Inspection · 2022-04-21

Based on a review of 2 records, staff records do not contain documentation of a completed Sex Offender search and a Child Abuse and Neglect Search for residences outside of the state of Virginia in the past 5 years.
Evidence:
2 of 2 records reviewed did not include documentation of out of state background searches for another state of residency within the past 5 years. Sex Offender and Child Abuse and neglect are both required for these staff. (Staff 1,2)

Based on a review of records, one staff record does not include documentation of a completed Central Registry Search (CPS) within 30 days of employment.
Evidence:
There is no CPS search result on file for Staff 1. (Date of Hire: 10/26/21)

Based on direct observation, a child under 10 years of age was not kept in actual sight and sound supervision.
Evidence:
At LI arrival (11:00 AM) classrooms were observed leaving the playground area and entering the stairwell adjacent to the parking lot to enter the facility. LI witnessed one child (4 yr. old) run ahead of the group and go behind 3 large boxes that had been delivered to the main entrance of the facility. The child was entirely out of sight of the classroom staff. As the reminder of the children and staff entered the classroom, the child remained outside of the facility. Upon hearing the classroom door close, the child came out from behind the boxes and ran approximately 20 feet to the door, opening the door himself and entering the room.

Based on direct observation, a ratio of 1:10 (staff:children) was not maintained in the room containing children aged 3 years to school age eligible.
Evidence: On 3 separate instances during the inspection, one staff person left the classroom containing 14 children leaving one staff with more than 10 children. Once to make copies of work sheets in the office, twice to take one child (each time) to the bathroom down the hallway.

Based on direct observation, during the designated rest period, when children are resting, ratios that
Evidence:
1. The classroom containing children aged 16 months through 24 months, did not maintain a 1:10 (staff:children) ratio. LI observed the classroom during the designated rest period to have 1 staff person with 11 children.
2. The classroom containing children aged two years of age did not maintain a 1:16 ratio. LI observed the classroom during the designated rest period to have 1 staff to 19 children.

Based on a review of policies and procedures, the facility failed to follow their written policy for medication administration.
Evidence:
The parent handbook states: "The medication must be in the original container/packaging, including the pharmacist instructions."
Evidence:
One medication (Auvi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.

Based on observation, allergy lists for children were not kept confidential.
Evidence:
The allergy lists in the Red room and the Green room were posted on a bulletin board in full view of anyone entering or standing in the classroom.

Based on the Owner's statement, staff files were not available for review.
Evidence;
*4/21/22 the Owner stated the Director had been working on the files, and she was not sure where they were currently located. Files were not available for review.

Based on observation, the diaper disposal system in the Toddler room is not foot operated.
Evidence:
The diapers are disposed of into a trash can that does not have a lid on it.

Based on a review of medications, one medication was not maintained in the original container with the prescription label attached.
Evidence:
*4/21/22 -One emergency medication was in a plastic "ziplock" baggie, not in the original prescription box. (Child #2)
*5/11/22 - Same emergency medication is still in a plastic "ziplock" baggie.

Based on a review of medication authorizations, medications were not returned or the authorization renewed after 14 days of the authorization expiring.
Evidence:
Two authorizations for medication present at the center were expired. The authorizations expired 4/5/22. (Child #2)

Based on multiple staff interviews, children are not allowed second helpings of food.
Evidence:
Through multiple staff interviews it was determined that there is not always second helpings of food available for children. Staff have searched the kitchen and asked other classrooms for additional food for children.

Based on a review of records, a separate record was not maintained for each child.
Evidence:
3 child records were requested for review.
1 of 3 child records could not be located during the inspection for review. The child has allergies and emergency medications at the facility. (Child 1)

Based on staff statements and direct observation, written attendance has not been maintained in each group of children documenting arrival and departure.
Evidence:
1, The infant room did not have any written attendance available for review. Staff stared they had not kept attendance, either on paper or on the Ipad.
2. The Green room did not have attendance documenting children's arrival or departures. There were 14 children in the Green room. The attendance, kept on the Ipad, inaccurately reflected 10 children in the room. When the teacher updated the attendance, the Ipad reflected 13 children. When questioned, as to the discrepancy, staff could not reconcile the children in the room with the attendance sheet. One child in the room had never been added to the attendance on the Ipad attendance system.