Inspection · 2024-08-28
(540) 272-6558
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
8VAC20-770 Background Checks
20 Access to minor's records
22.1 Background Checks Code, Carbon Monoxide
32.1 Report by person other than physician
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced, on-site renewal inspection was initiated on August 28, 2024 and completed on August 28, 2024 as a part of probation, and the provisional licensure period. The on-site inspection began at 10:20 a.m. and ended at 2:30 p.m. The inspector reviewed compliance
in the areas listed above.
There were 58 children present and 9 staff. The inspector reviewed six children?s records and eight 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 deficient practice will be or has been corrected. Submit your POC within five (5) business days from today, which will be the close of business on September 11, 2024. A POC submitted after this date will not appear on the public website.
Violations
6SYSTEMIC VIOLATION
Based on review of documentation, the center failed to request out of state background checks for any staff that has resided outside of Virginia in the last five years prior to employment.
Evidence: Staff #3, date of hire 8/10/2024, had a New York state identification card issued in 2023 on file in the record. Staff interview revealed that the staff member had resided outside of the state of Virginia in the last five years. There was no out of state central registry or sex offender check on file.
Staff #4, date of hire 7/30/2024, indicated out of state residence in Georgia on their central registry background check form in the last five years. There was no out of state central registry or sex offender check on file.
SYSTEMIC VIOLATION
Based on review of documentation, the center failed to ensure that central registry background check results were obtained within 30 days of employment.
Evidence: The central registry results for Staff #5, hired 9/18/2023, was dated 1/25/2024.
Based on observation, the center failed to ensure all equipment and material was maintained in safe, operable condition. Evidence: In the three?s classroom reading nook, there was a CD player plugged in and sitting in the window sill which created a trip hazard and falling-object hazard. The CD player was partially off the ledge of the sill.
Evidence: In the three?s classroom, there was a set of keys stored on top of bookcase. Staff interview confirmed that there was a canister of pepper spray on the keys accessible to children in care.
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure all behavioral guidance was constructive in nature. Evidence: While in the director?s office, the assistant director and licensing inspector heard staff #2 in the three?s classroom use a very loud voice tone to shout at a child.