Inspection · 2022-01-18
Date
2022-01-18
Complaint Related
No
Licensing Inspector
Nanette Roberts
(757) 404-2322
(757) 404-2322
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.
8VAC20-770 Background Checks (22VAC40-191)
Inspector Notes
This inspection was conducted by licensing staff using an alternate remote protocol, including telephone contacts, documents review, interviews and a in-person tour of the program A renewal inspection was initiated on 1/18/22 and concluded on 1/20/22. The provider was contacted by telephone to initiate the inspection. There were 46 children present and 9 staff. The inspector emailed the director/provider a list of items required to complete the inspection. The Inspector reviewed 4 children?s records and 4 staff records, along with any requested program records submitted by the facility to determine if required documentation was complete. Information gathered during the inspection determined non-compliance(s) with applicable standards or law and violations were documented on the violation notice issued to the program.
Violations
9Standard 8VAC20-770-60-C-2
Based on a review of our staff records, it was determined that the facility did not deny continued employment of a staff who did not have a search of the central registry finding within 30 days of employment.
Evidence:
1. The record for staff #2 (date of hire 9/10/21) did not contain documentation of a completed search of the central registry finding.
2. Staff #5 (Program Director) reviewed the record for the staff #2, and confirmed that the search of the central registry finding has not been received.
Evidence:
1. The record for staff #2 (date of hire 9/10/21) did not contain documentation of a completed search of the central registry finding.
2. Staff #5 (Program Director) reviewed the record for the staff #2, and confirmed that the search of the central registry finding has not been received.
Plan of Correction: The facility responded: The CPS registry was resubmitted for Staff #2. Due to COVID-19, there has been a delay in processing.
Standard 8VAC20-780-270-A
Based on observation and interviews, it was determined that the facility did not ensure that all areas and equipment of the center shall be maintained in a safe and operable condition.
Evidence:
1. There were areas of peeling paint on the door and door frame located in the Two's classroom that provides entry to the playground.
2. There were multiple floor tiles that were damaged and provided possible tripping hazard in the Infant classroom and the Two's classroom.
3. Staff #5 (Program Director) confirmed the items listed above were not in a safe and operable condition.
Evidence:
1. There were areas of peeling paint on the door and door frame located in the Two's classroom that provides entry to the playground.
2. There were multiple floor tiles that were damaged and provided possible tripping hazard in the Infant classroom and the Two's classroom.
3. Staff #5 (Program Director) confirmed the items listed above were not in a safe and operable condition.
Plan of Correction: The facility responded: Maintenance was notified to repair the tile and paint areas that need to be touched up.
Standard 8VAC20-780-350-B
Based on observation and interviews, it was determined that the licensee did not ensure that for children, 16 months up to 24 months, a ratio of one staff member for every five children is maintained at all times children are in care.
Evidence:
1. There were 14 children present with staff #1 and staff #2 in the Toddler classroom during the entire inspection.
2. When staff #1 was asked the ages of the children present, staff #1 stated that children present were 16 months to 24 months. Based on the age of children present in the Toddler classroom, the required staff-to child ratio would be one staff for every five children.
3. Both staff present in the classroom confirmed that the facility did not maintain the required staff-to-child ratio of one staff for every five children for this grouping of children.
Evidence:
1. There were 14 children present with staff #1 and staff #2 in the Toddler classroom during the entire inspection.
2. When staff #1 was asked the ages of the children present, staff #1 stated that children present were 16 months to 24 months. Based on the age of children present in the Toddler classroom, the required staff-to child ratio would be one staff for every five children.
3. Both staff present in the classroom confirmed that the facility did not maintain the required staff-to-child ratio of one staff for every five children for this grouping of children.
Plan of Correction: The facility responded: The Director was the staff assigned to the classroom. The Director stepped away to assist with the inspection.
Standard 8VAC20-780-440-B
Based on observation it was determined that the licensee did not ensure that that a crib shall be provided for children in care and identified for use by a specific child.
