Inspection · 2023-07-11
Date
2023-07-11
Complaint Related
No
Licensing Inspector
Jennifer Moore
(540) 430-0384
(540) 430-0384
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
X 8VAC20-780 Administration.
X 8VAC20-780 Staff Qualifications and Training.
X 8VAC20-780 Physical Plant.
X 8VAC20-780 Staffing and Supervision.
X 8VAC20-780 Programs.
X 8VAC20-780 Special Care Provisions and Emergencies
X 8VAC20-780 Special Services.
X 8VAC20-820 THE LICENSE.
X 8VAC20-820 THE LICENSING PROCESS.
X 8VAC20-820 HEARINGS PROCEDURES.
X 8VAC20-770 Background Checks
X 22.1 Early Childhood Care and Education
X 63.2 Child Abuse & Neglect
Inspector Notes
The licensing inspector conducted an unannounced inspection on Tuesday, July 11, 2023 in response to a self-reported incident that the Department received on June 26, 2023 regarding care and protection, forbidden action and behavior guidance. The investigation was initiated on July 11, 2023, and concluded on July 20, 2023. On July 11, 2023, the inspector was on site at the center from approximately 2:00pm to 4:15pm. Interviews with the center staff were completed, observations were made in the center, and documentation was reviewed. Additional interviews were conducted on July 17, 2023 and July 20, 2023.
The preponderance of the evidence gathered during the investigation supports the allegation; therefore, the complaint is determined to be valid. Though not a part of the original complaint, there were violations found during the inspection regarding mandated reporting and policies and procedures. See the violation notice for more details.
Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 5 business days from today. Please specify how the deficient practice will be or has been corrected. Your plan of correction should contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measures. Please do not use staff names, list staff by positions only.
If you have any questions about this inspection, please contact the licensing inspector at (804) 929-3771.
Violations
5Standard 8VAC20-780-340-A
Based on interviews, the center failed to ensure care and protection for a child in care on June 21, 2023.
Evidence:
On July 11, 2023 and July 17, 2023, both staff #1 and staff #2 stated the following:
1. a. On multiple occasions on June 21,2023, child #1 (Age 5 years) was wrapped in a weighted blanket restricting the child?s movement in an effort to calm the child down. b. Staff #2 stated that the child asked to be released more than once. c. Staff #1 stated that the child said that staff #2 was hurting him.
2. Staff #2 tied a mask around child #1?s head to prevent the child from spitting on the staff. It was reported that the mask looked ?entirely too tight? and child #1 struggled to get the mask off. Child #1 reported the mask was ?really tight?.
3. Staff #2 put the hood of a weighted jacket on child #1?s to prevent the child from spitting on the staff. Staff #2 stated that the weighted jacket was ?just a temporary barrier until I can get the mask?. Staff #1 stated ?The hood was not wrapped around his face for long, but it was tight enough that if it stayed that way, he could have struggled breathing.?
4. Staff #2 called the parent for assistance with child #1 on June 21, 2023. During the phone call, the parent could hear staff #2 yelling and stating that child #1?s spit was dripping down her [staff #2] face. The parent reported hearing ?a power struggle? and ?the level of panic in her [staff #2] voice? was upsetting. The parent reported that child #1 stated that staff #2 held him down with the weighted blanket and didn?t let him up. The child reenacted the incident for approximately 7-10 days. The child also stated that staff #2 put a mask on his face ?really tight? and he did not like it.
5. When asked by the Licensing inspector if the report made by staff #1 regarding staff #2?s actions towards child #1 was considered child abuse or neglect, staff #1?s response was, ?yes, abusive?.
Evidence:
On July 11, 2023 and July 17, 2023, both staff #1 and staff #2 stated the following:
1. a. On multiple occasions on June 21,2023, child #1 (Age 5 years) was wrapped in a weighted blanket restricting the child?s movement in an effort to calm the child down. b. Staff #2 stated that the child asked to be released more than once. c. Staff #1 stated that the child said that staff #2 was hurting him.
2. Staff #2 tied a mask around child #1?s head to prevent the child from spitting on the staff. It was reported that the mask looked ?entirely too tight? and child #1 struggled to get the mask off. Child #1 reported the mask was ?really tight?.
