Inspection · 2022-05-27
Date
2022-05-27
Complaint Related
No
Licensing Inspector
D'Nae Goodwin
(757) 404-3063
(757) 404-3063
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 (8VAC20-770)
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
63.2 Child Abuse & Neglect
Inspector Notes
A monitoring inspection was conducted on 5/27/22 from 12:45pam until 1:45pm. At the time of the inspection, there were 10 children in care with 3 staff present. Children were observed engaging in free play and resting quietly during nap time. Diapering and handwashing procedures were also observed. A record review was conducted at the center on 6/17/22 from 9;30am until 11:30 am. A sample of 6 children's records and 6 staff records were reviewed. First aid and emergency supplies, the emergency preparedness plan, documentation of emergency practice drills and required center postings were reviewed. Information gathered during the inspection determined non-compliance with applicable standards or law. Violations are listed on the violation notice issued to the center and were discussed with the center owner during the exit interview.
Violations
18Standard 22.1-289.035-B-2
Based on record review and interview, the center did not ensure that the results of a
national fingerprint search are received for each staff member before employment.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain the results of a national fingerprint search. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking documentation of the results of a national fingerprint search.
national fingerprint search are received for each staff member before employment.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain the results of a national fingerprint search. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking documentation of the results of a national fingerprint search.
Plan of Correction: The center responded with the following: An appointment for fingerprinting will be scheduled for staff 1 as soon as possible. Once received, the results will be forwarded to the licensing inspector. Going forward, center management will ensure fingerprint results have been received prior to employment.
Standard 22.1-289.035-B-4
Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry is obtained from any state in which the individual has resided in the preceding five years.
Evidence:
1. Staff 2 has a hire date of 5/14/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of Georgia within the past five years. The results of a central registry search from the state of Georgia was not available for staff 2.
2. The center owner confirmed that the central registry search for staff 2 from the state of Georgia has not been requested.
Evidence:
1. Staff 2 has a hire date of 5/14/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of Georgia within the past five years. The results of a central registry search from the state of Georgia was not available for staff 2.
2. The center owner confirmed that the central registry search for staff 2 from the state of Georgia has not been requested.
Plan of Correction: The center responded with the following: The out-of-state central registry search request for staff 2 will be requested and results will be forwarded to the licensing inspector. Going forward, center management will ensure out-of-state background checks are completed in the appropriate timeframes.
Standard 8VAC20-770-60-B
Based on record review and interview, the center did not ensure that an employee of a licensed registered child day program must not be employed until the agency has the person's completed sworn statement or affirmation.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain a sworn statement or affirmation. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking a sworn statement or affirmation.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain a sworn statement or affirmation. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking a sworn statement or affirmation.
Plan of Correction: The center responded with the following: Staff 1 will complete a sworn statement as soon as possible and it will be placed in the staff's record.
Standard 8VAC20-770-60-C-2
Based on record review and interview, the center did not ensure that the results of a central registry finding are received within 30 days of employment.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain the results of a central registry finding. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking documentation of a central registry finding.
Evidence:
1. The record for staff 1 (date of hire unknown) does not contain the results of a central registry finding. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22.
2. The center owner confirmed that the record for staff 1 is lacking documentation of a central registry finding.
Plan of Correction: The center responded with the following: The central registry request for staff 1 will be mailed off as soon as possible and results will be forwarded to the licensing inspector. Going forward, center management will ensure central registry checks are completed within the required timeframe.
Standard 8VAC20-780-130-A
Based on record review and interview, the center did not ensure that documentation that each child has received the immunizations required by the State Board of Health are obtained before the child can attend the center.
Evidence:
1. The records for child 2 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of immunizations. Both children were in care on the day of the inspection.
2. The center owner confirmed that the records for child 2 and child 6 are lacking documentation of immunizations.
Evidence:
1. The records for child 2 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of immunizations. Both children were in care on the day of the inspection.
2. The center owner confirmed that the records for child 2 and child 6 are lacking documentation of immunizations.
Plan of Correction: The center responded with the following: The parents of child 2 and child 6 will be contacted to obtain documentation of immunizations.
Standard 8VAC20-780-140-A
Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance.
Evidence:
1. The records for child 2 (date of enrollment unknown), child 3 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of a physical examination.
2. The center owner confirmed that the records for child 2, child 3 and child 6 are lacking documentation of a physical examination.
Evidence:
1. The records for child 2 (date of enrollment unknown), child 3 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of a physical examination.
2. The center owner confirmed that the records for child 2, child 3 and child 6 are lacking documentation of a physical examination.
Plan of Correction: The center responded with the following: The parents of child 2, child 3 and child 6 will be contacted to obtain documentation of physical exams.
Standard 8VAC20-780-160-A
Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening.
Evidence:
1. The record for staff 2 (date of hire: 5/14/22) does not contain documentation of a negative tuberculosis screening.
2. The center owner confirmed that the record for staff 2 is lacking documentation of a negative tuberculosis screening.
Evidence:
1. The record for staff 2 (date of hire: 5/14/22) does not contain documentation of a negative tuberculosis screening.
2. The center owner confirmed that the record for staff 2 is lacking documentation of a negative tuberculosis screening.
Plan of Correction: The center responded with the following: Staff 2 will obtain a TB screening as soon as possible.
