Inspection · 2023-06-21
Date
2023-06-21
Complaint Related
No
Licensing Inspector
Brandie Viscayda
(757) 636-3427
(757) 636-3427
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
Inspector Notes
An unannounced monitoring inspection was conducted on June 21, 2023. The inspector arrived at 9:10am and departed at approximately 1:30pm. There were 33 children and 6 staff members present. A sample size of ten records were reviewed which included five children?s records and five staff records. The Inspector observed staff and children?s interactions throughout the inspection. Children were observed during free play, diapering, lunch, handwashing, and nap. No medications are administered at the center. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented. The violations are listed on the violation notice issued to the center and were reviewed with the site owner/director at the exit interview.
Violations
10Standard 8VAC20-770-60-B
Based on record review and interview, it was determined that the center did not ensure that sworn statements were completed prior to the first day of employment.
Evidence:
1. All 5 staff records that were reviewed did not have a signed sworn statement completed prior to the first day of employment.
2. Staff #1, the director, confirmed that there were no sworn statements completed for the 5 staff members prior to the first day of employment.
Evidence:
1. All 5 staff records that were reviewed did not have a signed sworn statement completed prior to the first day of employment.
2. Staff #1, the director, confirmed that there were no sworn statements completed for the 5 staff members prior to the first day of employment.
Plan of Correction: The center responded with the following: The records were updated.
Standard 8VAC20-770-60-C-2
Based on record review and interview, it was determined that the center did not ensure that central registry results by the end of the 30th day of employment was completed.
Evidence:
1. All 5 staff records that were reviewed did not have the Virginia Central Registry results by the end of the 30th day of employment.
2. Staff #1, the director, confirmed that there the Virginia Central Registry results were not completed by the end of the 30th day of employment.
Evidence:
1. All 5 staff records that were reviewed did not have the Virginia Central Registry results by the end of the 30th day of employment.
2. Staff #1, the director, confirmed that there the Virginia Central Registry results were not completed by the end of the 30th day of employment.
Plan of Correction: The center responded with the following: Director has submitted the VA Central Registry for each staff. Director will issue a registry check before the end of the employees 30th day.
Standard 8VAC20-780-270-A
Based on observation and interview, it was determined that the center did not ensure that areas and equipment of the center shall be maintained in a safe and operable condition.
Evidence:
1. In the main hallway of the center in front of the 1 year old classroom, where all the children pass and walk through to go to their classrooms, there is a water HVAC leak from the ceiling. There are containers catching the water from the ceiling and a wet towel beside the containers. There is water on the floor around the containers making it a significant tripping, slipping, and injury hazard to the children in care.
2. In the infant room there are physical plant violations for the following:
a. Three of the four crib sheets are loose fitting making it a chocking hazard to the children in care.
b. The power cord to the television that is mounted to the wall is in reach of children in care. Should the children pull on the power cord, it poses as an injury and tipping hazard.
3. In the 1 year old room there are physical plant violations for the following:
a. There are several spots throughout the classroom that have peeling paint to the walls where the staples were removed.
b. There is a power cord to the television that is on the floor and in reach of the children. This poses as an injury hazard to the children in care.
c. The toy bin shelf stands unstable and not mounted to the floor or the wall. With it being unstable poses as a tipping and injury hazard to the children in care.
d. The door knob handle to the classroom is broken with a sharp pointing edge left on the handle which is directly at the level of the children's heads. There is no knob to open the door. The handle is in reach of children in care and poses as a significant injury hazard to the children.
4. In the 4-5 year old classroom there are physical plant violations for the following:
a. The baseboard to the floor is loose and unstable along one side of the wall. This poses as a possible injury hazard to the children in care.
b. The carpet on the classroom has tape to reinforce the tear. The tape was tearing off making it a tripping hazard to the children in care.
Evidence:
1. In the main hallway of the center in front of the 1 year old classroom, where all the children pass and walk through to go to their classrooms, there is a water HVAC leak from the ceiling. There are containers catching the water from the ceiling and a wet towel beside the containers. There is water on the floor around the containers making it a significant tripping, slipping, and injury hazard to the children in care.
