Inspection · 2023-12-05
Date
2023-12-05
Complaint Related
No
Licensing Inspector
Trisha Brown
(757) 404-2601
(757) 404-2601
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
8VAC20-800 Transportation
8VAC20-800 Nighttime Care
8VAC20-820 THE LICENSE.
8VAC20-820 THE LICENSING PROCESS.
8VAC20-820 HEARINGS PROCEDURES.
8VAC20-770 Background Checks
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
54.1 Provider must be MAT certified to administer prescription medication.
63.2 Child abuse and neglect
Inspector Notes
An unannounced renewal inspection was initiated on December 5, 2023, and concluded on December 6, 2023. There were seven children in care with the provider on December 5, 2023. Children present ranged in age from three months to three years old. Children were observed in provider and self-directed activities including nap, restroom routines and transitions. Violations regarding children?s records, number of caregivers present, immunization updates, , linens, activities, and provider training were cited and can be found on the attached violation notice. These violations were reviewed with the provider during the exit interview at the conclusion of the inspection.
Violations
9Standard 8VAC20-800-210-A
Based on record review the provider failed to obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities.
Evidence:
Training certificates for Caregiver #1 available for reviewed showed a total of seven hours of training was obtained during the 2022-2023 licensure period.
Evidence:
Training certificates for Caregiver #1 available for reviewed showed a total of seven hours of training was obtained during the 2022-2023 licensure period.
Plan of Correction: The caregiver initially provided seven hours of training for 2023, with an additional nine hours documented in an email, as requested by the inspector the following day for verification. As the inspector requested training for both 2022 and 2023, the caregiver will submit the remaining training hours to achieve a total of thirty four hours training.
Standard 8VAC20-800-510-A
Based on observation the provider failed to ensure that a child is provided with an individual crib, cot, rest mat, or bed for resting or napping.
Evidence:
Today there are three children in care under the age of 12 months. However, there are only two cribs available for use.
Evidence:
Today there are three children in care under the age of 12 months. However, there are only two cribs available for use.
Plan of Correction: The provider recognizes the perspective presented to the inspector and chooses to adhere to it
Standard 8VAC20-800-520-B
Based on observation the provider failed to ensure that cribs be provided for children from birth through 12 months of age.
Evidence:
Child#2, who is 16months old was observed sleeping in a crib but was later moved to a cot. The provider stated that crib Child#2 was sleeping in belong to Child#4.
Evidence:
Child#2, who is 16months old was observed sleeping in a crib but was later moved to a cot. The provider stated that crib Child#2 was sleeping in belong to Child#4.
Plan of Correction: The provider acknowledged that sharing the crib was not appropriate, removed the sheet, and committed to taking extra safeguards
Standard 8VAC20-800-530-C
Based on observation the provider failed to ensure that linens are assigned for individual use.
Evidence:
1 ? Upon arrival Child #3 was observed in the crib next to the kitchen table with a blue and white print crib sheet in place. However, later Child #5 was placed in the same crib without the crib sheet being changed.
2 ? During the inspection Child#2 was observed sleeping in a crib closest to the back door with a blue and white fitted sheet. However, later Child#4 was placed in the same crib without the crib sheet being changed.
Evidence:
1 ? Upon arrival Child #3 was observed in the crib next to the kitchen table with a blue and white print crib sheet in place. However, later Child #5 was placed in the same crib without the crib sheet being changed.
2 ? During the inspection Child#2 was observed sleeping in a crib closest to the back door with a blue and white fitted sheet. However, later Child#4 was placed in the same crib without the crib sheet being changed.
Plan of Correction: 1- The crib was strategically positioned in a highly visible areas for easy baby monitoring following inspection, the blue and white printed crib sheet was replaced immediately after the following conclusion of the inspection.
2 - During the inspection, the inspector brought up the placement of child #2 in a crib. However, the provider did not address the issue of placing child #4 in a crib. The inspector continued to emphasize the importance of placing the child in a crib, and the provider responded by stating that she would change the sheet.
2 - During the inspection, the inspector brought up the placement of child #2 in a crib. However, the provider did not address the issue of placing child #4 in a crib. The inspector continued to emphasize the importance of placing the child in a crib, and the provider responded by stating that she would change the sheet.
Standard 8VAC20-800-570-A
Based on observation the provider failed to ensure that a caregiver does not exceed 16 points by
using the required point system to determine if an additional caregiver is needed.
