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Inspection · 2022-06-13

Date

2022-06-13

Complaint Related

Licensing Inspector

Michelle Argenbright
(540) 848-4123

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 HEARINGS PROCEDURES.
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

Thank you for your time and assistance with the unannounced monitoring inspection conducted on June 13, 2022. The on-site inspection was from 9:45 a.m. to 1:30 p.m. On this date, there were 88 children present in nine classrooms and in the care of seventeen staff members. The total enrollment for the program was 119 children. The exceptions to compliance were noted on the violation notice and the risk ratings were noted on the supplemental page. There were eleven staff members' records and ten children's records reviewed. Nine classrooms were toured and observations were made in three of those rooms. The medication and medication paperwork were reviewed for two children. All interactions between children and staff were age appropriate and positive. Some items that were reviewed and observed included: required posted information, injury reports, documentation of evacuation, shelter-in-place, and lockdown drills, emergency supplies, first aid kit, warm water temperature, resilient surfacing, outdoor play, water play, circle time, singing, infant care, centers in the Pre-K room, infant feeding, diaper changing procedures, hand washing and bathroom procedures, transitions, lunch, and nap time.

Please complete the plan of correction and date to be corrected sections for each violation cited on the violation notice and return it to me within 5 business days from today. Please specify how the deficient practice will be or has been corrected. Your plan of correction should contain: 1) steps to correct the noncompliance with the standard(s): 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s).

Please contact your licensing inspector, Chrystal King, if you have questions concerning this inspection, the licensing standards, and/or if I may be of assistance to you at 804-297-4469.

Violations

Standard 22.1-289.035-B-4

Based on record review, center did not ensure that a copy of the results of a criminal history record check was obtained from any state in which the individual has resided in the preceding five years prior to the first date of employment.

Evidence:
The date of employment for Staff # 3 is 5/31/2022. There were no results in the file.

Plan of Correction: The center sent a request on 6/13/22 to obtain results of the criminal history record check for the missing state for Staff #3 and placed the clear results in the file upon receipt. Date corrected was 7 /1/22. The center will consistently use an updated staff file checklist to include check boxes for multiple states and ensure there are multiple leadership members who review the files prior to start date moving forward.

Standard 8VAC20-770-60-C-2

Based on record review, center did not ensure that a copy of the results of a central registry check was obtained within 30 days of employment.

Evidence: The date of employment for Staff # 9 is 6/1/2021. There were no results in the file.

Plan of Correction: The center attempted to obtain the results of the central registry check originally sent for Staff #9. When the reply came back, it was stated that this was not found in the system. Therefore, the center submitted a new request on 6/21/22, after Staff #9 had returned from vacation and was able to get the request notarized. The new request was placed in the file. As of 7 /1/22 the center requested an update, as the results were not yet returned. Date to be corrected or followed up on 7/21/22. Moving forward, the center will create an outlook invite to alert them of all due dates for checks and ensure that there is daily documented outreach when not received within 30 days.

Standard 8VAC20-780-500-B

Based on a serious injury report and interview with staff, the center failed to ensure that for children younger than three years, a changing table or counter top designated for changing was used as the nonabsorbent surface for diapering or changing.

Evidence:
1. Per the serious injury report submitted by the facility to the department on 6/8/2022, on 6/7/2022, Child #2 "was bending over during a diaper change. When the child stood up, he bumped the back of his head on the porcelain bathroom sink. He did not have a bump initially but one did appear later. Eyes were checked for dilation. He did begin throwing up after awhile as well and did not seem himself."
2. The date of birth for Child # 2 is 3/9/2020.
3. The director confirmed that while the classroom has a changing table in the classroom, for years they have not utilized it for children that show interest in potty training.

Plan of Correction: Children under the age of three will be changed on the designated changing tables when soiled and then will also be brought to the restroom for toilet learning opportunities. The rooms were rearranged, and materials were moved to the changing table locations to ensure this implementation occurs moving forward. Leadership is working with staff to train them on the appropriate procedures. The dry erase boards in the restroom identify those who are of the age of three and older and permitted to toilet learn in the restroom if this is agreed upon with the toilet learning contract that will be created between the center and the family of each applicable child. Date corrected was 7 /1/22.

View original record on Virginia Department of Social Services