Inspection · 2023-10-24

Based on review of three staff?s records, the center failed to ensure that all required out of state background checks were obtained.

Evidence:
Staff # 1 had a documented employment date of 08/09/2023. Staff # 1 indicated on the sworn statement that they have lived outside of the state of Virginia in the past five years. An out of state Child Protective Service findings was not in the record.

Based on review of five children?s records, the center failed to ensure that all children had the immunization record prior to beginning attendance.

Evidence:

The record for Child # 2, with a documented
first day of attendance of 02/28/2023, did not have the immunization prior to attending. The immunizations in the record were dated 7/24/2023.

Based on record review and interviews, the center failed to 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 record for Child # 2 contained documentation that the first date of attendance was 02/28/2023; the date on the physical exam for Child 2 was 07/24/2023.
2. The record for Child # 3 contained documentation that the first date of attendance was 06/29/2023; there was not documentation of a physical exam in the record.

Based on record review, the center failed to ensure that each report of immunization and
physical examination shall include the date of the physical examination and dates
immunizations were received and shall be signed by a physician, his designee, or an
official of a local health department.

Evidence:

1. The immunization report in the record for Child # 3 was not dated by a physician, his
designee, or an official of a local health department.

2. The immunization report in the record for Child # 4 was not signed by a physician, his
designee, or an official of a local health department.

Based on observation, the center failed to ensure that in areas used by children of
preschool age or younger electrical outlets shall have protective covers.

Evidence:

There were 2 uncovered electrical outlets on wall next to the outside door in the infant room. The uncovered outlets were not accessible to the children.

Based on observation of the playground area, the center failed to ensure all immediate fall zones had the required amount of resilient surfacing.

Evidence:
Observed on the playground the measurable amount of resilient surfacing was 3 or 4 inches with dirt being the main part of the resilient surfacing around the climbable play equipment.
According to the attachment VII in the Standards for Licensed Child Day Center the amount of resilient surfacing is six to nine inches based on the height if the equipment. Children were observed on the playground using the climbing equipment.

Based on observation, the center failed to ensure that all medications were locked.

Evidence:

On the shelf in child # 1 basket was an opened tube of prescription diaper cream that was unlocked.

Based on observation and review of medications and authorizations, the center
failed to ensure that all medications were returned to the parent or guardian within 14 days after the authorization expired or disposed of by the center.

Evidence:

Medication authorization for Child # 1 to administer prescription diaper cream was signed by the parent on 09/11/2023 and expired on 09/24/2023. The medication had not been returned to the parent. The medication was observed in the center on the day of the investigation.

Based on review of nonprescription medication and topicals, the center failed to ensure that all nonprescription medication and topicals were not kept or used beyond the expiration date.

Evidence:

1. There were two diaper ointments in the toddler room that had expired. The AD ointment expired on 7/23 and the Destin expired on 1/23.

Based on review of sunscreens, the center failed to ensure that all sunscreens were labeled with the owner?s name.

Evidence:

There was a diaper ointment in the toddler room that was not labeled with the owner?s name.