Inspection · 2023-02-16

Based on a review of records, staff records do not contain documentation of a completed nationwide fingerprint search prior to employment.
Evidence:
*Results are dated 10/05/2022 for Staff H. (DOH: 5/27/22)
*No results are on file for Staff A.

Based on a review of records, staff records do not contain all required background search documentation for residences outside of the state of Virginia in the past 5 years. Criminal History search results prior to the first day of employment and a child abuse and neglect search (CPS) submitted within 30 days of employment with results received within 45 days of employment.
Evidence:
*Staff B (DOH: 8/30/22) CPS search was submitted 12/1/22. Results on file 1/12/23.
*Staff C (DOH;10/31/22) Has no CPS results on file for 2 residences outside of Virginia within the last 5 years. No Criminal History search results for one of those residences.
*Staff D (DOH: 9/12/22) has no CPS search results on file for one residence outside of Virginia in the past 5 years.

Based on a review of records, staff records do not contain documentation of a completed Sworn Disclosure Statement (SDS), prior to the first day of employment,
Evidence:
2 of 10 staff records reviewed were missing completed SDSs.
*Staff A has no SDS available for review. (DOH: 9/2022)
*Staff I has a signed form on file; however, none of the questions are answered on the form. (DOH: 12?19/22)

Based on a review of records, staff records do not contain documentation of a competed Central Registry Search (CPS) within 30 days of employment.
Evidence:
*No CPS results are on file for 3 of 10 records reviewed.
(Staff A: DOH 9/2022), (Staff D: DOH 0/12/22), (Staff E: DOH 9/21/2022).
*Results on file are dated 11/17/22 for Staff H. (DOH: 5/27/22)

Based on a review of records, child records do not include documentation of immunizations prior to the first day of attendance.
Evidence:
*No immunization record available. (Child 1)
*Immunization record on file has no immunizations recorded, the form is blank. (Child 4)

Based on a review of records, child records do not include an updated immunization record every 6 months until the age of 2 years of age.
Evidence:
No updated record of immunizations is on file. (Child 2,3)

Based on a review of records, one child record does not contain documentation of a completed physical within 30 days of enrollment.
Evidence:
The physical form available for review is blank, there is no information on the form. (Child 4: First day of attendance: 7/16/21)

Based on a review of records, staff records do not contain documentation of a negative tuberculosis screening, at the time of employment that was completed within the last 30 calendar days of the date of employment.
Evidence:
*Staff G has no documentation on file (DOH: 1/12/23)
*Staff E screening is dated 1/27/22. (DOH: 9/21/22)
*Staff F screening is dare 7/12/22. (DOH: 9/21/22)
*Staff H(DOH: 5/27/22) has 1 screening on file dated 4/16/22 (more than 30 days prior to employment), and a second screening dated 11/19 22 (not prior to employment),

Based on a review of records, staff records do not contain documentation of the required Virginia Department of Education-sponsored orientation course being completed within 90 days of employment.
Evidence:
There is no documentation of the completed training course available for review.
(Staff A: DOH 9/22), (Staff C: DOH: 10/31/22)

Based on a review of records, there is no documentation of completed orientation within the allowable time frame.
Evidence:
*No documentation of orientation: (Staff A,C,G, I)
*No documentation of the required 10 hour training within 90 days of employment. (Staff C Date of Hire (DOH): 10/31/22)
*No documentation of first aid training within 30 days of employment (Staff A: DOH 9/2022)
(Staff B: DOH 8/30/22), (Staff C: DOH 10/31/22).

Based on observation, a child with an emergency medication was not always in the care of a staff member who meets the requirements of having Medication Administration Training (MAT) certification.
Evidence:
Child #6 has an emergency medication on site. At the time of LI arrival, there was no staff with MAT certification present.

Based on observation, areas and equipment of the center inside and out was not maintained in a clean safe and operable manner.
Evidence:
*A plastic play structure on the playground is broken, with sharp edges exposed and finger entrapment holes.
*One toilet in the large multi-stall bathroom has a broken tank lid with sharp edges exposed.

Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children.
Evidence:
*Cleaning materials were under the cabinet under the sink in the bathroom, unlocked. A gallon jug of soap labeled keep out of reach of children was sitting on the counter.
(Preschool room)
*Hand sanitizer container was accessible in the "false window frame" next to the kitchen play structure. (Green room)
*Air freshener plug-ins and solid air fresheners were accessible in multiple rooms.

Based on observation electrical outlets did not have protective covers.
Evidence:
In the Ocean's room, 2 outlets were uncapped.

Based on observation, multiple bathrooms in the facility did not have toilet paper and disposable towels available for use.
Evidence:
*3 of 4 stalls in the multi-stall bathroom did not have toilet paper available. (4th stall was open, but had a sign saying do not use).
*No disposable towels were available in any bathroom used by 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."
One medication (Avi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.

Based on observation, the list of children's allergies was not kept confidential.
Evidence:
The posted allergy list in 2 rooms was not kept confidential. The list showed children that have allergies, names and their allergy. (Infant room, 2's room)

Based on observation, cribs and cots were not identified for use by a specific child.
Evidence:
*1 crib in use in the infant room was not labeled to identify the user.
*Cots in multiple rooms were not labeled to identify the child using them.

Based on observation, diaper disposal trash can does not have plastic liner.
Evidence:
The trash can in the green room for diaper disposal is not leak-proof or have a plastic liner.

Based on a review of medications, medication authorizations are not available for review.
Evidence:
One long term medication (Avi-Q) on site has no authorization available for review. (Child 6)

Based on a review of medication, one medication is not in the original box with a prescription label attached.
Evidence:
One Avi-Q medication on site, is in a plastic zip-lock baggie with no box or prescription label attached. (Child 6)

Based on observation, sunscreen was not stored inaccessible to children under 5 years of age.
Evidence:
*Sunscreen stored under the changing table in the 2's room was not inaccessible to children.
The door to the table was open.
*Sunscreen stored under the sink int he Green room was not stored inaccessible to children. The cabinet was not locked (lock was broken).

Based on observation, diaper ointments or creams were not stored inaccessible to children.
Evidence:
*Diaper ointments were stored under the diaper changing table in the 2's room, accessible to children. The door was open to the cabinet.
*Diaper ointments were stored under the sink in the Green room, in an unlocked cabinet. The lock was broken.

Based on observation, when food is brought from home, the container was not clearly dated and labeled to identify the owner.
Evidence:
2 lunch containers in the Ocean's room (Preschool) were not labeled or dated.

Based on observation, infant bottles were not dated.
Evidence:
2 infant bottles were labeled with infant's names; however, they were not dated.

Based on a review of records, child records do not contain all required components.
Evidence:
6 child records were reviewed. Missing information includes:
*Previous School information (Child 1)
*Documentation of an annual update and confirmation of up-to-date information.
(Child 5: record is dated 9/10/21), (Child 4: record is dated 11/23/21)
*Parent work information for 1 parent (Child 4)
*Parent work information for both parents (Child 5)

Based on a review of records, one child record does not contain documentation of allergies.
Evidence:
There is no information regarding allergies on file. (Child 1)

Based on a review of records, child records do not contain documentation of a written allergy action plan for a diagnosed food allergy that included instructions from a physician and steps to be taken in the event of a suspected or confirmed allergic reaction.
Evidence:
3 of 3 child records were reviewed with a documented food allergy.
*1 of 3 records had no allergy action plan available. (Child 6)
*2 of 3 records had an allergy plan signed by the parent only that did not include physician's instructions. (Child ren 2,3)

Based on a review of records, staff records do not contain all required information.
Evidence:
8 of 10 records reviewed were missing documentation of the following information:
1. References:
*3 of 8 missing 2 references (Staff E, G, I)
*1 of 8 missing a second reference (Staff D)
* 1 of 8 missing a signature of the person completing 2 phone references. (Staff F)
2. 3 of 8 were missing an emergency contact. (Staff A, H, I)
3. Documentation to demonstrate the individual posses the education and experience required for the job position.
* No experience documented (Staff C, I)
* No qualifications documented (Staff F, I)