Inspection · 2023-06-28
Date
2023-06-28
Complaint Related
No
Licensing Inspector
Sharon Curlee
(804) 840-8312
(804) 840-8312
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
8VAC20-800 Administration
8VAC20-800 Personnel
8VAC20-800 Household Members
8VAC20-800 Physical Health of Caregivers and Household Members
8VAC20-800 Caregiver Training
8VAC20-800 Physical Equipment and Environment
8VAC20-800 Care of Children
8VAC20-800 Preventing the Spread of Disease
8VAC20-800 Medication Administration
8VAC20-800 Emergencies
8VAC20-800 Nutrition
8VAC20-770 Background Checks
22.1 Background Checks Code, Carbon Monoxide
Inspector Notes
An unannounced monitoring inspection was conducted on Wednesday, June 28, 2023, to determine the provider's compliance with licensing standards. The inspector was on site from 9:50am to approximately 12:05pm. During the inspection, there were a total of ten children in care, totaling 18 points, in the direct care of one caregiver. Upon arrival, the children were observed watching television in a designated space on the first floor of the family day home. Later, the children were observed transitioning to their designated space downstairs. The children were observed taking bathroom breaks, during free-play, and playing outside. All areas used for childcare were inspected. The family day home has age and stage appropriate materials and supplies. The caregiver was observed having positive interactions with the children in care. The first aid kit and nonemergency supplies were inspected and found complete. Per the provider, there are no pets in the home, no firearms, transportation is not provided, and medication is not administered at this time. Two caregivers' records and five children's records were reviewed.
Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program.
Violations
9Standard 8VAC20-800-100-A
Based on a review of five children's records and interview, the provider did not obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance for three children.
Evidence: 1) The record of Child #2 (DOA: 02/06/23) did not contain a physical examination.
2) The record of Child #4 (DOA: 09/05/22) did not contain a physical examination.
3) The record of Child #5 (DOA: 11/01/22) did not contain a physical examination.
4) During interview, the provider acknowledged a physical examination was not obtained for Child #2, Child #4, and Child #5 within the required timeframe.
Evidence: 1) The record of Child #2 (DOA: 02/06/23) did not contain a physical examination.
2) The record of Child #4 (DOA: 09/05/22) did not contain a physical examination.
3) The record of Child #5 (DOA: 11/01/22) did not contain a physical examination.
4) During interview, the provider acknowledged a physical examination was not obtained for Child #2, Child #4, and Child #5 within the required timeframe.
Plan of Correction: The missing physical examinations will be requested for each child.
Standard 8VAC20-800-200-A
Based on a review of two caregivers' records and interview, the provider did not ensure one caregiver, who is a substitute provider and assistant, received the required orientation within the first week of assuming job responsibilities.
Evidence: 1) The record of Caregiver #2, employed on 06/01/2020, did not contain documentation that the provider conducted orientation by the end of their first week of assuming job responsibilities. 2) During interview, the provider acknowledged the orientation was not completed as required.
Evidence: 1) The record of Caregiver #2, employed on 06/01/2020, did not contain documentation that the provider conducted orientation by the end of their first week of assuming job responsibilities. 2) During interview, the provider acknowledged the orientation was not completed as required.
Plan of Correction: Orientation will be documented for any new caregivers in the future.
Standard 8VAC20-800-210-A
Based on a review of two caregivers' records and interview, the provider did not ensure two caregivers obtained a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities.
Evidence: 1) The record of Caregiver #1 contained a total of 9 hours of annual training from 1/2022-12/2022. 2) The record of Caregiver #2, employed on 06/01/2020, did not contain any annual training from 06/2022-06/2023. 3) During interview, the provider confirmed additional documentation of annual training for Caregiver #1 and Caregiver #2 could not be located.
Evidence: 1) The record of Caregiver #1 contained a total of 9 hours of annual training from 1/2022-12/2022. 2) The record of Caregiver #2, employed on 06/01/2020, did not contain any annual training from 06/2022-06/2023. 3) During interview, the provider confirmed additional documentation of annual training for Caregiver #1 and Caregiver #2 could not be located.
Plan of Correction: Each caregiver will obtain and maintain documentation of annual training.
Standard 8VAC20-800-350-E
Based on the water temperature taken and interview, the hot water taps available to children were not maintained within the range of 105 degrees F and 120 degrees F.
Evidence: 1) On 06/28/23, the inspector tested the hot water tap in the main bathroom sink used by children. The water registered 122.3 degrees F.
2) During interview, the provider acknowledged the hot water temperature was not maintained within the required range.
Evidence: 1) On 06/28/23, the inspector tested the hot water tap in the main bathroom sink used by children. The water registered 122.3 degrees F.
2) During interview, the provider acknowledged the hot water temperature was not maintained within the required range.
Plan of Correction: The water temperature will be regulated.
Standard 8VAC20-800-500-C
Based on observation, the provider did not ensure that stationary outdoor playground equipment was placed at least 6 feet from the perimeter of other play structures or obstacles.
