Inspection · 2025-01-14
Date
2025-01-14
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.
Yes
Areas Reviewed
22.1 Religious Exempt; Background Checks Code; Carbon Monoxide
32.1 Report by person other than physician
54.1 Must be MAT Certified
63.2 Child abuse and neglect
8VAC20-770 Background Checks
8VAC20-790 Subsidy Program Vendor Requirements for Child Day Centers
During the inspection, the inspector reviewed the areas listed above to include standards found out of compliance during the previous inspection. Unless otherwise noted as a violation within this inspection report, the provider was in compliance with the standards reviewed. If there were any serious injuries or fatalities related to a violation, the details will be included in the description of the violation.
Inspector Notes
An unannounced , on-site subsidy health and safety inspection was initiated on 01/14/2025 and completed on 01/14/2025. The on-site inspection began at 3:35 pm and ended at 5:45 pm. The inspector reviewed compliance in the areas listed above. There were 84 children present and 14 staff. The inspector reviewed 5 children's records on-site and 6 staff records on site.
The inspection included:
*Document Review
*Tour of the Facility
*Interviews
*Observations
Information gathered during the inspection determined non-compliance with applicable standards or law, and violations are documented on the violation notice issued to the program.
Please complete the plan of correction (POC) and date to be corrected sections for each violation cited on the violation notice. Specify how the deficient practice will be or has been corrected. Submit your POC within five (5) business days from today, which will be the close of business on 01/24/2025. A POC submitted after this date will not appear on the public website.
Violations
15Standard 22.1-289.035-A
All applicants for employment, employees, applicants to serve as volunteers, and volunteers shall undergo a background check in accordance with subsection B prior to employment or beginning to serve as a volunteer and every five years thereafter.
1. The sworn statement or affirmation for staff 3 expired in November 2024.
2. The sworn statement or affirmation for staff 5 expired in November 2023.
3. The sworn statement or affirmation for staff 6 expired in July 2024. The central registry check expired in August 2024.
1. The sworn statement or affirmation for staff 3 expired in November 2024.
2. The sworn statement or affirmation for staff 5 expired in November 2023.
3. The sworn statement or affirmation for staff 6 expired in July 2024. The central registry check expired in August 2024.
Plan of Correction: Completed
Standard 22.1-289.035-B-4
Repeat Violation
Authorize the child day center to obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years.
The results of a criminal record check, sex offender check and central registry check are not on file for staff 2. Staff 2 has been employed for more than 12 months.
Authorize the child day center to obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years.
The results of a criminal record check, sex offender check and central registry check are not on file for staff 2. Staff 2 has been employed for more than 12 months.
Plan of Correction: Completed
Standard 22.1-289.058
Each building that was built before 2015 and that houses a child day program that is licensed pursuant to this chapter or any program described in subdivision A 4, B 1, or B 5 of ? 22.1-289.030 that serves preschool-age children shall be equipped with at least one carbon monoxide detector.
There are no carbon monoxide detectors in any of the buildings where children are in care.
There are no carbon monoxide detectors in any of the buildings where children are in care.
Plan of Correction: Completed
Purchased (2) carbon monoxide detectors for each building for a total of 6 detectors.
Purchased (2) carbon monoxide detectors for each building for a total of 6 detectors.
Standard 8VAC20-790-540-B
Children's records shall include all of the required elements.
The enrollment records for child 1, 2, 3, 4 and 5 lacked documentation of the address and telephone number for each custodial parent's place of employment.
The enrollment records for child 1, 2, 3, 4 and 5 lacked documentation of the address and telephone number for each custodial parent's place of employment.
Plan of Correction: Completed.
RCA Admin contacted the (5) individual families and acquired the address and telephone number for each custodial parent's place of employment.
RCA Admin contacted the (5) individual families and acquired the address and telephone number for each custodial parent's place of employment.
Standard 8VAC20-790-560-A
Repeat Violation
Staff shall be evaluated by a health professional and be issued a statement that the individual is determined to be free of communicable tuberculosis (TB). Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.