Evidence:
1. There were 7 children present in the Infant classroom and only 6 cribs present.
2. None of the 6 cribs present were identified for use by a single child.
3. The staff in the Infant classroom confirmed that there were less cribs than children present and none of the cribs were labeled.
Evidence:
1. There were 7 children present in the Infant classroom and only 6 cribs present.
2. None of the 6 cribs present were identified for use by a single child.
3. The staff in the Infant classroom confirmed that there were less cribs than children present and none of the cribs were labeled.
Plan of Correction: The facility responded: There was a drop-in infant from another facility that is closed due to COVID-19. An additional crib was added from the closet immediately.
Standard 8VAC20-780-500-B
Based on observation and interview, it was determined that the licensee did not ensure that a nonabsorbent surface is used for diapering.
Evidence:
1. Both diaper changing pads in the Infant classroom had a tear.
2. The Infant room staff confirmed that the diaper changing surface was not nonabsorbent due to the tear in the changing pad.
Evidence:
1. Both diaper changing pads in the Infant classroom had a tear.
2. The Infant room staff confirmed that the diaper changing surface was not nonabsorbent due to the tear in the changing pad.
Plan of Correction: The facility responded: New changing pads were purchased for the infant classroom.
Standard 8VAC20-780-540-A
Based on a review of the facility's first aid kits, it was determined that the facility did not ensure that there is a first kit on the facility's vehicle used for transporting children that contain all of the required items.
Evidence:
1. There was no first aid kit for either of the vehicles used for transporting the children to and from school on a daily basis.
2. Staff #5 (Program Director) confirmed that neither vehicle used for transporting the children contained a first aid kit.
Evidence:
1. There was no first aid kit for either of the vehicles used for transporting the children to and from school on a daily basis.
2. Staff #5 (Program Director) confirmed that neither vehicle used for transporting the children contained a first aid kit.
Plan of Correction: The facility responded: First aid kits were added to the vans.
Standard 8VAC20-780-550-K
Based on a review of the documents contained on the bus used to transport children daily to and from public school, it was determined that the licensee did not ensure that the center shall prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business (such as field trips, pickup/drop off of children to or from schools, etc.). This document must be kept in vehicles that centers use to transport children to and from the center.
Evidence:
1. Neither of the facility's vehicles used for transporting children contained the required emergency document.
2. Staff #5 (Program Director) confirmed that the facility's vehicles did not contain the required emergency document.
Evidence:
1. Neither of the facility's vehicles used for transporting children contained the required emergency document.
2. Staff #5 (Program Director) confirmed that the facility's vehicles did not contain the required emergency document.
Plan of Correction: The facility responded: The emergency documentation was created for both vans.
Standard 8VAC20-780-560-G
Based on interviews, it was determined that the licensee did not ensure that when food is brought from home it is labeled with the child's name and date.
Evidence:
1. The Licensing Inspector observed two cans of formula on top of the refrigerator in the Toddler/Infant classroom that were not labeled with the date that they were opened.
2. The staff present in the classroom acknowledged that the two cans of formula were not labeled with the date.
Evidence:
1. The Licensing Inspector observed two cans of formula on top of the refrigerator in the Toddler/Infant classroom that were not labeled with the date that they were opened.
2. The staff present in the classroom acknowledged that the two cans of formula were not labeled with the date.
Plan of Correction: The facility responded: The cans of formula was labeled and staff was re-trained to write the date on open formula cans.
Standard 8VAC20-780-570-C
Based on a review of documentation and interviews, it was determined that the licensee did not ensure that the record of each child shall contain the child's feeding schedule and brand of formula.
Evidence:
1. There was no documentation of a feeding schedule for each child and the brand of formula.
2. The staff present in the Infant classroom confirmed that there was not documentation of a feeding schedule for each child who is on formula and the name brand of the formula.
Evidence:
1. There was no documentation of a feeding schedule for each child and the brand of formula.
2. The staff present in the Infant classroom confirmed that there was not documentation of a feeding schedule for each child who is on formula and the name brand of the formula.
Plan of Correction: The facility responded: A feeding schedule was added in the infant classroom.