Inspection · 2023-11-20
Date
2023-11-20
Complaint Related
No
Licensing Inspector
Rebecca Forestier
(540) 309-2835
(540) 309-2835
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
22.1 Early Childhood Care and Education
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced monitoring inspection was conducted on 11/20/2023. There were 57 children, ages 2 months - 4 years, 12 staff members providing direct care and supervision and various support staff present during the inspection. The inspector reviewed compliance in the areas of administration, staff qualifications and trainings, physical plant, staffing and supervision, programs, emergencies, and nutrition. The children were observed during self-directed activities, teacher directed activities, outdoor time, mealtime and naptime. A total of 5 children?s records, 5 staff records and 1 medication were reviewed. The inspector discussed the following with the provider: playground policy, children?s records, fire inspection, and medications. The inspector arrived for the inspection at approximately 9:45 am and departed at approximately 2:45 pm.
The information gathered during the inspection determined non- compliance with applicable standards or law and violations were documented on the violation notice to the provider.
Violations
13Standard 8VAC20-780-130-A
SYSTEMIC VIOLATION
Based on record review, the center failed to obtain documentation that each child has received the immunization required by the State Board of Health before the child can attend the center.
Evidence: The record for Child 4 documented the first date of attendance as 10/09/2023. The immunization record was obtained 10/11/2023.
Based on record review, the center failed to obtain documentation that each child has received the immunization required by the State Board of Health before the child can attend the center.
Evidence: The record for Child 4 documented the first date of attendance as 10/09/2023. The immunization record was obtained 10/11/2023.
Plan of Correction: Provider will obtain before children are enrolled.
Standard 8VAC20-780-140-A
SYSTEMIC VIOLATION
Based on record review, the center failed to obtain documentation 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: The record for Child 5 documented the first date of attendance of 07/13/2022. The physical examination was dated 02/20/2023.
Based on record review, the center failed to obtain documentation 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: The record for Child 5 documented the first date of attendance of 07/13/2022. The physical examination was dated 02/20/2023.
Plan of Correction: Provider will obtain within the required timeframe.
Standard 8VAC20-780-280-B
SYSTEMIC VIOLATION
Based on observations and interviews with staff, the center failed to ensure that hazardous substances such as cleaning materials, insecticides and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.
Evidence: An aerosol can of ?disinfectant spray? and an unlabeled spray bottle containing purple liquid was located in the unlocked bottom drawer of a 3 drawer unit located in the ?4s? room. Staff 5 confirmed the purple liquid was ?Fabuloso and bleach mixture.?
Based on observations and interviews with staff, the center failed to ensure that hazardous substances such as cleaning materials, insecticides and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.
Evidence: An aerosol can of ?disinfectant spray? and an unlabeled spray bottle containing purple liquid was located in the unlocked bottom drawer of a 3 drawer unit located in the ?4s? room. Staff 5 confirmed the purple liquid was ?Fabuloso and bleach mixture.?
Plan of Correction: Provider will ensure hazards substances are locked and review standards with staff.
Standard 8VAC20-780-280-F
SYSTEMIC VIOLATION
Based on observations and interview with staff, the center failed to ensure that if hazardous substances are not kept in original containers, the substitute containers shall clearly indicate their contents and shall not resemble food or beverage containers.
Evidence: An unlabeled spray bottle containing purple liquid was located in the unlocked bottom drawer of a 3-drawer unit located in the ?4s? room. Staff 5 confirmed the purple liquid was ?Fabuloso and bleach mixture.?
Based on observations and interview with staff, the center failed to ensure that if hazardous substances are not kept in original containers, the substitute containers shall clearly indicate their contents and shall not resemble food or beverage containers.
Evidence: An unlabeled spray bottle containing purple liquid was located in the unlocked bottom drawer of a 3-drawer unit located in the ?4s? room. Staff 5 confirmed the purple liquid was ?Fabuloso and bleach mixture.?
Plan of Correction: Bottle was labeled during inspection
Standard 8VAC20-780-330-B
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles.
Evidence:
1. The resilient surfacing, (mulch) under the small climbing equipment with the blue slides measured less than one inch. The ground was visible at the bottom of the slide. The small climbing equipment measured approximately 3? tall. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
2. The resilient surfacing, (mulch) under the large climbing equipment with the blue slide measured approximately one inch. The large climbing equipment measured approximately 5?9? tall. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
3. The resilient surfacing, (mulch) under the ?stepping pads? measured approximately two inches. The ?stepping pads? equipment measured approximately 16? off the ground. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles.
Evidence:
1. The resilient surfacing, (mulch) under the small climbing equipment with the blue slides measured less than one inch. The ground was visible at the bottom of the slide. The small climbing equipment measured approximately 3? tall. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
2. The resilient surfacing, (mulch) under the large climbing equipment with the blue slide measured approximately one inch. The large climbing equipment measured approximately 5?9? tall. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
3. The resilient surfacing, (mulch) under the ?stepping pads? measured approximately two inches. The ?stepping pads? equipment measured approximately 16? off the ground. The required amount of resilient surfacing is 6?. Children were observed using this equipment.
Plan of Correction: Mulch has been ordered.
Standard 8VAC20-780-340-A
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection and guidance.
Evidence: On 11/21/2023 at approximately 10:45 am, Child 6 (18 months) and Child 7 (21 months) were observed strapped into a stroller which was left unattended in the hallway for approximately 1.5 minutes. During that time, Child 1 was observed repeatedly striking Child 2 approximately 6 times on the head and face. Child 2 was observed crying and bringing their left arm and hand over their face and head to protect themselves. Staff 1 was unaware of these actions until the Licensing Inspector brought the incident to their attention.
Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection and guidance.
