Inspection · 2024-01-23
Date
2024-01-23
Complaint Related
Yes
Licensing Inspector
Tara K Martin
(804) 588-2371
(804) 588-2371
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
20 Access to minor?s records
22.1 Early Childhood Care and Education
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced complaint inspection was conducted on 01/23/2024 in response to allegations received by the licensing office on 01/22/2023 in the areas of administration, special care provisions and emergencies and special services. The inspection concluded with an electronic record review on 01/24/2023 and 1/25/2023. There were 77 children, ages 16 months -10 years, and 13 staff providing direct care and supervision to children present during the inspection. Staff were interviewed and a total of 5 children?s records, 4 staff records, 8 medications and additional documents were reviewed. The inspector arrived for the inspection at approximately 2:30 pm and departed approximately 5:05 pm.
Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the provider.
The information gathered pursuant to an investigation of the complaint supports the allegation and the complaint was determined to be valid.
Violations
8Standard 8VAC20-780-200-A
Based on interview with staff, the center failed to ensure the center shall have a qualified program director or qualified back-up program director who meets one the director qualifications who shall regularly be on site at least 50% if the centers hours of operation.
Evidence: Staff 6 confirmed no qualified program director is regularly on site. The last day of employment for the most recent qualified program director was 10/08/2023.
Evidence: Staff 6 confirmed no qualified program director is regularly on site. The last day of employment for the most recent qualified program director was 10/08/2023.
Plan of Correction: A director has been hired and is expected to start in approximately 2 weeks.
Standard 8VAC20-780-245-J-3
Based on interviews and document review, the center failed to ensure any child for whom emergency medications have been prescribed shall always be in the care of a staff member or independent contractor who has satisfactorily completed the Medication Administration Training (MAT) program.
Evidence:
1. Staff 6 confirmed that Staff 5 is the only MAT certified staff employed. Staff 6 confirmed that Staff 5?s work schedule is Monday- Friday 8:00 am - 5:30 pm.
2. Attendance records indicate on 1/15/2023 Child 5 arrived for care at 7:40 am; emergency medications have been prescribed for Child 5.
3. Attendance records indicate on 1/18/2023 Child 3 arrived for care at 7:39 am, Child 4 arrived for care at 6:25 am, Child 5 arrived for care at 7:55 am, and Child 6 arrived 7:12 am. emergency medications have been prescribed for Child 3, Child 4, Child 5, and Child 6.
4. Attendance records indicate on 1/19/2023 Child 3 arrived for care at 7:51 am, Child 4 arrived for care at 7:55 am, and Child 5 arrived for care at 7:11 am; emergency medications have been prescribed for Child 3, Child 4, and Child 5.
Evidence:
1. Staff 6 confirmed that Staff 5 is the only MAT certified staff employed. Staff 6 confirmed that Staff 5?s work schedule is Monday- Friday 8:00 am - 5:30 pm.
2. Attendance records indicate on 1/15/2023 Child 5 arrived for care at 7:40 am; emergency medications have been prescribed for Child 5.
3. Attendance records indicate on 1/18/2023 Child 3 arrived for care at 7:39 am, Child 4 arrived for care at 6:25 am, Child 5 arrived for care at 7:55 am, and Child 6 arrived 7:12 am. emergency medications have been prescribed for Child 3, Child 4, Child 5, and Child 6.
4. Attendance records indicate on 1/19/2023 Child 3 arrived for care at 7:51 am, Child 4 arrived for care at 7:55 am, and Child 5 arrived for care at 7:11 am; emergency medications have been prescribed for Child 3, Child 4, and Child 5.
Plan of Correction: Provider will get more staff trained.
Standard 8VAC20-780-40-M
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: There was a white board on the wall of the 2-year-old classroom. The diagnosed food allergy for Child 3 and Child 5 were listed on the board. The information on the board was visible to anyone that may enter the classroom. The information was not kept in a confidential manner.
Evidence: There was a white board on the wall of the 2-year-old classroom. The diagnosed food allergy for Child 3 and Child 5 were listed on the board. The information on the board was visible to anyone that may enter the classroom. The information was not kept in a confidential manner.
Plan of Correction: Provider will ensure information is kept confidential.