There was no TB screening on file for staff 1. Staff 1 has been employed for more than 4 months.
Staff shall be evaluated by a health professional and be issued a statement that the individual is determined to be free of communicable tuberculosis (TB). Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.
There was no TB screening on file for staff 1. Staff 1 has been employed for more than 4 months.
Plan of Correction: Completed
Standard 8VAC20-790-580-A
The vendor shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center.
Child 1, who was in care during the inspection, did not have documentation of receiving required immunizations.
Child 1, who was in care during the inspection, did not have documentation of receiving required immunizations.
Plan of Correction: Completed
Standard 8VAC20-790-600-B
Within the first 90 days of employment or subsidy vendor approval all staff who work directly with children shall complete Virginia Preservice Training for Child Care Staff.
Staff 1, who has been employed for more than 90 days, lacks documentation of completion of Virginia Preservice training.
Staff 1, who has been employed for more than 90 days, lacks documentation of completion of Virginia Preservice training.
Plan of Correction: Completed
Standard 8VAC20-790-600-F
Staff who work directly with children shall, in addition to preservice and orientation training required in subsections A through D of this section, annually attend at least 16 hours of training and staff development activities, to include the department's health and safety update course.
1. Staff 2, who has been employed for two years, has completed only 7 of the required 16 hours of annual training for 2024.
2. Staff 3, who has been employed for nine years, has completed only 5 of the required 16 hours of annual training for 2024.
3. Staff 4, who has been employed for four years, has completed only 3 of the required 16 hours of annual training for 2024. There is no documentation that staff 4 has obtained the 3 hour subsidy update training.
4. Staff 5, who has been employed for six years, has completed only 15 of the required 16 hours of annual training for 2024.
5. Staff 6, who has been employed for 15 years, has completed only 4 of the required 16 hours of annual training for 2024. There is no documentation that staff 6 has completed the 3 hour annual updated training.
1. Staff 2, who has been employed for two years, has completed only 7 of the required 16 hours of annual training for 2024.
2. Staff 3, who has been employed for nine years, has completed only 5 of the required 16 hours of annual training for 2024.
3. Staff 4, who has been employed for four years, has completed only 3 of the required 16 hours of annual training for 2024. There is no documentation that staff 4 has obtained the 3 hour subsidy update training.
4. Staff 5, who has been employed for six years, has completed only 15 of the required 16 hours of annual training for 2024.
5. Staff 6, who has been employed for 15 years, has completed only 4 of the required 16 hours of annual training for 2024. There is no documentation that staff 6 has completed the 3 hour annual updated training.
Plan of Correction: Staff 1 - completed
Staff 2 - completed
Staff 3 - 6 - In progress completion by COB 1/31/2025
Staff 2 - completed
Staff 3 - 6 - In progress completion by COB 1/31/2025
Standard 8VAC20-790-630-A
Areas and equipment outside of the center, shall be maintained in a safe condition. Unsafe conditions shall include splintered, cracked or otherwise deteriorating wood.
One area of wooden landscape timber, on the preschool outdoor play area, has a significate area of deterioration resulting in splintered wood and an exposed metal spike.
One area of wooden landscape timber, on the preschool outdoor play area, has a significate area of deterioration resulting in splintered wood and an exposed metal spike.
Plan of Correction: Completed.
All wood presented within the inspection has been replaced. Additional playground areas have been replaced.
All wood presented within the inspection has been replaced. Additional playground areas have been replaced.
Standard 8VAC20-790-630-C-2
Electrical outlets shall have protective covers that are of a size that cannot be swallowed by children.
One electrical outlet, accessible to children, lacked a protective cover.
One electrical outlet, accessible to children, lacked a protective cover.
Plan of Correction: Completed.
Secured outlet with protective cover. Implemented review part of Daily Walkthrough for all Admin and Staff. Implemented training. Staff and teaches signed safety training.
Secured outlet with protective cover. Implemented review part of Daily Walkthrough for all Admin and Staff. Implemented training. Staff and teaches signed safety training.
Standard 8VAC20-790-640-A
Repeat Violation
Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children.