2. In the infant room there are physical plant violations for the following:
a. Three of the four crib sheets are loose fitting making it a chocking hazard to the children in care.
b. The power cord to the television that is mounted to the wall is in reach of children in care. Should the children pull on the power cord, it poses as an injury and tipping hazard.
3. In the 1 year old room there are physical plant violations for the following:
a. There are several spots throughout the classroom that have peeling paint to the walls where the staples were removed.
b. There is a power cord to the television that is on the floor and in reach of the children. This poses as an injury hazard to the children in care.
c. The toy bin shelf stands unstable and not mounted to the floor or the wall. With it being unstable poses as a tipping and injury hazard to the children in care.
d. The door knob handle to the classroom is broken with a sharp pointing edge left on the handle which is directly at the level of the children's heads. There is no knob to open the door. The handle is in reach of children in care and poses as a significant injury hazard to the children.
4. In the 4-5 year old classroom there are physical plant violations for the following:
a. The baseboard to the floor is loose and unstable along one side of the wall. This poses as a possible injury hazard to the children in care.
b. The carpet on the classroom has tape to reinforce the tear. The tape was tearing off making it a tripping hazard to the children in care.
Plan of Correction: The center responded with the following:
1. The leak was corrected by an HVAC specialist that same day. Director introduced the specialist to licensing inspector. The leak started overnight and Admin contacted the property manager upon notice.
2. A)ordered and fitted
B) cord secured properly to wall
3. A) Wall to be painted over on 6/30/3023
B) Power cord secured to wall properly.
C) Toy shelf was secured during inspection.
D) Door handle was replaced on 6/22/23
4. Baseboard was resealed and carpet was corrected and taped down after inspection.
1. The leak was corrected by an HVAC specialist that same day. Director introduced the specialist to licensing inspector. The leak started overnight and Admin contacted the property manager upon notice.
2. A)ordered and fitted
B) cord secured properly to wall
3. A) Wall to be painted over on 6/30/3023
B) Power cord secured to wall properly.
C) Toy shelf was secured during inspection.
D) Door handle was replaced on 6/22/23
4. Baseboard was resealed and carpet was corrected and taped down after inspection.
Standard 8VAC20-780-440-B
Based on observation and interview, it was determined that the center did not ensure that cribs be identified for use by a specific child.
Evidence:
1. In the infant room with 4 children present, the 4 cribs did not have labels or names that identified each crib use by a specific child.
2. Staff #1 confirmed that the cribs were not labeled with the children?s names that identified for use by a specific child.
Evidence:
1. In the infant room with 4 children present, the 4 cribs did not have labels or names that identified each crib use by a specific child.
2. Staff #1 confirmed that the cribs were not labeled with the children?s names that identified for use by a specific child.
Plan of Correction: The center responded with the following: 1. Labels have been placed in a visible space. 2. Staff are able to see where the labels are.
Standard 8VAC20-780-440-E
Based on observation and interview, it was determined that the center did not ensure that there shall be at least 12 inches of space between occupied cots.
Evidence:
1. During nap time in the 2 and 3 year old classroom, the four cots were side by side with no space between each individual cot.
2. Staff #1 confirmed that the cots in the 2 and 3 year old classroom were not 12 inches of space between occupied cots.
Evidence:
1. During nap time in the 2 and 3 year old classroom, the four cots were side by side with no space between each individual cot.
2. Staff #1 confirmed that the cots in the 2 and 3 year old classroom were not 12 inches of space between occupied cots.
Plan of Correction: The center responded with the following: Cots will be 12 inches apart from now on.
Standard 8VAC20-780-440-L
Based on observation and interview, it was determined that the center did not ensure that filled comforter blankets shall not be used by children under two years of age.
Evidence:
1. Of the 4 children in the infant room there were 3 infants with comforter filled blankets being used in their cribs.
2. Staff #1, the director, and the infant staff confirmed that they are using the comforter filled blankets with three of the four children that are under the age of two years old.
Evidence:
1. Of the 4 children in the infant room there were 3 infants with comforter filled blankets being used in their cribs.
2. Staff #1, the director, and the infant staff confirmed that they are using the comforter filled blankets with three of the four children that are under the age of two years old.