Standard 8VAC20-780-500-A
Systemic Violation
Based on observations, the center failed to ensure that children?s hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks and staff shall wash their hands with soap and running water before and after helping a child use the toilet.
Evidence:
1. The children in the toddler class were observed getting up from their nap mats and going to the table for afternoon snack without washing hands or using a disposable wipe.
2. The children in the 2-year-old class were observed getting up from eating afternoon snack and going to the rug for teacher-directed activities without washing hands or using a disposable wipe.
3. Staff 2 was observed helping 3 children in the restroom without washing hands before and after helping each child.
Based on observations, the center failed to ensure that children?s hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks and staff shall wash their hands with soap and running water before and after helping a child use the toilet.
Evidence:
1. The children in the toddler class were observed getting up from their nap mats and going to the table for afternoon snack without washing hands or using a disposable wipe.
2. The children in the 2-year-old class were observed getting up from eating afternoon snack and going to the rug for teacher-directed activities without washing hands or using a disposable wipe.
3. Staff 2 was observed helping 3 children in the restroom without washing hands before and after helping each child.
Plan of Correction: Provider will remind staff of standard.
Standard 8VAC20-780-510-B
Systemic Violation
Based on document review and staff interviews, the center failed to ensure that prescription and nonprescription medication shall be given to a child only with written authorization from the parent.
Evidence: Staff 5 verified that prescription Medication 8 was administered to Child 7 on 01/23/2024 at approximately 10:00 am and on previous days. Staff 6 verified the authorization form for prescription Medication 8 was not available for review.
Based on document review and staff interviews, the center failed to ensure that prescription and nonprescription medication shall be given to a child only with written authorization from the parent.
Evidence: Staff 5 verified that prescription Medication 8 was administered to Child 7 on 01/23/2024 at approximately 10:00 am and on previous days. Staff 6 verified the authorization form for prescription Medication 8 was not available for review.
Plan of Correction: Provider will obtain authorization form.
Standard 8VAC20-780-510-L
Systemic Violation
Based on observations, the center failed to ensure that medications shall be kept in a locked place using a safe locking method that prevents access by children.
Evidence: Prescription Medication 8 was located unlocked sitting on the top of the cubby shelf in the Toddler room. Children were observed in the area and the medication was accessible.
Based on observations, the center failed to ensure that medications shall be kept in a locked place using a safe locking method that prevents access by children.
Evidence: Prescription Medication 8 was located unlocked sitting on the top of the cubby shelf in the Toddler room. Children were observed in the area and the medication was accessible.
Plan of Correction: Provider will remind staff of standard and keep medication locked.
Standard 8VAC20-780-510-N
Systemic Violation
Based on staff interviews and document review, the center failed to ensure that centers shall keep a record of medications given to children which shall include all of the elements required by the standards.
Evidence: Staff 5 verified that prescription Medication 8 was administered on 01/23/2024 at approximately 10:00 am and on previous days. Staff 5 verified they had not documented the 10:00 am 1/23/2024 dose in the medication administration log. Staff 5 and Staff 6 verified the medication administration log could not be located for review.
Based on staff interviews and document review, the center failed to ensure that centers shall keep a record of medications given to children which shall include all of the elements required by the standards.
Evidence: Staff 5 verified that prescription Medication 8 was administered on 01/23/2024 at approximately 10:00 am and on previous days. Staff 5 verified they had not documented the 10:00 am 1/23/2024 dose in the medication administration log. Staff 5 and Staff 6 verified the medication administration log could not be located for review.
Plan of Correction: Provider will maintain medication administration log.
Standard 8VAC20-780-560-G
Based on observations and staff interviews, the center failed to ensure that when food is brought from home the food container shall be sealed and clearly dated and labeled in a way that identifies the owner.
Evidence:
1. In the Toddler room, there were 7 lunchboxes without a date. Staff 3 confirmed the lunchboxes were brought from home.
2. In the 2-year-old room, there were 15 lunchboxes without a date. Staff 2 confirmed the lunchboxes were brought from home.
Evidence:
1. In the Toddler room, there were 7 lunchboxes without a date. Staff 3 confirmed the lunchboxes were brought from home.
2. In the 2-year-old room, there were 15 lunchboxes without a date. Staff 2 confirmed the lunchboxes were brought from home.
Plan of Correction: Provider will place date on lunchboxes.