1. Cleaning agents were observed stored on open shelves in the two-year old classroom.
2. Hand Sanitizing agents, containing warning labels indicating contents as hazardous, were observed stored on open shelves in the three-year old and four-year old classroom
Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children.
1. Cleaning agents were observed stored on open shelves in the two-year old classroom.
2. Hand Sanitizing agents, containing warning labels indicating contents as hazardous, were observed stored on open shelves in the three-year old and four-year old classroom
Plan of Correction: Completed.
RCA conducted training and review with all RCA staff and teachers. The RCA Director personally conducted the training within each classroom, and each teacher signed the completion of the RCA policy on classroom safety.
The RCA Director and RCA Administrators implemented a daily walk through of all classrooms to take place at a minimum of (3) times per day at random times.
RCA conducted training and review with all RCA staff and teachers. The RCA Director personally conducted the training within each classroom, and each teacher signed the completion of the RCA policy on classroom safety.
The RCA Director and RCA Administrators implemented a daily walk through of all classrooms to take place at a minimum of (3) times per day at random times.
Standard 8VAC20-790-670-H
Children less than 10 years of age shall always be within actual sight and sound supervision of staff.
1. A group of 6 preschool children were observed alone in a classroom without any adult or staff supervision. The staff responsible for this class, staff 5, was not in the classroom or hallway area when the classroom was reviewed at approximately 4:02 pm.
2. At approximately 4:10 pm the staff person responsible for the supervision of a group of 10 preschool children was not able to provide sight and sound supervision as she was sitting at a desk with her back to all of the children in the class. This staff had ear buds on which were plugged into a cell phone that this staff appeared to be engaged with.
1. A group of 6 preschool children were observed alone in a classroom without any adult or staff supervision. The staff responsible for this class, staff 5, was not in the classroom or hallway area when the classroom was reviewed at approximately 4:02 pm.
2. At approximately 4:10 pm the staff person responsible for the supervision of a group of 10 preschool children was not able to provide sight and sound supervision as she was sitting at a desk with her back to all of the children in the class. This staff had ear buds on which were plugged into a cell phone that this staff appeared to be engaged with.
Plan of Correction: Completed.
RCA conducted training and review with all RCA Staff and teachers. The RCA Director personally conducted the training within each classroom, and each teacher signed the completion of the RCA policy on children's supervision.
RCA conducted training and review with all RCA Staff and teachers. The RCA Director personally conducted the training within each classroom, and each teacher signed the completion of the RCA policy on children's supervision.
Standard 8VAC20-790-760-B-3-c
A nonabsorbent surface for diapering or changing shall by used.
The diaper changing pad in the two-year classroom had two rips on the surface.
The diaper changing pad in the two-year classroom had two rips on the surface.
Plan of Correction: Completed.
Purchased and in the classroom.
Purchased and in the classroom.
Standard 8VAC20-790-790-C
Repeat Violation
Shelter-in-place procedures or maps shall be posted in a location conspicuous to staff and children on each floor of each building.
Shelter-in-place procedures were not posted on the evacuation plans posted throughout the facility.
Shelter-in-place procedures or maps shall be posted in a location conspicuous to staff and children on each floor of each building.
Shelter-in-place procedures were not posted on the evacuation plans posted throughout the facility.
Plan of Correction: Completed.
Printed Shelter in Place procedures throughout the facility.
Printed Shelter in Place procedures throughout the facility.
Standard 8VAC20-790-800-B
The vendor shall maintain a record of the dates of the practice drills for one year.
1. The emergency log for the facility lacked documentation of fire drills for January , February, March and April of 2024.
2. The emergency log for the facility lacked documentation of two required shelter-in-place practice drills for 2024.
1. The emergency log for the facility lacked documentation of fire drills for January , February, March and April of 2024.
2. The emergency log for the facility lacked documentation of two required shelter-in-place practice drills for 2024.
Plan of Correction: Printed and reviewed Subsidy requirement. Implemented an immediate action plan to hold monthly drills as per required guidelines.