3. Staff #2 put the hood of a weighted jacket on child #1?s to prevent the child from spitting on the staff. Staff #2 stated that the weighted jacket was ?just a temporary barrier until I can get the mask?. Staff #1 stated ?The hood was not wrapped around his face for long, but it was tight enough that if it stayed that way, he could have struggled breathing.?
4. Staff #2 called the parent for assistance with child #1 on June 21, 2023. During the phone call, the parent could hear staff #2 yelling and stating that child #1?s spit was dripping down her [staff #2] face. The parent reported hearing ?a power struggle? and ?the level of panic in her [staff #2] voice? was upsetting. The parent reported that child #1 stated that staff #2 held him down with the weighted blanket and didn?t let him up. The child reenacted the incident for approximately 7-10 days. The child also stated that staff #2 put a mask on his face ?really tight? and he did not like it.
5. When asked by the Licensing inspector if the report made by staff #1 regarding staff #2?s actions towards child #1 was considered child abuse or neglect, staff #1?s response was, ?yes, abusive?.
Plan of Correction: These strategies were in place per parent request. We have retrained staff on KinderCare expectations on appropriate child guidance and not utilizing tactics outside of our guidelines, regardless of parent requests. Any tools, such as a weighted blanket or jacket, will be approved moving forward with our Risk and Inclusion Services Department, to include appropriate training on the use of these items.
Standard 8VAC20-780-40-E
Based on documentation review and interviews, the center did not maintain compliance with their own policies and procedures required by standards.
Evidence:
The center's discipline policies and procedures were not followed on Wednesday, June 21, 2023, when the following occurred:
a. Staff #2 wrapped a weighted blanked around child #1 (age 5 years) holding the blanket together on the child?s right shoulder with the child?s arms down. Child #1 drops to the floor. Staff #2 kneeled over child #1 and continued to hold the weighted blanket restricting child?s #1?s upper body movement. Child #1 screamed. Child #1 reported, ?[Staff #2] held me down and didn?t let me up.?
b. Staff #2 tied a face mask around the face and head of child #1 to prevent the child from spitting. It was reported that the mask looked ?entirely too tight?. Child #1 reported the mask was ?really tight?.
c. Staff #2 put the hood of a weighted jacket on child #1?s head to prevent the child from spitting.
d. The center?s policies and procedures for guidance, protection of and respect for children states that, ?Employees must adhere to all applicable state and local laws governing child guidance or discipline. Employees are required to use positive guidance techniques and to refrain from any unacceptable measures while caring for children on behalf of the Company. Unacceptable measures include: Employees may not use physical actions to punish or humiliate children in any way or to demonstrate to a child what it ?feels like" to be the victim of aggression. Employee may not threaten or imply that physical punishment may occur as the result of a child's behavior. Employee may never physically restrain a child as punishment.? These policies and procedures were not followed by staff #2 on Wednesday, June 21, 2023.
Evidence:
The center's discipline policies and procedures were not followed on Wednesday, June 21, 2023, when the following occurred:
a. Staff #2 wrapped a weighted blanked around child #1 (age 5 years) holding the blanket together on the child?s right shoulder with the child?s arms down. Child #1 drops to the floor. Staff #2 kneeled over child #1 and continued to hold the weighted blanket restricting child?s #1?s upper body movement. Child #1 screamed. Child #1 reported, ?[Staff #2] held me down and didn?t let me up.?
b. Staff #2 tied a face mask around the face and head of child #1 to prevent the child from spitting. It was reported that the mask looked ?entirely too tight?. Child #1 reported the mask was ?really tight?.
c. Staff #2 put the hood of a weighted jacket on child #1?s head to prevent the child from spitting.
d. The center?s policies and procedures for guidance, protection of and respect for children states that, ?Employees must adhere to all applicable state and local laws governing child guidance or discipline. Employees are required to use positive guidance techniques and to refrain from any unacceptable measures while caring for children on behalf of the Company. Unacceptable measures include: Employees may not use physical actions to punish or humiliate children in any way or to demonstrate to a child what it ?feels like" to be the victim of aggression. Employee may not threaten or imply that physical punishment may occur as the result of a child's behavior. Employee may never physically restrain a child as punishment.? These policies and procedures were not followed by staff #2 on Wednesday, June 21, 2023.
