Inspection · 2023-08-22

Based upon staff interview, the facility has not ensured that they have maintained current written list of all children's allergies, sensitivities and dietary restrictions.
Evidence:
Staff 1 was unable to produce a current written list of children with allergies, sensitivities and dietary restrictions.

Repeat violation
Based upon review of children's records, the facility has not ensured that each child's record includes all required information.
Evidence:
1. The records provided for child 1, child 2 and child 3 did not include the street addresses for the persons designated to be contacted if a parent cannot be reached.
2. The records for child 1, 2 and 3 did not include the addresses for the parent's/guardian's place of employment.

Based upon review of staff records, the facility has not ensured that staff have completed documentation of the individual's sworn statement or affirmation as to whether the individual has been the subject of a founded child abuse or neglect complaint or has been convicted of a crime.
Evidence;
The records provided for staff 2 and 4 did not include completed and signed sworn disclosure or affirmation statements.

Based upon review of staff records, the facility has not ensured that staff records include documentation that the ten hour pre-service training required by 8VAC20-790-600 has been completed.
Evidence:
The record provided for staff 4 did not include documentation of the required preservice training.

Repeat violation
Based upon observation, the facility has not ensured that hazardous substances are kept in locked places using safe locking methods that prevent access by children.
Evidence:
1. There were containers of disinfectant, hand sanitizer and antibacterial hand soap, all with warning labels, on the sink in the girls' restroom.
2. There were containers of diaper creams, with warning labels on an open shelf in the infant area.

Based upon observation and staff interview, the facility has not ensured that the diaper changing area has access to a sink with warm running water.
Evidence:
1. There was no sink near the diaper changing station in the infant area at the far side of the long classroom.
2. Staff stated that after changing a child's diaper, the staff person and the child were walked across the classroom, through the doors to the entry hallway where there was a portable sink with water to wash hands. This sink did not have warm water.

Based upon staff interview, the facility has not ensured that prescription medication is administered only with written permission of the parent.
Evidence:
1. Staff 1 stated that staff 2 administered Diazepam to child 1 who appeared to be having a seizure. The facility did not have written authorization from the parent for the Diazepam to be administered.
2. Staff 2 confirmed that she administered the Diazepam to child 1 without written parent authorization.

Based upon staff interview, the facility has not ensured that medication is administered by staff who has satisfactorily completed a training program developed by the Board of Nursing and taught by a registered nurse, a licensed practical nurse, a nurse practitioner, a physician assistant, a physician or pharmacist (Medication Administration Training, MAT).
Evidence:
Staff 1 and 2 both verified that staff 2 administered Diazepam rectally to child 1 who appeared to be having a seizure. Staff 2 has not completed a training program to be allowed to administer medication to the children (Medication Administration Training - MAT). Staff 2 has not obtained the additional training required to administer rectally administered medication.

Based upon observation and staff interview, the facility has not ensured that medication has been dispensed by a pharmacy and is maintained in the original labeled container.
Evidence:
Staff 1 produced Diazepam that is stored for emergency administration to child 1. The medication was not labeled with the child's name, nor was it in an original labeled prescription container.

Based upon staff interview, the facility has not ensured that a record is kept of prescription medication given to children.
Evidence:
Staff 1 stated that Diazepam had been administered to children 1 who appeared to be having a seizure. There was no written record documenting the administration of the Diazepam.

Based upon observation and staff interview, the facility has not ensured that emergency evacuation and shelter-in-place procedures or maps are posted in locations conspicuous to staff and children.
Evidence:
1. There were no emergency evacuation and shelter-in-place procedures or maps posted in the foyer, hallway or classrooms of the facility.
2. Staff 1 verified with a walk-through that no procedures or maps were posted.