Inspection · 2020-08-26

Based on record review, the provider did not obtain documentation of a physical examination prior to each child's attendance or within 30 days after the first day of attendance.

Evidence: Child #3 (Start Date: 4/17/2023) did not have a physical examination on file.

Based on record review and staff interview, the provider did not obtain for each caregiver an updated tuberculosis screening or test that was completed within the last two years.

Evidence: Staff #2's most recently tuberculosis test on file was completed 8/26/2020.

Based on observation, potentially poisonous supplies, such as disinfectants, were not stored in an area inaccessible to children.

Evidence: A disinfectant spray with the words "Caution: Keep out of reach of children" was sitting on top of a storage bin approximately 3 feet in height within the programming space and was accessible to the children in care.

Based on observation, children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision had access to stairs.

Evidence: There was no gate at the bottom of the stairs leading from the main level of the home to the child care space in the basement. Children in care at the time of inspection ranged from 8 weeks to 4 years old.

Based on record review, the provider did not maintain an up-to-date record at the family day home for each enrolled child.

Evidence: Child #1 (Start Date: 9/5/2023) was present on site and did not have a file.

Based on record review, the provider did not ensure that all children's records contained all required information.

Evidence:
1. Child #2 (Start Date: 9/5/2023) was present at the time of inspection and did not have the following information: physician name and phone number, two emergency contacts with name, address, and phone number, medical insurance and policy number, and authorization for emergency medical care.
2. Child #3 (Start Date: 4/17/2023) was present at the time of inspection and did not have the medical insurance policy number on file.
3. Child #4 (Start Date: 5/2/2023) was present at the time of inspection and was missing one emergency contact in the file.
4. Child #5 (Start Date: 9/30/2021) was present at the time of inspection and was missing the medical insurance policy number and one emergency contact in the file.

Based on observation, the provider did not ensure that the diapering area had a diapering surface that was nonabsorbent.

Evidence: The changing pad had a cloth cover on it making it absorbent.

Based on record review, the provider did not ensure that all parents were provided required written information prior to the child's first day of attendance.

Evidence:
1. Child #2 (Start Date: 9/5/2023), Child #3 (Start Date: 4/17/2023), Child #4 (Start Date: 5/2/2023), Child #5 (Start Date: 9/30/2021), and Child #6 (Start Date: 2/10/2020) did not have documentation on file that parents were provided the provider's medication administration policy.
2. Child #2 was missing documentation on file that parents were provided the provisions of the family day home's emergency preparedness and response plan.
3. Child #2 and Child #6 did not have documentation on file that parents were informed whether or not there is liability insurance in force on the family day home operation.

Based on record review and staff interview, the family day home did not have a written emergency preparedness and response plan.

Evidence: There was no emergency preparedness and response plan available at the time of inspection.

Based on record review, the provider did not obtain documentation that all children have been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations.

Evidence: Child #2 (Start Date: 9/5/2023) and Child #3 (Start Date: 4/17/2023) did not have immunizations on file.

Based on record review and staff interview, the provider did not ensure the menu for the current one-week period was given to parents or kept on file.

Evidence: The menu for the week of 9/5/2023 hadn't been developed at the time of inspection.

Based on observation, the provider did not have an operable thermometer available to monitor refrigerator and freezer compartment temperatures.

Evidence: There was no thermometer in the refrigerator or freezer compartments that was located in the programming space and utilized for the family day home.