Plan of Correction: The center responded with the following: Blankets were removed from crib and staff was instructed to follow licensing standards. No blankets are to be used for infants.
Standard 8VAC20-780-450-A
Based on observation and interview, it was determined that the center did not ensure cots 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. In the 1 year old classroom, there were two children asleep on their cots which both did not have a bottom cover to the cot.
2. In the 2 and 3 year old classroom all four children on their cots did not have linens consisting of a top cover and a bottom cover.
3. In the 3 year old classroom all six children on their cots did not have linens consisting of a top cover and a bottom cover.
4. Staff #1 confirmed that not all the children in care had linens that consist of a top cover and bottom cover for their cot.
Evidence:
1. In the 1 year old classroom, there were two children asleep on their cots which both did not have a bottom cover to the cot.
2. In the 2 and 3 year old classroom all four children on their cots did not have linens consisting of a top cover and a bottom cover.
3. In the 3 year old classroom all six children on their cots did not have linens consisting of a top cover and a bottom cover.
4. Staff #1 confirmed that not all the children in care had linens that consist of a top cover and bottom cover for their cot.
Plan of Correction: The center responded with the following: Bottom covers were delivered the next business day to cover the bottom of the cots. Director has sent photos of each violation corrected as well.
Standard 8VAC20-780-500-B
Based on observation and interview, it was determined that the center did not ensure that the diapering area shall have a nonabsorbent surface for diapering or changing.
Evidence:
1. The changing pad located in the children?s bathroom has tears to the padding making it an absorbent surface for diapering or changing.
2. Staff #1 confirmed the tears to the changing pad to the children?s bathroom and staff were using the pad throughout the day for diapering children.
Evidence:
1. The changing pad located in the children?s bathroom has tears to the padding making it an absorbent surface for diapering or changing.
2. Staff #1 confirmed the tears to the changing pad to the children?s bathroom and staff were using the pad throughout the day for diapering children.
Plan of Correction: The center responded with the following: Diaper pad was delivered that evening.
Standard 8VAC20-780-550-P
Based on record review and interview, it was determined that the center did not ensure that they maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include the following: 1. Date and time of injury; 2. Name of injured child; 3. Type and circumstance of the injury; 4. Staff present and treatment; 5. Date and time when parents were notified; 6. Any future action to prevent recurrence of the injury; 7. Staff and parent signatures or two staff signatures; and 8. Documentation on how parent was notified.
Evidence:
1. There was a minor injury that occurred on May 30, 2023, however the injury report did not contain the required documentation including the date and time of the injury, documentation of date and time when the parents were notified, any future action to prevent recurrence of the injury, and staff and parent signatures or two staff signatures.
2. Staff #1 confirmed that there was not a signed copy of the incident report from May 30, 2023.
Evidence:
1. There was a minor injury that occurred on May 30, 2023, however the injury report did not contain the required documentation including the date and time of the injury, documentation of date and time when the parents were notified, any future action to prevent recurrence of the injury, and staff and parent signatures or two staff signatures.
2. Staff #1 confirmed that there was not a signed copy of the incident report from May 30, 2023.
Plan of Correction: The center responded with the following: The injury report did not put on the traditional injury report, however, the injury was in fact noted but did not have the date implemented. Admin will following paper protocol for every incident. Make sure all reports are signed and dated.
Standard 8VAC20-780-70
Based on record review and interview, it was determined that the center did not ensure that the following staff records contain documentation that two or more references as to character and reputation as well as competency were checked before employment.
Evidence:
1. All 5 staff records that were reviewed did not have two or more references as to character and reputation as well as competency were checked before employment.
2. Staff #1, the director, confirmed that there were no reference checks completed for the 5 staff records that were reviewed.
Evidence:
1. All 5 staff records that were reviewed did not have two or more references as to character and reputation as well as competency were checked before employment.
2. Staff #1, the director, confirmed that there were no reference checks completed for the 5 staff records that were reviewed.
Plan of Correction: The center responded with the following: All staff records were viewed and updated.