Plan of Correction: These strategies were in place per parent request. We have retrained staff on KinderCare expectations on appropriate child guidance and not utilizing tactics outside of our guidelines, regardless of parent requests. Any tools, such as a weighted blanket or jacket, will be approved moving forward with our Risk and Inclusion Services Department, to include appropriate training on the use of these items.
Standard 8VAC20-780-400-B
Based on interviews, the center did not ensure behavioral guidance was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts.
Evidence:
1. On June 21, 2023, child #1 (age 5 years) was wrapped in a weighted blanket multiple times by staff #1 and staff #2 as a means to manage behavior.
2. On June 21, 2023, staff #2 tied a mask around the head of child #1 to prevent him from spitting.
3. On June 21, 2023, staff #2 put a weighted jacket on child #1?s head to prevent the child from spitting on the staff.
Evidence:
1. On June 21, 2023, child #1 (age 5 years) was wrapped in a weighted blanket multiple times by staff #1 and staff #2 as a means to manage behavior.
2. On June 21, 2023, staff #2 tied a mask around the head of child #1 to prevent him from spitting.
3. On June 21, 2023, staff #2 put a weighted jacket on child #1?s head to prevent the child from spitting on the staff.
Plan of Correction: These strategies were in place per parent request. We have retrained staff on KinderCare expectations on appropriate child guidance and not utilizing tactics outside of our guidelines, regardless of parent requests. Any tools, such as a weighted blanket or jacket, will be approved moving forward with our Risk and Inclusion Services Department, to include appropriate training on the use of these items.
Standard 8VAC20-780-410-1
Based on documentation and interviews, the facility did not ensure the forbidden action of restricting movement through binding or tying and forcing a child to assume an uncomfortable position did not occur.
Evidence:
1. On July 11, 2023, staff #1 stated the following occurred on June 21, 2023: a. Staff #2 wrapped a weighted blanket around child #1 (age 5 years). Staff #2 began to kneel over child #1 with the weighted blanket wrapped around the child, pinning the blanket over the child on the floor. Child #1?s arms were pinned under the blanket, he was kicking his feet and heard exclaiming, ?you?re hurting me?. b. While on the phone, child #1?s parent recommended that child #1 should put on a mask because he was spitting. Staff #2 put the child?s face mask on his face and tied the mask loops around the back of the child?s head. Staff #1 stated that the mask looked like it was tied ?entirely too tight?. c. Staff #2 took the jacket hood and put it on child #1?s head and then wrapped it around his face and held it in the back. Staff #1 stated ?The hood was not wrapped around his face for long, but it was tight enough that if it stayed that way he could have struggled breathing.?
2. On July 17, 2023, staff #2 stated the following occurred on June 21, 2023: a. Staff #2 wrapped child #1?s weighted blanket around the child holding the blanket together on the child?s right shoulder so that his arms would be down. Somehow the child got to the floor and staff #2 stated, ?I?m kneeling over him, he?s underneath me?. Staff #2 explained that she was kneeling over the child with both hands holding the weighted blanket. Child #1 was kicking and screaming. Staff #2 stated, ?he would say let me go? several different times, both in reference to moving out of the wrapped weighted blanket and leaving out of the room but does not remember him saying that he was hurt. b. Staff #2 attempted to use a ?quick tie method? to tie the mask around child #1?s head. The mask shortly came off. c. Staff #2 laid the child?s weighted jacket on the child?s head to prevent him from spitting. Staff #2 stated that the weighted jacket was ?just a temporary barrier until I can get the mask?. Before she could bend down to get the mask, the jacket was off his head.
3. On July 20, 2023, the parent of child #1 stated the following occurred on June 21, 2023: Staff #2 called the parent for assistance with child #1. The parent could hear staff #2 yelling and explaining that child #1?s spit was coming down her face. The parent also asked the staff to wrap child #1 with his weighted blanket ?like a burrito? to calm the child down. The parent reported hearing ?a power struggle? and ?the level of panic in her [staff #2] voice upset me?. The parent also reported that child #1 stated that staff #2 held him down with the weighted blanket and didn?t let him up. The child also stated that staff #2 put a mask on his face ?really tight? and he did not like it.
