Inspection · 2024-01-29
Date
2024-01-29
Complaint Related
No
Licensing Inspector
Rene Old
(757) 404-1784
(757) 404-1784
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
8VAC20-800 Administration
8VAC20-800 Personnel
8VAC20-800 Household Members
8VAC20-800 Physical Health of Caregivers and Household members
8VAC20-800 Caregiver Training
8VAC20-800 Physical Equipment and Environment
8VAC20-800 Care of Children
8VAC20-800 Preventing the Spread of Disease
8VAC20-800 Medication Administration
8VAC20-800 Emergencies
8VAC20-800 Nutrition
8VAC20-800 Nighttime Care
8VAC20-820 THE LICENSE
8VAC20-820 THE LICENSING PROCESS
8VAC20-820 HEARINGS PROCEDURES
8VAC20-770 Background Checks
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
54.1 Provider must be MAT certified to administer prescription medication.
63.2 Child abuse and neglect
Inspector Notes
An unannounced monitoring inspection was conducted on 01/29/2024 from 9:58 am - 12:15 pm. At the time of entrance there were 8 children in care with the program. The ages of the children in care counted for a total of 23 points. A second caregiver arrived at approximately 10:15 am.
Children were observed during free play and morning snack in the child care room. One infant was observed napping. Records were observed for 8 children.
The information gathered found violations in the areas of required postings, administration, physical equipment and environment, care of children and nutrition. These violations are listed on the violation notice and were reviewed with the provider at the conclusion of the inspection.
Violations
14Standard 22.1-289.011-F
Based on observation, the provider failed to ensure that the findings of the most recent inspection of the facility shall be posted on the premises of the family day home.
Evidence:
1. The findings of the most recent inspection, conducted on 11/09/2023, were not posted.
a. The provider confirmed that the inspection documents were not posted.
Evidence:
1. The findings of the most recent inspection, conducted on 11/09/2023, were not posted.
a. The provider confirmed that the inspection documents were not posted.
Plan of Correction: Provider has posted current inspection.
Standard 8VAC20-800-100-A
Based on record review and interview, the provider failed to obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance.
Evidence:
1. Child 5, enrollment date 11/06/2023, lacks documentation of the required physical exam.
a. The provider confirmed that a physical exam was not on file for child 5.
Evidence:
1. Child 5, enrollment date 11/06/2023, lacks documentation of the required physical exam.
a. The provider confirmed that a physical exam was not on file for child 5.
Plan of Correction: Parent was able to pick up child and get physical done.
Standard 8VAC20-800-240-A
Repeat Violation:
Based on observation, the provider failed to ensure that provider failed to ensure that areas and furnishings of the family day home, inside and outside, shall be maintained in a clean, safe, and operable condition. Unsafe conditions shall include, but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or could snag skin.
Evidence:
1. The outdoor smoker ,located on the backyard deck, has widespread areas of rust and peeling rust on the back side containing the ash vent in addition to the side facing the children's outdoor play area of the backyard.
a. This smoker is located on an area of the deck that is open and accessible to children playing in the backyard which is the designated outdoor play area.
2. Two pieces of metal were observed protruding from the outdoor smoker in an area directly above the ash vent. This is a protrusion hazard as the protruding metal is at face /body height of the children in care.
3. The plastic weaving was coming apart in all areas of the back of one chair placed on the outdoor deck.
a. Children must pass through this area to access the backyard play area.
4. The freezer, located in the child care room, was not secured or locked in any way to prevent children access.
a. The freezer is accessible to children in the child care room.
Based on observation, the provider failed to ensure that provider failed to ensure that areas and furnishings of the family day home, inside and outside, shall be maintained in a clean, safe, and operable condition. Unsafe conditions shall include, but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or could snag skin.
Evidence:
1. The outdoor smoker ,located on the backyard deck, has widespread areas of rust and peeling rust on the back side containing the ash vent in addition to the side facing the children's outdoor play area of the backyard.
a. This smoker is located on an area of the deck that is open and accessible to children playing in the backyard which is the designated outdoor play area.
2. Two pieces of metal were observed protruding from the outdoor smoker in an area directly above the ash vent. This is a protrusion hazard as the protruding metal is at face /body height of the children in care.
3. The plastic weaving was coming apart in all areas of the back of one chair placed on the outdoor deck.
a. Children must pass through this area to access the backyard play area.
4. The freezer, located in the child care room, was not secured or locked in any way to prevent children access.
a. The freezer is accessible to children in the child care room.
