Inspection · 2025-10-14
Licensing Inspector
Susan Ellington-Sconiers
(804) 588-2368
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.
8VAC20-780 Special Services.
8VAC20-820 THE LICENSE.
8VAC20-820 THE LICENSING PROCESS
8VAC20-820 HEARINGS PROCEDURES
8VAC20-770 Background Checks (8VAC20-770)
20 Access to minors records
22.1 Background Checks Code, Carbon Monoxide
22.1 Early Childhood Care and Education
63.2 Child Abuse & Neglect
During the inspection, the inspector reviewed the areas listed above to include standards found out of compliance during the previous inspection. Unless otherwise noted as a violation within this inspection report, the provider was in compliance with the standards reviewed. If there were any serious injuries or fatalities related to a violation, the details will be included in the description of the violation.
Inspector Notes
An unannounced, on-site monitoring inspection was initiated 10/14/2025 3:23 p.m. to 5:53 p.m. and completed on 10/15/2025 from 1:39 p.m. to 4:26 p.m. The inspector reviewed compliance in the areas listed above. There were 81 children present and 12 staff. The inspector reviewed 7 children?s records and 5 staff records on-site. This inspection included document review, tour of the facility, interviews, and 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 01/08/2026. A POC submitted after this date will not appear on the public website.
Standard 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. S1, S2, and S3 who had been employed for less than two weeks, did not have a central registry search requested.
Plan of Correction: A mandatory pre-employment checklist will be used that includes:
Central Registry search request submitted; Date submitted; Proof of submission attached; Supervisor signature confirming completion.
Ongoing
Standard 8VAC20-780-150-B
Repeat Violation
Immunization records are required to be signed and dated by a physician, his designee, or an official of the local health department. The immunization record for C2 was not signed.
Plan of Correction: Do an audit of each child's folder to ensure that the copy of complete comprehensive physical and immunization records have the physician's signature. Train each member of staff to ensure that they know where to find the physician's signature on each record. Communicate with parents that signatures must be on each record.
Audit completed by 01/30/2026.
Ongoing
Standard 8VAC20-780-160-C
A tuberculosis (TB) screening is required every two years from the last screening. S5 updated screening was due 1 month ago. The updated screening has not yet been completed.
Plan of Correction: A staff screening compliance tracker will be created listing: Employee name; Required Screenings; Date completed; Expiration/renewal due date.
The tracker will be maintained electronically and reviewed monthly.
Ongoing
Standard 8VAC20-780-260-B
The center shall provide for review the annual approval from the health department. The last inspection available for review was dated 07/24/2024.
Plan of Correction: The Health Inspection is attached to this report.
10/2025
Standard 8VAC20-780-500-A
Children?s hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks. Children were observed entering the dining area from the bus drop off and immediately eating a meal without washing their hands.
Plan of Correction: Upon arriving, students should enter the dining area to place belongings down and then go to the bathroom to wash hands. All other monitoring of students washing hands or using disposable wraps.
Ongoing
Standard 8VAC20-780-510-G
Medications shall be labeled with the child?s name, the name of the medication, the dosage amount, and the time or times to be given. A medication was observed at the center and identified by center staff as belonging to C5. The medication did not have the pharmacy label the child?s name, the name of the medication, the dosage amount, and the time or times to be given.
Plan of Correction: Do an audit of all medications to ensure that the pharmacy label with the child's name, name of the medication, the dosage amount, and the time or times to be given. Train all staff in what information is required when receiving medication. To include in Parent Handbook and notifications to parents the required labels.
Audit all medications to be completed by 01/30/2026. Training and communication will be ongoing. Inclusion of the Parent Handbook was completed 01/06/2026.
Standard 8VAC20-780-550-D
Evacuation drills procedures shall be practiced monthly. Drill records did not document a
drill in 08/2025.
Plan of Correction: Continue to implement fire drills procedures/practices each month.
Standard 8VAC20-780-60-A
A written care plan is required for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. C6, who has been enrolled for over a month, has a diagnosed food allergy and did not have a written care plan in their file.
Plan of Correction: The Food Allergy and Anaphylaxis Emergency Care Plan (FARE) will be attached to the acceptance email to all parents with directions that if their child has an allergy, the plan must be completed and signed before the child can begin.
Ongoing