Evidence:
1. On July 11, 2023, staff #1 stated the following occurred on June 21, 2023: a. Staff #2 wrapped a weighted blanket around child #1 (age 5 years). Staff #2 began to kneel over child #1 with the weighted blanket wrapped around the child, pinning the blanket over the child on the floor. Child #1?s arms were pinned under the blanket, he was kicking his feet and heard exclaiming, ?you?re hurting me?. b. While on the phone, child #1?s parent recommended that child #1 should put on a mask because he was spitting. Staff #2 put the child?s face mask on his face and tied the mask loops around the back of the child?s head. Staff #1 stated that the mask looked like it was tied ?entirely too tight?. c. Staff #2 took the jacket hood and put it on child #1?s head and then wrapped it around his face and held it in the back. Staff #1 stated ?The hood was not wrapped around his face for long, but it was tight enough that if it stayed that way he could have struggled breathing.?
2. On July 17, 2023, staff #2 stated the following occurred on June 21, 2023: a. Staff #2 wrapped child #1?s weighted blanket around the child holding the blanket together on the child?s right shoulder so that his arms would be down. Somehow the child got to the floor and staff #2 stated, ?I?m kneeling over him, he?s underneath me?. Staff #2 explained that she was kneeling over the child with both hands holding the weighted blanket. Child #1 was kicking and screaming. Staff #2 stated, ?he would say let me go? several different times, both in reference to moving out of the wrapped weighted blanket and leaving out of the room but does not remember him saying that he was hurt. b. Staff #2 attempted to use a ?quick tie method? to tie the mask around child #1?s head. The mask shortly came off. c. Staff #2 laid the child?s weighted jacket on the child?s head to prevent him from spitting. Staff #2 stated that the weighted jacket was ?just a temporary barrier until I can get the mask?. Before she could bend down to get the mask, the jacket was off his head.
3. On July 20, 2023, the parent of child #1 stated the following occurred on June 21, 2023: Staff #2 called the parent for assistance with child #1. The parent could hear staff #2 yelling and explaining that child #1?s spit was coming down her face. The parent also asked the staff to wrap child #1 with his weighted blanket ?like a burrito? to calm the child down. The parent reported hearing ?a power struggle? and ?the level of panic in her [staff #2] voice upset me?. The parent also reported that child #1 stated that staff #2 held him down with the weighted blanket and didn?t let him up. The child also stated that staff #2 put a mask on his face ?really tight? and he did not like it.
Plan of Correction: These strategies were in place per parent request. We have retrained staff on KinderCare expectations on appropriate child guidance and not utilizing tactics outside of our guidelines, regardless of parent requests. Any tools, such as a weighted blanket or jacket, will be approved moving forward with our Risk and Inclusion Services Department, to include appropriate training on the use of these items.
Standard 8VAC20-780-80-B
Based on an interview, the center did not ensure any suspected incident of child abuse be reported in accordance with ?63.2-1509 of the Code of Virginia.
Evidence:
1. When asked by the Licensing inspector if the report made by staff #1 regarding staff #2?s actions towards child #1 on June 21, 2023 was considered child abuse or neglect, staff #1?s response was, ?yes, abusive?.
2. On July 11, 2023, staff #1 stated, ?I feel like [staff #2] took it a couple steps further than what was asked.?
3. Staff #1 failed to report suspected child abuse in accordance with ? 63.2-1509 of the Code of Virginia.
Evidence:
1. When asked by the Licensing inspector if the report made by staff #1 regarding staff #2?s actions towards child #1 on June 21, 2023 was considered child abuse or neglect, staff #1?s response was, ?yes, abusive?.
2. On July 11, 2023, staff #1 stated, ?I feel like [staff #2] took it a couple steps further than what was asked.?
3. Staff #1 failed to report suspected child abuse in accordance with ? 63.2-1509 of the Code of Virginia.
Plan of Correction: District Leader reported the situation to Kandra Brown, licensor June 26, 2023