Inspection · 2022-10-17
Date
2022-10-17
Complaint Related
No
Licensing Inspector
Karen Dickens
(571) 423-6978
(571) 423-6978
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.
? 8VAC20-820 THE LICENSE.
? 8VAC20-820 THE LICENSING PROCESS.
? 8VAC20-820 HEARINGS PROCEDURES.
? 8VAC20-770 Background Checks (8VAC20-770)
? 20 Access to minor?s records
? 22.1 Background Checks Code, Carbon Monoxide
? 63.2 Child Abuse & Neglect
? 8VAC20-790 Subsidy Regulations.
Inspector Notes
An unannounced renewal inspection was conducted today between the hours of 10:45 am-1:00 pm. There were a total of 18 children with six supervising staff members present. Children were observed during snack time, lunch time, handwashing, engaged in group activities and outdoor play time. A selection of staff and children records, and other documents were reviewed. The physical space, emergency supplies, evacuation drills, attendance records, and the Emergency Preparedness Plan were reviewed. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Karen.dickens@doe.virginia.gov.
Violations
11Standard 22.1-289-036-B-4
Based on record review and interview, it was determined that the Corporation did not ensure that board officers that lived out of the state of Virginia within the last five years have in their files the results of an out of state Central Registry search request within 30 days of employment.
Evidence:
1. The record for Officer #1(Date of hire-06/27/2022) did not contain documentation of an out of state Central Registry search request. Officer #1 had declared on their Sworn Statement that they lived out of the state of Virginia within the last five years before employment.
2. Staff #5 confirmed that Officer #1's Out of State Central Registry search results had not been obtained.
Evidence:
1. The record for Officer #1(Date of hire-06/27/2022) did not contain documentation of an out of state Central Registry search request. Officer #1 had declared on their Sworn Statement that they lived out of the state of Virginia within the last five years before employment.
2. Staff #5 confirmed that Officer #1's Out of State Central Registry search results had not been obtained.
Plan of Correction: The Officer is currently awaiting out of state Child Abuse and Neglect search results. Once the results are returned, the director will email the licensing inspector.
Standard 8VAC20-770-40-D-1-a
Based on record review, it was determined that the Corporation did not ensure that a Central registry search results were not obtained by the end of the 30th day of employment for all officers.
Evidence:
1. Officer #1's record (Date of hire-06/27/2022) did not contain documentation of Central Registry search results. The copy of the Central Registry Search was dated 08/18/2022.
Evidence:
1. Officer #1's record (Date of hire-06/27/2022) did not contain documentation of Central Registry search results. The copy of the Central Registry Search was dated 08/18/2022.
Plan of Correction: The Officer is awaiting Central Registry results from VA. Once the officer receives the results, the director will email the licensing inspector with the results.
Standard 8VAC20-780-130-A
Based on record review and interview, the center did not obtain documentation that each child has received immunizations required by the State Board of Health before the child can attend the center.
Evidence:
1. Child #4's record (Start date-5/23/22) did not contain documentation of an immunization record.
2. Staff #5 confirmed that the immunization record had not been obtained from the parents.
Evidence:
1. Child #4's record (Start date-5/23/22) did not contain documentation of an immunization record.
2. Staff #5 confirmed that the immunization record had not been obtained from the parents.
Plan of Correction: Management will email and call the parents to obtain missing immunization records.
Standard 8VAC20-780-130-E
Based on record review, the center did not obtain documentation of additional immunizations once every six months for children under the age of two years.
Evidence:
1. Child #2's record (Start date-7/5/22) did not contain documentation of additional immunizations once every six moths. The last update was dated 03/24/22.
Evidence:
1. Child #2's record (Start date-7/5/22) did not contain documentation of additional immunizations once every six moths. The last update was dated 03/24/22.
Plan of Correction: Management have emailed the parents to get a copy of the additional immunization records from the physician.
Standard 8VAC20-780-140-A
Based on record review and interview, each child did not have a physical examination by or under the direction of a physician.
Evidence:
1. Child #4's record (Start date-5/23/22) did not contain documentation of a physical examination by or under the direction of a physician.
2. Staff #5 confirmed that documentation of a physical examination had not been obtained from the parents.
Evidence:
1. Child #4's record (Start date-5/23/22) did not contain documentation of a physical examination by or under the direction of a physician.