Plan of Correction: Metal pieces on the back of the smoker has been removed. (2/3/24)
The rust on the smoker has been cleaned off and painted. (2/3/24)
The plastic chair has been put in the trash. (2/8/24)
Latch has been put on the freezer. (2/5/24)
The rust on the smoker has been cleaned off and painted. (2/3/24)
The plastic chair has been put in the trash. (2/8/24)
Latch has been put on the freezer. (2/5/24)
Standard 8VAC20-800-280
Based on observation, the provider failed to ensure that potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates shall be stored away from food in areas inaccessible to children.
Evidence:
1. A can of chemical cleaning agent was observed stored inside of the ash vent for the outdoor smoker. The vent was not secured or locked in any way to prevent access by children.
a. This smoker vent is accessible to children during outdoor play.
Evidence:
1. A can of chemical cleaning agent was observed stored inside of the ash vent for the outdoor smoker. The vent was not secured or locked in any way to prevent access by children.
a. This smoker vent is accessible to children during outdoor play.
Plan of Correction: Chemicals were removed. (01/29/24)
A lock has been placed on the smoker. (01/30/24)
A lock has been placed on the smoker. (01/30/24)
Standard 8VAC20-800-320-A
Based on observation, the provider failed to ensure that small electrical appliances such as, but not limited to, curling irons, toasters, blenders, can openers, and irons shall be unplugged unless being used by the caregiver or with children under close supervision.
Evidence:
1. A blow dryer was observed plugged into a wall outlet in the family room and a Keurig coffee maker was observed plugged into a wall outlet in the kitchen.
a. Neither of these small electrical appliances were in use during the inspection.
Evidence:
1. A blow dryer was observed plugged into a wall outlet in the family room and a Keurig coffee maker was observed plugged into a wall outlet in the kitchen.
a. Neither of these small electrical appliances were in use during the inspection.
Plan of Correction: Provider has unplugged both small appliances and will continue to do so.
Standard 8VAC20-800-50-A
Based on record review and interview, the provider failed to keep a written record of children in attendance each day.
1. The attendance record, which is the parent sign-in sheet, did not have documentation that child 1, child 5 and child 6 were in care.
a. The provider stated that she had not made a parent sign-in sheet for child 1 and child 5 and further confirmed that she did not have any written documentation that these children were in care.
b. The provider stated that child 6 had arrived at 9:40 am and confirmed that he had not been signed in on the attendance/parent sign in sheet.
1. The attendance record, which is the parent sign-in sheet, did not have documentation that child 1, child 5 and child 6 were in care.
a. The provider stated that she had not made a parent sign-in sheet for child 1 and child 5 and further confirmed that she did not have any written documentation that these children were in care.
b. The provider stated that child 6 had arrived at 9:40 am and confirmed that he had not been signed in on the attendance/parent sign in sheet.
Plan of Correction: Sign-in sheets has been put in place correctly, and parent went back and signed child 6 in and provider verified.
Standard 8VAC20-800-570-A
Based on observation, the provider failed to ensure that a caregiver does not exceed 16 points.
Evidence:
1. The provider was observed alone with 8 children whose ages counted for a total of 23 points when the inspector arrived at 09:58 am.
a. The provider confirmed that a second caregiver was not present.
b. A second caregiver arrived at approximately 10:15 am.
Evidence:
1. The provider was observed alone with 8 children whose ages counted for a total of 23 points when the inspector arrived at 09:58 am.
a. The provider confirmed that a second caregiver was not present.
b. A second caregiver arrived at approximately 10:15 am.
Plan of Correction: An assistant will be with the provider at all times.
Standard 8VAC20-800-60-A
Based on record review and interview, the provider failed to maintain an up-to-date record at the family day home for each enrolled child.
Evidence:
1. The provider stated that she did not have an enrollment record on hand for child 4 who was in care during the inspection.
a. The provider stated that child 4 began care on 01/29/2024.
Evidence:
1. The provider stated that she did not have an enrollment record on hand for child 4 who was in care during the inspection.
a. The provider stated that child 4 began care on 01/29/2024.
Plan of Correction: All paperwork has been collected and enrollment records have been updated.
Standard 8VAC20-800-60-B
Repeat Violation
Based on record review, the provider failed to ensure that children's records contain all of the required elements.
Evidence:
1. The enrollment record for child 1 lacked the following required information:
a. Address for the two designated emergency contacts;
b. Policy number for child's medical insurance;
c. Chronic physical problems, pertinent developmental information and any special accommodations needed;
d. Parent did not sign enrollment form.
2. The enrollment record for child 2 lacked the following required information:
a. Address for child's physician.
3. The enrollment record for child 3 lacked the following required information:
a. The address for the two designated emergency contacts;
b. The parent did not sign the enrollment form.
Based on record review, the provider failed to ensure that children's records contain all of the required elements.