Evidence:
1 - Upon arrival at 12:20pm the Caregiver #1 was observed to be alone caring for 7 children totaling 22 points. Which exceeds the maximum of 16 points per caregiver.
a. The provider stated that at 8am there were six children present who totaled 18 points. Then at 9am a seventh child was accepted into care which added an additional four points.
2 ? Caregiver #2 arrived at 12:24pm. Then at 1:24 Caregiver #2 left the child care room to eat in another room with the door closed. Finally, at 1:53pm Caregiver #2 left the family day care home. Therefore, the provider was alone with children totaling 22 points from 8am through 12:24pm and from 1:25pm through the end of the inspection at 2:07pm
a. The provider stated she did not have anyone to assist her. She further stated that a potential assistant had not yet completed the required paperwork.
using the required point system to determine if an additional caregiver is needed.
Evidence:
1 - Upon arrival at 12:20pm the Caregiver #1 was observed to be alone caring for 7 children totaling 22 points. Which exceeds the maximum of 16 points per caregiver.
a. The provider stated that at 8am there were six children present who totaled 18 points. Then at 9am a seventh child was accepted into care which added an additional four points.
2 ? Caregiver #2 arrived at 12:24pm. Then at 1:24 Caregiver #2 left the child care room to eat in another room with the door closed. Finally, at 1:53pm Caregiver #2 left the family day care home. Therefore, the provider was alone with children totaling 22 points from 8am through 12:24pm and from 1:25pm through the end of the inspection at 2:07pm
a. The provider stated she did not have anyone to assist her. She further stated that a potential assistant had not yet completed the required paperwork.
Plan of Correction: Recognizing the breach of the 16-point threshold, the provider promptly sought extra help, considering the challenge of securing swift assistance. Face with the difficulty of finding immediate support, the provider chose to relocate two children from the daycare after the inspection?s conclusion.
Standard 8VAC20-800-60-A
Based on record review and interview the provider failed to maintain an up-to-date record at the family day home for each enrolled child
Evidence:
1 ? The record for Child #3 did not contain all required emergency contact information, first and last dates of attendance, parents signed acknowledgement of the receipt of the required
Information, or proof of identity.
2 ? The provider stated that she did not all of the required enrollment information for Child #3.
3 ? The record for Child #4 did not contain addresses for the emergency contacts listed.
Evidence:
1 ? The record for Child #3 did not contain all required emergency contact information, first and last dates of attendance, parents signed acknowledgement of the receipt of the required
Information, or proof of identity.
2 ? The provider stated that she did not all of the required enrollment information for Child #3.
3 ? The record for Child #4 did not contain addresses for the emergency contacts listed.
Plan of Correction: 1 - The caregiver retrieved the enrollment information for child #3 through email. Next day, the caregiver sent the child #3?s immunization to the inspector as proof. -
2- The inspector stated that child #4 did not contain addresses for the emergency contacts listed as indicated in the violation. The provider will review the form for correction. It would be more convenient if the inspector points out the missing information on the same day as the inspection.
3- Following the conclusion of the inspection, Child # 4 was withdrawn from childcare on the same day.
2- The inspector stated that child #4 did not contain addresses for the emergency contacts listed as indicated in the violation. The provider will review the form for correction. It would be more convenient if the inspector points out the missing information on the same day as the inspection.
3- Following the conclusion of the inspection, Child # 4 was withdrawn from childcare on the same day.
Standard 8VAC20-800-600-B
Based on observations the provider failed to ensure that infants and toddlers spend no more than 30 minutes of consecutive time during waking hours, with the exception of mealtimes, confined in a crib, play pen, high chair, or other confining piece of equipment. The intervening time period between confinements shall be at least one hour.
1 ? Child#4 (5months old) was observed sitting in a rocking seat upon arrival at 12:20pm. The child was awake and cried periodically. The child was not moved from the rocking chair until 1:13pm.
2 ? Child#1 (13months old) who was awake and active was moved from one seating device to another without the required 1-hour break between each device from 12:20 until 2:07pm when the inspection ended.
1 ? Child#4 (5months old) was observed sitting in a rocking seat upon arrival at 12:20pm. The child was awake and cried periodically. The child was not moved from the rocking chair until 1:13pm.
2 ? Child#1 (13months old) who was awake and active was moved from one seating device to another without the required 1-hour break between each device from 12:20 until 2:07pm when the inspection ended.