Evidence: On 06/28/23, the inspector observed the garden timbers surrounding the play area were not placed at least 6 feet from the outdoor play equipment. The distance was approximately 2'5 and 4' between the slides and the garden timbers.
Evidence: On 06/28/23, the inspector observed the garden timbers surrounding the play area were not placed at least 6 feet from the outdoor play equipment. The distance was approximately 2'5 and 4' between the slides and the garden timbers.
Plan of Correction: The garden timbers will be removed to ensure all obstacles are moved away from the playground equipment.
Standard 8VAC20-800-570-A
Based on a review of documentation and observation, the provider did not ensure that each caregiver did not exceed 16 points.
Evidence: At the time of the inspection on 06/28/23, there were ten children in care for a total of 18 points with one caregiver, exceeding 16 points per caregiver.
The provider shall ensure that a caregiver does not exceed 16 points by using the following point system to determine if an additional caregiver is needed: 1. Children from birth through 15 months of age count as four points each; 2. Children from 16 months through 23 months of age count as three points each; 3. Children from two through four years of age count as two points each; 4. Children from five years through nine years of age count as one point each; and 5. Children who are 10 years of age and older count as zero points.
Evidence: At the time of the inspection on 06/28/23, there were ten children in care for a total of 18 points with one caregiver, exceeding 16 points per caregiver.
The provider shall ensure that a caregiver does not exceed 16 points by using the following point system to determine if an additional caregiver is needed: 1. Children from birth through 15 months of age count as four points each; 2. Children from 16 months through 23 months of age count as three points each; 3. Children from two through four years of age count as two points each; 4. Children from five years through nine years of age count as one point each; and 5. Children who are 10 years of age and older count as zero points.
Plan of Correction: The provider is in the process of hiring a new caregiver. This will ensure one caregiver does not exceed 16 points.
Standard 8VAC20-800-60-B
Based on a review of five children's records and interview, the provider did not ensure five children's records contained the required information.
Evidence: 1) The record of Child #1 (DOA: 02/05/08) did not contain documentation of the review of the child's emergency contact information as required by 8VAC20-800-780 B. The last written confirmation occurred was dated 03/01/21.
2) The record of Child #2 (DOA: 04/09/21) did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
3) The record of Child #3 (DOA: 11/01/22) did not contain the address of the two emergency contacts listed. The record did not contain proof of the child's age and identity as required by 8VAC20-800-80.
4) The record of Child #4 (DOA: 09/05/22) did not contain the address of the second emergency contact listed. The record did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
5) The record of Child #5 (DOA: 11/01/22) did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
6) During interview, the provider acknowledged the documentation was not on file for each child.
Evidence: 1) The record of Child #1 (DOA: 02/05/08) did not contain documentation of the review of the child's emergency contact information as required by 8VAC20-800-780 B. The last written confirmation occurred was dated 03/01/21.
2) The record of Child #2 (DOA: 04/09/21) did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
3) The record of Child #3 (DOA: 11/01/22) did not contain the address of the two emergency contacts listed. The record did not contain proof of the child's age and identity as required by 8VAC20-800-80.
4) The record of Child #4 (DOA: 09/05/22) did not contain the address of the second emergency contact listed. The record did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
5) The record of Child #5 (DOA: 11/01/22) did not contain documentation of the parent's signed acknowledgement of the receipt of the information required by 8VAC20-800-70.
6) During interview, the provider acknowledged the documentation was not on file for each child.
Plan of Correction: The missing information will be obtained for each child.
Standard 8VAC20-800-830-D
Based on a review of the family day homes' emergency response drills, the provider did not maintain the records of emergency evacuation and shelter-in-place drills for one year.
Evidence: 1) The most recent emergency evacuation drill documented was 01/04/23. 2) During interview, the provider reported the emergency evacuation drills have been conducted monthly, but documentation could not be located at the time of the inspection.
3) Per the provider, the most recent shelter-in-place drill was practiced on 04/18/23, but the documentation could not be located at the time of the inspection.
Evidence: 1) The most recent emergency evacuation drill documented was 01/04/23. 2) During interview, the provider reported the emergency evacuation drills have been conducted monthly, but documentation could not be located at the time of the inspection.
3) Per the provider, the most recent shelter-in-place drill was practiced on 04/18/23, but the documentation could not be located at the time of the inspection.
Plan of Correction: The documentation will be located. The provider will continue to main documentation of emergency drills as required.
Standard 8VAC20-800-90-A
Based on a review of five children's record and interview, the provider did not obtain documentation that one child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations before the child may attend the family day home.
Evidence: 1) The immunization documentation in the record of Child #5 (DOA: 11/01/22) did not indicate if the child was adequately immunized. The documentation did not have the date or physician's signature to show the requirements were met. 2) During interview, the provider reported there is no other documentation on file that would verify Child #5 is adequately immunized.
Evidence: 1) The immunization documentation in the record of Child #5 (DOA: 11/01/22) did not indicate if the child was adequately immunized. The documentation did not have the date or physician's signature to show the requirements were met. 2) During interview, the provider reported there is no other documentation on file that would verify Child #5 is adequately immunized.
Plan of Correction: The correct immunization documentation will be requested for the child.