Inspection · 2024-04-18
Date
2024-04-18
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
8VAC20-780 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.
8VAC20-770 Background Checks (8VAC20-770)
22.1 Background Checks Code, Carbon Monoxide
63.2 Child Abuse & Neglect
Inspector Notes
An unannounced monitoring inspection was initiated on 04/18/2024 at 12:15 pm and completed on 04/18/2024 at 4:45 pm.
At the time of the tour there were 67 children in care with 13 teaching staff. The children in care ranged in age from infant - school age. Children were observed during lunch and nap. School age children were observed playing games and engaged in table activities.
Records were reviewed for six children and four staff.
Information gathered during the inspection determined non-compliance with applicable standards and violations were documented on the violation notice issued to the facility. These violations were reviewed with the program director at the conclusion of the inspection.
Violations
7Standard 8VAC20-780-130-E
Based on record review and interview, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years.
Evidence:
1. The most recent immunizations on file for child 3, age 23 months, were administered on 01/20/2023.
2. The most recent immunizations on file for child 4, age 22 months, were administered on 03/27/2023.
3. The most recent immunizations on file for child 6, age 19 months, were administered on 11/04/2022.
3. The program director confirmed that updated immunization records were not on file for child 3, child 4 and child 6.
Evidence:
1. The most recent immunizations on file for child 3, age 23 months, were administered on 01/20/2023.
2. The most recent immunizations on file for child 4, age 22 months, were administered on 03/27/2023.
3. The most recent immunizations on file for child 6, age 19 months, were administered on 11/04/2022.
3. The program director confirmed that updated immunization records were not on file for child 3, child 4 and child 6.
Plan of Correction: Center has requested updated immunization or appointment confirmation to be provided no later than 5/17/24 in order to continue care for child 3 and child 4 who are still in attendance. Child 6 is no longer in attendance at the center. Moving forward, Center Management will calendar when updated immunizations are due for children and will communicate to families ahead of time that these updates will be needed in order to continue care.
Standard 8VAC20-780-140-A
Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before attendance or within 30 days after the first day of attendance.
Evidence:
1. Child 1, enrollment date 07/22/2022, does not have documentation of a physical exam on file.
2. The Program Director confirmed that a physical exam was not on file for child 1.
Evidence:
1. Child 1, enrollment date 07/22/2022, does not have documentation of a physical exam on file.
2. The Program Director confirmed that a physical exam was not on file for child 1.
Plan of Correction: Physical exam has been added to the child's file. Moving forward, Center Management will ensure children's files are complete before allowing the child to start at the center.
Standard 8VAC20-780-340-A
Based on staff interviews and record review, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection.
Evidence:
1. On 04/04/2024 at approximately 10:00 am, staff 2 fed a 15 week old child, child 2, another child's bottle containing breast milk.
a. Administrative staff reported to the inspector, on 04/08/2024, that staff 2 had mistakenly given child 5's bottle to child 2.
2. The program director and staff 1 confirmed that staff 2 fed child 2 4 ounces of child 5's breast milk.
a. Staff 1 stated that staff 2 told her that she had fed child 2 the wrong bottle after completion of the feeding.
b. Staff 1 stated that staff 2 additionally stated that she did not look at the name label on the bottle before feeding child 2.
3. Staff 1 stated that while both bottles were similar in color, both were dated and labeled with each child's name.
a. Staff 1 and the program director stated that staff 2 failed to follow center policy by failing to check the name label before feeding.
Evidence:
1. On 04/04/2024 at approximately 10:00 am, staff 2 fed a 15 week old child, child 2, another child's bottle containing breast milk.
a. Administrative staff reported to the inspector, on 04/08/2024, that staff 2 had mistakenly given child 5's bottle to child 2.
2. The program director and staff 1 confirmed that staff 2 fed child 2 4 ounces of child 5's breast milk.
a. Staff 1 stated that staff 2 told her that she had fed child 2 the wrong bottle after completion of the feeding.
b. Staff 1 stated that staff 2 additionally stated that she did not look at the name label on the bottle before feeding child 2.
3. Staff 1 stated that while both bottles were similar in color, both were dated and labeled with each child's name.
a. Staff 1 and the program director stated that staff 2 failed to follow center policy by failing to check the name label before feeding.
Plan of Correction: Staff 2 is no longer employed at the center. Infant staff currently working have signed off on the Infant Feeding policy as a refresher to ensure we are properly verifying bottle labels before providing to the child.
Standard 8VAC20-780-540-C
Based on review and interview, the center failed to ensure that the required first aid kit contain all of the required elements.
Evidence:
1. The first aid kit for the facility lacked triangular bandages.
2. The program director stated there were no triangular bandages in the facility first aid kit.
Evidence:
1. The first aid kit for the facility lacked triangular bandages.
2. The program director stated there were no triangular bandages in the facility first aid kit.
Plan of Correction: Triangular bandages have been ordered and will be added to the first aid kit no later than 5/15/24. Moving forward, Center Management will calendar monthly checks to verify all required items are in first aid kits.
Standard 8VAC20-780-540-E
Based on observation, the center failed to ensure there was one working, battery operated radio in each building used by children.
Evidence:
The battery operated radio was not working and the director stated she lacked working batteries for the radio.
Evidence:
The battery operated radio was not working and the director stated she lacked working batteries for the radio.
Plan of Correction: New battery operated radio has been purchased and is in the center's first aid kit. Moving forward, Center Management will calendar monthly checks to verify the battery-operated radio is in working condition.
Standard 8VAC20-780-60-A
Based on record review and interview, the center failed to ensure that children's records contain all of the required elements.
Evidence:
1. The enrollment record for child 2, enrollment date 03/11/2024, lacked documentation of viewing proof of the child's age and identity.
2. The Program Director confirmed that verification of proof of age and identity was not on file for child 2.
Evidence:
1. The enrollment record for child 2, enrollment date 03/11/2024, lacked documentation of viewing proof of the child's age and identity.
2. The Program Director confirmed that verification of proof of age and identity was not on file for child 2.
Plan of Correction: Center has requested proof of age/identity to be provided no later than 5/17/24 in order to continue care. Moving forward, Center Management will ensure children's files are complete.
Standard 8VAC20-780-70
Based on record review and interview, the center failed to ensure that staff records contain all of the required elements.
Evidence:
1. The employment file for staff 1, hire date 02/08/2024 lacked documentation of orientation training which is required within seven days of employment.
2. The employment file for staff 2, hire date 03/11/2024, lacked documentation of orientation training.
2. The Program Director confirmed that she did not have documentation that staff 1 and staff 2 had completed orientation training.
Evidence:
1. The employment file for staff 1, hire date 02/08/2024 lacked documentation of orientation training which is required within seven days of employment.
2. The employment file for staff 2, hire date 03/11/2024, lacked documentation of orientation training.
2. The Program Director confirmed that she did not have documentation that staff 1 and staff 2 had completed orientation training.
Plan of Correction: Documentation of Orientation has been signed by Staff 1 and added to the employee file. Staff 2 is no longer employed at the center so we were unable to add to the employee file. Moving forward, Center Management will ensure Documentation of Orientation training is completed for all new hires within their first 7 days.