Standard 8VAC20-780-340-F
Based on observation and interview, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff.
Evidence:
1. During the inspection on 5/27/22, inspectors observed staff 3 (infant teacher) take an infant into the restroom and close the door to change that child's diaper, leaving the other 4 infants in her care without sight and sound supervision.
2. Staff 3 confirmed that she took one of the infants into the restroom to change her diaper and closed the door, leaving the other 4 infants in her care without sight and sound supervision.
Evidence:
1. During the inspection on 5/27/22, inspectors observed staff 3 (infant teacher) take an infant into the restroom and close the door to change that child's diaper, leaving the other 4 infants in her care without sight and sound supervision.
2. Staff 3 confirmed that she took one of the infants into the restroom to change her diaper and closed the door, leaving the other 4 infants in her care without sight and sound supervision.
Plan of Correction: The center responded with the following: Center staff will be retrained on appropriate sight and sound supervision at all times.
Standard 8VAC20-780-350-B-1
Based on observation and interview, the center did not ensure that the staff-to-children ratio of 1:4 for birth up to 16 months is maintained.
Evidence:
1. During the inspection on 5/27/22, the inspectors observed 1 staff person caring for 5 infants in the infant room. The number and ages of the children required 2 staff to be present.
2. Staff 3 confirmed that she was the only staff person in the infant room with 5 children.
Evidence:
1. During the inspection on 5/27/22, the inspectors observed 1 staff person caring for 5 infants in the infant room. The number and ages of the children required 2 staff to be present.
2. Staff 3 confirmed that she was the only staff person in the infant room with 5 children.
Plan of Correction: The center responded with the following: The center will ensure that appropriate ratios are maintained at all times.
Standard 8VAC20-780-410-2
Based on observation and interview, the center did not ensure enclosure in a small confined space or any space that the child cannot freely exit himself is forbidden.
Evidence:
1. During the inspection on 5/27/22, the inspectors observed child 4 (age 23 months), child 5 (age 20 months) and child 7 (age 17 months) strapped in their high chairs from the time of inspectors' arrival at 12:45pm until 1:20pm.
2. Staff 1 and staff 2 stated child 4, child 5 and child 7 had been in the high chairs since 11:45am and that they kept them in the high chairs because they would not lay down at nap time and would run around the center and wake the other children who were napping.
a. Child 4, child 5 and child 7 were not taken out of the high chairs until the licensing inspectors asked staff 1 and 2 why the children were still confined to the their high chairs.
Evidence:
1. During the inspection on 5/27/22, the inspectors observed child 4 (age 23 months), child 5 (age 20 months) and child 7 (age 17 months) strapped in their high chairs from the time of inspectors' arrival at 12:45pm until 1:20pm.
2. Staff 1 and staff 2 stated child 4, child 5 and child 7 had been in the high chairs since 11:45am and that they kept them in the high chairs because they would not lay down at nap time and would run around the center and wake the other children who were napping.
a. Child 4, child 5 and child 7 were not taken out of the high chairs until the licensing inspectors asked staff 1 and 2 why the children were still confined to the their high chairs.
Plan of Correction: The center responded with the following: Staff are supposed to have children who are not napping engage in a quiet activity. Staff will be retrained on the center's procedures for children who do not nap and appropriate ways to engage non-napping children during quiet time.
Standard 8VAC20-780-440-B
Based on record review and interview, the center did not ensure cribs shall be identified for use by a specific child.
Evidence:
1. In the infant room, there were 3 infants who were placed in cribs identified for use by other children.
2. In the infant room, 1 infant did not have a crib identified for use by that child.
3. Staff 3 confirmed that the infants were not placed in the correct cribs and that one infant did not have a crib identified for use.
Evidence:
1. In the infant room, there were 3 infants who were placed in cribs identified for use by other children.
2. In the infant room, 1 infant did not have a crib identified for use by that child.
3. Staff 3 confirmed that the infants were not placed in the correct cribs and that one infant did not have a crib identified for use.
Plan of Correction: The center responded with the following: This was corrected during the inspection. Staff will be reminded to place children in their individually labeled cribs.
Standard 8VAC20-780-450-A
Based on observation and interview, the center did not ensure that cots and mats used by children other than infants during the designated rest period shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges.
Evidence:
1. Three of the children did not have bottom covers during the designated rest period.
2. Staff confirmed that not all of the children in care have the required bottom covers during nap time.
Evidence:
1. Three of the children did not have bottom covers during the designated rest period.
2. Staff confirmed that not all of the children in care have the required bottom covers during nap time.
Plan of Correction: The center responded with the following: Parents have been reminded to bring in top and bottom covers for their children's cots. Additional covers have been ordered to have at the center in case a child does not have a top or bottom cover.