2. Staff #5 confirmed that documentation of a physical examination had not been obtained from the parents.
Plan of Correction: Management have emailed and called the parents to obtain a copy of the physical examination. Once received, the results will be placed in the record.
Standard 8VAC20-780-210-A-4
Based on record review and staff interview, the facility did not ensure that the program leaders had six months of supervised programmatic experience.
Evidence:
1. Staff #1's record (Start date-09/06/2022) documented that Staff #1 is a program leader. Staff #1 has documentation of a high school diploma, but does not contain documentation of prior supervised programmatic experience.
2. Staff #5 stated that Staff #1 has had prior supervised programmatic experience, but was unable to provide documentation of Staff #1's supervised programmatic experience.
Evidence:
1. Staff #1's record (Start date-09/06/2022) documented that Staff #1 is a program leader. Staff #1 has documentation of a high school diploma, but does not contain documentation of prior supervised programmatic experience.
2. Staff #5 stated that Staff #1 has had prior supervised programmatic experience, but was unable to provide documentation of Staff #1's supervised programmatic experience.
Plan of Correction: The director will email and call the lead teacher's previous places of employment to obtain documentation of six moths of supervised programmatic experience.
Standard 8VAC20-780-240-E
Based on record review, staff did not complete orientation training in first aid and cardiopulmonary resuscitation(CPR) as appropriate to the age of the children in care within 30 days of employment.
Evidence:
1. Staff #1's record (Start date-09/06/2022) did not contain documentation of complete orientation in first aid and CPR within 30 days of the first day of employment.
Evidence:
1. Staff #1's record (Start date-09/06/2022) did not contain documentation of complete orientation in first aid and CPR within 30 days of the first day of employment.
Plan of Correction: The staff member will get First Aid and CPR certified training this week.
Standard 8VAC20-780-260-A
Based on observation and interview, the center did not obtain an annual fire inspection report from the appropriate fire official having jurisdiction.
Evidence:
1. The center did not obtain an annual fire inspection report for the current year.
2. Staff #5 confirmed that the annual fire inspection had not been requested for the current year and that the inspection had not taken place.
Evidence:
1. The center did not obtain an annual fire inspection report for the current year.
2. Staff #5 confirmed that the annual fire inspection had not been requested for the current year and that the inspection had not taken place.
Plan of Correction: The director completed the application for fire permit and mailed it today. The inspection will conducted and the director will email the licensing inspector with the results.
Standard 8VAC20-780-270-A
Based on observation, areas and equipment of the center, inside and outside, were not maintained in a clean, safe and operable condition.
Evidence:
1. A corner post of the larger playground located near the roadside had deteriorating and splintering wood along the edge of the post that could snag skin.
2. Three loose panels were protruding out alongside the right side of the playground fence located near the building.
3. The wire fence that separates the toddler playground and the larger playground has unraveling wires at the bottom and top of the fence that could snag skin and clothing.
4. There was standing water located at the bottom of the two slides on the larger playground. The front area of the slides is saturated with an inch and half of water.
Evidence:
1. A corner post of the larger playground located near the roadside had deteriorating and splintering wood along the edge of the post that could snag skin.
2. Three loose panels were protruding out alongside the right side of the playground fence located near the building.
3. The wire fence that separates the toddler playground and the larger playground has unraveling wires at the bottom and top of the fence that could snag skin and clothing.
4. There was standing water located at the bottom of the two slides on the larger playground. The front area of the slides is saturated with an inch and half of water.
Plan of Correction: Work orders have been placed to address the fencing issues as well as the standing water. In the meantime, no children will be allowed to go onto the area with the water issues.
Standard 8VAC20-780-280-B
Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children.
Evidence:
1. In the Infant 2 classroom, two bottles of bleach and water solutions were located in an unlocked cabinet behind the diapering station.
Evidence:
1. In the Infant 2 classroom, two bottles of bleach and water solutions were located in an unlocked cabinet behind the diapering station.
Plan of Correction: The cabinet will be locked with a new lock.
Standard 8VAC20-780-550-G
Based on record review, documentation was not maintained of emergency evacuation, shelter-in-place, and lockdown drills.
Evidence:
1. The documentation for the emergency evacuation drills, shelter in place, and lockdown drills was missing the method used for notification of the drill and weather conditions.
Evidence:
1. The documentation for the emergency evacuation drills, shelter in place, and lockdown drills was missing the method used for notification of the drill and weather conditions.
Plan of Correction: Management will either use the department's model form or add the missing information to the emergency evacuation log.