Plan of Correction: 1- Child #4 (5 months old) was sleeping at 12:30 pm and awoke at 12:55 pm. The child was awake and crying. The inspector advised the provider to reposition the child. The provider then moved the child from the rocking chair to tummy time,
2- child #1 (13-month-old) was on the verge of failing asleep when the bell rang; the child got up from her bed and walked. The provider then took the child and placed her back in her bed. After 10 minutes, the child shifted from her bed to reach for a toy while the provider searched for the necessary documents to present to the inspector. Since it was naptime and to minimize disturbance for another napping child, The provider allowed child #1 to remain in her current spot rather than moving her.
2- child #1 (13-month-old) was on the verge of failing asleep when the bell rang; the child got up from her bed and walked. The provider then took the child and placed her back in her bed. After 10 minutes, the child shifted from her bed to reach for a toy while the provider searched for the necessary documents to present to the inspector. Since it was naptime and to minimize disturbance for another napping child, The provider allowed child #1 to remain in her current spot rather than moving her.
Standard 8VAC20-800-690-A
Based on observation the provider failed to ensure that a child is not left unattended on a changing table during diapering.
Evidence:
While changing the diaper of six-month-old Child#3, the provider walked away from the diaper changing table to attend to Child#5 who was across the room crying in his crib. There was not any safety strap visible or engaged when the provider walked away from the diaper changing table, and no other caregiver was present.
Evidence:
While changing the diaper of six-month-old Child#3, the provider walked away from the diaper changing table to attend to Child#5 who was across the room crying in his crib. There was not any safety strap visible or engaged when the provider walked away from the diaper changing table, and no other caregiver was present.
Plan of Correction: The caregiver discreetly moved as another child cried and sought attention, Despite this, when the inspector highlighted the importance of child safety, the provider demonstrated a clear understanding of the significance of insuring the baby?s safety.
1 - he provider brought along a helper as the inspector mandated the need for a full-time assistant. Following the inspection, the caregiver removed two babies from childcare.
2 - The caregiver state that she has a helper due to incomplete paperwork is preventing the helper from starting work.
1 - he provider brought along a helper as the inspector mandated the need for a full-time assistant. Following the inspection, the caregiver removed two babies from childcare.
2 - The caregiver state that she has a helper due to incomplete paperwork is preventing the helper from starting work.
Standard 8VAC20-800-90-C
Based on record review and interview the provider failed to obtain documentation of additional immunizations once every six months for children under the age of two years as required.
Evidence:
1 ? The record for Child#1 and #2 contained only one immunization record. There was not any documentation of updated immunization information in either record.
a. he documented date of birth of Child#1 was October 29, 2022. The only available immunization record was dated January 4, 2023.
b. The documented date of birth of Child#2 was July 29, 2022. The only available immunization record was dated October 5, 2022.
2 ? The provider confirmed that there was not any additional immunization information available for Child #1 and #2 to review during the inspection. Child #1 had a documented date of enrollment as January 4, 2023, Child #2 had a documented date of enrollment as November 1, 2022.
Evidence:
1 ? The record for Child#1 and #2 contained only one immunization record. There was not any documentation of updated immunization information in either record.
a. he documented date of birth of Child#1 was October 29, 2022. The only available immunization record was dated January 4, 2023.
b. The documented date of birth of Child#2 was July 29, 2022. The only available immunization record was dated October 5, 2022.
2 ? The provider confirmed that there was not any additional immunization information available for Child #1 and #2 to review during the inspection. Child #1 had a documented date of enrollment as January 4, 2023, Child #2 had a documented date of enrollment as November 1, 2022.
Plan of Correction: 1- The inspector was uncertain whether the provider has shown her the immunization record for child #1
The provider presented the immunization record to the inspector through email.
a. The immunization record for child #1 born on October 29, was dated, November 1, 2023
2 - Child #2 born July 29, 2022 has a document that includes the latest immunization record dated January 27, 2023. The provider received a letter from Child # 2?s physician mentioning the delays in getting the child vaccinated. the provider has submitted the letter to the inspector.
The provider presented the immunization record to the inspector through email.
a. The immunization record for child #1 born on October 29, was dated, November 1, 2023
2 - Child #2 born July 29, 2022 has a document that includes the latest immunization record dated January 27, 2023. The provider received a letter from Child # 2?s physician mentioning the delays in getting the child vaccinated. the provider has submitted the letter to the inspector.