Standard 8VAC20-780-510-G
Based on observation and interview, the center did not ensure that medication shall be labeled with the child's name.
Evidence:
1. There was a bottle of children's Tylenol in the center that was not labeled with the child's name.
2. Staff confirmed that the medication was not labeled with the child's name and could not state who the medication belonged to.
Evidence:
1. There was a bottle of children's Tylenol in the center that was not labeled with the child's name.
2. Staff confirmed that the medication was not labeled with the child's name and could not state who the medication belonged to.
Plan of Correction: The center responded with the following: The medication does not belong to any child currently enrolled at the center and was disposed of. Going forward, the center will ensure that all children's medication is properly labeled.
Standard 8VAC20-780-510-L
Based on observation and interview, the center did not ensure that medication shall be kept in a locked place using a safe locking method that prevents access by children.
Evidence:
1. There was a bottle of children's Tylenol, a bottle of over-the-counter liquid allergy medication and a Flonase spray in an unlocked cubby in the preschool classroom and was assessible to the children in care.
2. Staff 3 confirmed that the medication was not in a locked place and was assessible to children in care.
Evidence:
1. There was a bottle of children's Tylenol, a bottle of over-the-counter liquid allergy medication and a Flonase spray in an unlocked cubby in the preschool classroom and was assessible to the children in care.
2. Staff 3 confirmed that the medication was not in a locked place and was assessible to children in care.
Plan of Correction: The center responded with the following: The medication was placed in a locked place during the inspection. The center will ensure all medication stored at the center is kept locked.
Standard 8VAC20-780-520-C
Based on observation and interview, the center did not ensure that if diaper ointment or cream is used that they shall be inaccessible to children.
Evidence:
1. There was a container of diaper cream on an open shelf under the changing table in the bathroom that was accessible to children in care.
2. Staff 3 confirmed that the diaper cream was accessible to children.
Evidence:
1. There was a container of diaper cream on an open shelf under the changing table in the bathroom that was accessible to children in care.
2. Staff 3 confirmed that the diaper cream was accessible to children.
Plan of Correction: The center responded with the following: The diaper cream was removed from the shelf and placed in an area inaccessible to children.
Standard 8VAC20-780-570-B
Based on observation and interview, the center did not ensure that bottle fed infants who cannot hold their own bottles shall be held when fed and that bottles shall not be propped.
Evidence:
1. There were 3 infants in infant carrier seats drinking from bottles that were propped up with blankets, creating a choking hazard.
2. Staff 3 confirmed that the infants were being fed bottles by propping the bottles with blankets.
Evidence:
1. There were 3 infants in infant carrier seats drinking from bottles that were propped up with blankets, creating a choking hazard.
2. Staff 3 confirmed that the infants were being fed bottles by propping the bottles with blankets.
Plan of Correction: The center responded with the following: This was corrected during the inspection. Staff will be retrained on appropriate infant feeding procedures.
Standard 8VAC20-780-60-A
Based on record review and interview, the center did not ensure that children's records contain all the required information.
Evidence:
1. The records for child 1, child 2, child 3, child 4 and child 5 do not contain the first dates of attendance.
2. The record for child 3 does not contain the address for one of the two designated people to call in an emergency if a parent cannot be reached.
3. There is no record for child 6 available for review.
3. The center owner confirmed that the records for child 1, child 2, child 3, child 4 and child 5 are lacking the above missing information and that there is no record available for review for child 6.
Evidence:
1. The records for child 1, child 2, child 3, child 4 and child 5 do not contain the first dates of attendance.
2. The record for child 3 does not contain the address for one of the two designated people to call in an emergency if a parent cannot be reached.
3. There is no record for child 6 available for review.
3. The center owner confirmed that the records for child 1, child 2, child 3, child 4 and child 5 are lacking the above missing information and that there is no record available for review for child 6.
Plan of Correction: The center responded with the following: Each child's date of enrollment will be documented in the child's record. The address for child 3's second emergency contact will be obtained from the parent. A record for child 6, with all the required information, will be completed.
Standard 8VAC20-780-70
Based on record review and interview, the center did not ensure that staff records contain all the required information.
Evidence:
1. The record for staff 1 does not contain a date of employment; a name, address and telephone number of a person to be notified in an emergency; or, documentation that two or more references as to character and reputation as well a competency were checked before employment.
2. The record for staff 2 (date of hire: 5/14/22) does not contain documentation that two or more references as to character and reputation as well a competency were checked before employment.
3. The center director confirmed that the records for staff 1 and staff 2 are lacking the above missing information.
Evidence:
1. The record for staff 1 does not contain a date of employment; a name, address and telephone number of a person to be notified in an emergency; or, documentation that two or more references as to character and reputation as well a competency were checked before employment.
2. The record for staff 2 (date of hire: 5/14/22) does not contain documentation that two or more references as to character and reputation as well a competency were checked before employment.
3. The center director confirmed that the records for staff 1 and staff 2 are lacking the above missing information.
Plan of Correction: The center responded with the following: The missing information for staff 1 and staff 2 will be obtained and placed in their record.