the center alone with children for at least three months and has not completed a staff orientation. The record for staff #5 who has been employed at the center for at least two years did not have documentation of a completed orientation.
Plan of Correction: Staff #1 and staff #5 will not be permitted to work alone with children until orientation training is completed. Orientation training has been scheduled within 5 business days. A new hire orientation log will be created and signed by both the staff members and director upon completion. this will be placed in the employee's file.
Standard 8VAC20-780-245-A
REPEAT VIOLATION
Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. The record for staff #3, staff #4 and staff #5 who have all been working at the center for over a year did not have documentation of annual training for 2024.
Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. The record for staff #3, staff #4 and staff #5 who have all been working at the center for over a year did not have documentation of annual training for 2024.
Plan of Correction: Our staff training will be reviewed immediately. Staff below 16 hours have been scheduled for mandatory training sessions within the next 30 days. A professional development log will be created. Completed hours reviewed accordingly by the administrator. Staff will not be permitted to remain employed if they do not complete the annual training requirements.
Standard 8VAC20-780-270-A
REPEAT VIOLATION
Areas and equipment of the center, inside and outside, shall be maintained in an operable condition. The following maintenance issues were observed outside: A broken push walker toy, broken plastic playhouse panels and a broken plastic car seat.
Areas and equipment of the center, inside and outside, shall be maintained in an operable condition. The following maintenance issues were observed outside: A broken push walker toy, broken plastic playhouse panels and a broken plastic car seat.
Plan of Correction: Broken toys were removed immediately as a violation was noted. Replacement over repair. The broken items will occur as soon as possible. A weekly outdoor safety check will be conducted by staff to ensure that all equipment is in good working order. A maintenance log will be permitted to track repairs or replace broken items. All broken damaged equipment will be clearly marked and removed.
Standard 8VAC20-780-280-B
REPEAT VIOLATION
Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A bottle of hand sanitizer in the preschool room had the warning label, ?Keep out of reach of children? and was unlocked within reach of children.
Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A bottle of hand sanitizer in the preschool room had the warning label, ?Keep out of reach of children? and was unlocked within reach of children.
Plan of Correction: Hand sanitizer had been immediately removed from child access in a lock cabinet. A daily classroom safety checklist has been implemented to ensure all hazardous items are locked prior to children entering the room. Staff will receive refresher training on hazardous material storage requirements.
Standard 8VAC20-780-60-A
REPEAT VIOLATION
Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required information.
The record for child #1 did not contain the employment phone number for one parent.
The record for child #2 did not list two emergency contacts.
The record for child #3 did not contain the address of both emergency contacts.
The record for child #2 and #4 did not contain documentation of the first day of attendance.
Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required information.
The record for child #1 did not contain the employment phone number for one parent.
The record for child #2 did not list two emergency contacts.
The record for child #3 did not contain the address of both emergency contacts.
The record for child #2 and #4 did not contain documentation of the first day of attendance.
Plan of Correction: Parent of the affected children have been contacted to provide missing information. Updated documentation will placed in each child's file within 5 business days. An enrollment file audit checklist has been crated and will be reviewed by the administrative assistant before a child begins care to ensure all required fields are completed. Quarterly file audits will be conducted by the assistant director, with results documented and reviewed by the director.