Evidence: On 11/21/2023 at approximately 10:45 am, Child 6 (18 months) and Child 7 (21 months) were observed strapped into a stroller which was left unattended in the hallway for approximately 1.5 minutes. During that time, Child 1 was observed repeatedly striking Child 2 approximately 6 times on the head and face. Child 2 was observed crying and bringing their left arm and hand over their face and head to protect themselves. Staff 1 was unaware of these actions until the Licensing Inspector brought the incident to their attention.
Plan of Correction: Provider will review the standards with staff.
Standard 8VAC20-780-340-F
SYSTEMIC VIOLATION
Based on observations, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff.
Evidence: On 11/21/2023 at approximately 10:45 am, 4 children from the ?Step Up Infant (2)? room, ages 16 months- 24 months, were observe strapped into a stroller which was left unattended in the hallway for approximately 1.5 minutes. Staff 1 was observed in the classroom with one child placing linens on cots/mats while the 4 children were in the stroller in the hallway; during this time the 4 children in the stroller were not within sight and sound supervision of staff.
Based on observations, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff.
Evidence: On 11/21/2023 at approximately 10:45 am, 4 children from the ?Step Up Infant (2)? room, ages 16 months- 24 months, were observe strapped into a stroller which was left unattended in the hallway for approximately 1.5 minutes. Staff 1 was observed in the classroom with one child placing linens on cots/mats while the 4 children were in the stroller in the hallway; during this time the 4 children in the stroller were not within sight and sound supervision of staff.
Plan of Correction: Provider will review the standards with staff.
Standard 8VAC20-780-40-M
SYSTEMIC VIOLATION
Based on observation, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children?s allergies, sensitives and restrictions documented in the allergy plan. This list shall be dated and kept confidential in each room or area where children are present.
Evidence: A written list of children?s allergies, sensitives and restrictions was available for review in the kitchen during the inspection. The name of Child 1 was not listed. Child 1 has a documented food allergy requiring an allergy care plan. This list was not in each room where children where present.
Based on observation, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children?s allergies, sensitives and restrictions documented in the allergy plan. This list shall be dated and kept confidential in each room or area where children are present.
Evidence: A written list of children?s allergies, sensitives and restrictions was available for review in the kitchen during the inspection. The name of Child 1 was not listed. Child 1 has a documented food allergy requiring an allergy care plan. This list was not in each room where children where present.
Plan of Correction: Name was added during inspection.
Standard 8VAC20-780-430-I
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure if combs, toothbrushes, or other personal articles are used, they shall be individually assigned.
Evidence: Three unlabeled pacifiers were observed in the infant room.
Based on observation, the center failed to ensure if combs, toothbrushes, or other personal articles are used, they shall be individually assigned.
Evidence: Three unlabeled pacifiers were observed in the infant room.
Plan of Correction: Pacifiers were labeled during the inspection.
Standard 8VAC20-780-430-K
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure provision shall be made for an individual place for each child?s belongings.
Evidence:
1. Approximately 6 book bags, 7 jackets/coats, and a bag of pull ups were observed on a 2-shelf unit in the ?4?s? room.
2. Approximately 3 book bags, and 5 jackets/coats were observed on the floor in the ?old 2?s? room.
Based on observation, the center failed to ensure provision shall be made for an individual place for each child?s belongings.
Evidence:
1. Approximately 6 book bags, 7 jackets/coats, and a bag of pull ups were observed on a 2-shelf unit in the ?4?s? room.
2. Approximately 3 book bags, and 5 jackets/coats were observed on the floor in the ?old 2?s? room.
Plan of Correction: Cubbies have been ordered.
Standard 8VAC20-780-510-P
Based on observation and record review, the center failed to ensure when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed.
Evidence: The authorization for Medication 1 expired on 10/01/2022. Medication 1 was observed at the center on 11/21/2023.
Evidence: The authorization for Medication 1 expired on 10/01/2022. Medication 1 was observed at the center on 11/21/2023.
Plan of Correction: Provider will obtain new authorization.
Standard 8VAC20-780-560-F
Based on observation, the center failed to ensure that when a center chooses to provide meals or snacks, the center shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United Stated Department of Agriculture.
Evidence: All the required components for lunch were not provided. Lunch requires 5 of the following 5 components: fluid milk, meat/meat alternate, vegetables, fruits, and grains. Children were observed being served chicken nuggets, corn, and green beans. No grain or fluid milk was served with the meal.
Evidence: All the required components for lunch were not provided. Lunch requires 5 of the following 5 components: fluid milk, meat/meat alternate, vegetables, fruits, and grains. Children were observed being served chicken nuggets, corn, and green beans. No grain or fluid milk was served with the meal.
Plan of Correction: Children will be served all components.
Standard 8VAC20-780-80-A
SYSTEMIC VIOLATION
Based on observation, the center failed to ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.
Evidence:
1. The attendance record in the ?3-year-old? room indicated 11 children were present. There were 10 children observed in care at the time the attendance record was reviewed. The attendance did not document the departure as it occurred.
2. The attendance record in the ?Step Up Infant (2)? room indicated 7 children were present. There were 6 children observed in care at the time the attendance record was reviewed. The attendance did not document the departure as it occurred.
Based on observation, the center failed to ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.
Evidence:
1. The attendance record in the ?3-year-old? room indicated 11 children were present. There were 10 children observed in care at the time the attendance record was reviewed. The attendance did not document the departure as it occurred.
2. The attendance record in the ?Step Up Infant (2)? room indicated 7 children were present. There were 6 children observed in care at the time the attendance record was reviewed. The attendance did not document the departure as it occurred.
Plan of Correction: Provider will review the standards with staff.