Evidence:
1. The enrollment record for child 1 lacked the following required information:
a. Address for the two designated emergency contacts;
b. Policy number for child's medical insurance;
c. Chronic physical problems, pertinent developmental information and any special accommodations needed;
d. Parent did not sign enrollment form.
2. The enrollment record for child 2 lacked the following required information:
a. Address for child's physician.
3. The enrollment record for child 3 lacked the following required information:
a. The address for the two designated emergency contacts;
b. The parent did not sign the enrollment form.
Plan of Correction: Enrollment records have been completed. Parents have filled out the forms that were needed. (01/30/24)
Parents have written a note and sign it that no accommodations are needed for child 1 in daycare. (02/09/24).
Parents have written a note and sign it that no accommodations are needed for child 1 in daycare. (02/09/24).
Standard 8VAC20-800-70-A
Based on record review, the provider failed to ensure that before the child's first day of attendance, parents shall be provided in writing the written parent agreement:
Evidence:
1. The record for child 2 and child 4 lacked written notification of the policies for the administration of medications.
2. The written medication policy for the family day home, provided to each parent, indicates that the provider will administer both prescription and nonprescription medications however, the provider lacks the required MAT training to allow for the administration of both prescription and nonprescription medications.
a. The provider confirmed the medication notification sheet was not included in the enrollment record for these two children.
Evidence:
1. The record for child 2 and child 4 lacked written notification of the policies for the administration of medications.
2. The written medication policy for the family day home, provided to each parent, indicates that the provider will administer both prescription and nonprescription medications however, the provider lacks the required MAT training to allow for the administration of both prescription and nonprescription medications.
a. The provider confirmed the medication notification sheet was not included in the enrollment record for these two children.
Plan of Correction: Provider has removed all medication sheets out of the files, and has informed the parents. No medication sheets will be put back into files until provider finishes MAT training.
Standard 8VAC20-800-880
Based on observation, the provider failed to ensure that when family day homes provide snacks the home shall follow the most recent, age-appropriate nutritional requirement of USDA.
Evidence:
1. The snack served at approximately 10:45 am did not meet USDA guidelines as the foods served did not consist of two separate food components nor did the serving size meet the required meal pattern guidelines of USDA.
a. Preschool children were provided 4 individual slices each from a small mandarin orange and water. This serving size did not meet the 1/2 cup requirement of a fruit component required for snack for children ages 1 - 5 years. Additionally, water does not count as a food component.
b. Infants and toddlers were provided yogurt and water;
Evidence:
1. The snack served at approximately 10:45 am did not meet USDA guidelines as the foods served did not consist of two separate food components nor did the serving size meet the required meal pattern guidelines of USDA.
a. Preschool children were provided 4 individual slices each from a small mandarin orange and water. This serving size did not meet the 1/2 cup requirement of a fruit component required for snack for children ages 1 - 5 years. Additionally, water does not count as a food component.
b. Infants and toddlers were provided yogurt and water;
Plan of Correction: Provider is in contact with USDA representative who is currently helping with every issue concerning nutritional requirements.
Provider is currently still working with USDA representative.
Current issues are corrected.
Provider is currently still working with USDA representative.
Current issues are corrected.
Standard 8VAC20-800-90-C
Based on record review, the provider failed to obtain documentation of additional immunizations once every six months for children under the age of two years.
Evidence:
1. The immunization record for child 5 does not include documentation that required immunizations were administered once every six months for children under two years.
a. Child 5 was in care during the inspection and is under the age of two years.
Evidence:
1. The immunization record for child 5 does not include documentation that required immunizations were administered once every six months for children under two years.
a. Child 5 was in care during the inspection and is under the age of two years.
Plan of Correction: Parent picked up child and got a current physical and shot record.
Standard 8VAC20-800-940-B
Based on review and interview, the provider failed to have an operable thermometer available to monitor refrigerator and freezer compartment temperatures.
Evidence:
1. The provider and assistant stated that there was no thermometer available to monitor refrigerator and freezer compartment temperatures.
Evidence:
1. The provider and assistant stated that there was no thermometer available to monitor refrigerator and freezer compartment temperatures.
Plan of Correction: Provider has purchased a thermometer.
Standard 8VAC20-800-960-E
Based on observation, the provider failed to ensure that bottles shall be labeled with the child's full name and the date, if more than one infant is in care.
Evidence:
1. 2 of 3 bottles , for two different infants in care, were not labeled with the child's name.
2. 3 of 3 bottles, for two different infants in care, were not dated.
Evidence:
1. 2 of 3 bottles , for two different infants in care, were not labeled with the child's name.
2. 3 of 3 bottles, for two different infants in care, were not dated.
Plan of Correction: All bottles have names & dates on them, and from now on.