Angel's Place Daycare Center II

8VAC20-770-60-B

“Based on record review and interview, the center failed to ensure that an employee of a child day program must not be employed until the agency or home has the person's completed sworn statement or affirmation. Evidence: 1. There was no sworn statement or affirmation on file for staff 4 who was observed working in the program during the inspection. 2. The sworn statement or affirmation for staff 1, staff 2, and staff 3 were not dated therefore, no determination could be made as to if each was completed at the time of employment. 3. The program director confirmed that the sworn statements were missing and / or incomplete.”

8VAC20-780-570-A

“Based on observation, the center failed to ensure that when a child is placed in an infant seat or high chair, the protective belt shall be fastened securely. Evidence: 1. Six children in the orange classroom were observed sitting inside of infant table seats without the safety belt fastened.”

8VAC20-780-560-G

“Based on observation, the center failed to ensure that when food is brought from home, the food container shall be clearly dated. Evidence: 1. 5 of 12 cans of infant formula lacked a date indicating when the formula was received into the infant classroom. 2. A bottle of juice, in the older infant classroom, was not dated.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that the diapering surface shall be cleaned with soap and at least room temperature water and sanitized after each use. The definition of sanitized means the surface of the item is sprayed with the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes. Evidence: 1. The diaper changing table in the two-year old classroom was not cleaned with soap and water after completion of a diaper change at 4:05 pm. 2. The diaper changing table was not allowed to air dry for at least two minutes after the completion of 2 diaper changes at approximately 3:55 pm in the orange classroom. a. The surface of the diaper changing table was immediately wiped with a paper towel after the bleach and water solution was sprayed.”

8VAC20-780-280-D

“Based on observation, the center failed to ensure that cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single-service articles and shall be stored in areas physically separate from food. Evidence: 1. In the silver classroom a spray bottle of bleach and water solution was observed stored inside of a cabinet near a container of unpropped popcorn.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to, 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 clothing or snag skin. Evidence: 1. The following safety hazards were observed in the infant classroom: a. Dangling cords from infant swings and infant seats are a trip hazard. b. One crib with a manufacture date of 04/2010 is not compliant with current CPSC guidelines which requires all cribs to be manufactured on or after 06/28/2011. c. Two additional cribs lacked any type of label or certificate to determine if they meet current CPSC guidelines. d. A significate rip was observed in the cloth seat of an infant bouncy seat. 2. The microwave oven placed on top of the refrigerator in the green classroom is a toppling hazard. 3. The cuppy storage unit in the silver classroom is a toppling hazard as it has not been secured to the wall. 4. The rubber / carpet at the entrance to the blue classroom is not secured creating a trip hazard. 5. Two bags of trash containing food and soiled diapers was observed on the floor of the bathroom for the green classroom at approximately 4:15 pm. 6. The large playground has areas of uneven ground which create a potential trip hazard. a. Multiple areas of weeds need to be cut. b. The plastic outdoor play cube has several areas of cracked plastic which creates a pinch point hazard.”

8VAC20-780-260-A

“Based on record review and interview, the center failed to provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: 1. The most recent inspection from the Norfolk Fire Marshall was conducted on 02/03/2023. 2. The program director confirmed this as the most recent inspection.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent. Evidence: 1. The written parent agreement was not on file for child 1 who has an enrollment date of 09/12/2013. 2. The program director confirmed that a signed parent agreement was not on file for child 1.”

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 record for staff 5 and staff 6 could not be located. 2. The employment record for staff 1, staff 2, staff 3 and staff 4 lacked documentation of the date of employment. 3. The employment record for staff 2, staff 3, staff 4 and staff 7 lacked documentation of a job title. 4. The employment record for staff 3 and staff 4 lacked documentation of completion of orientation training. 5. The employment record for staff 3 and staff 4 lacked documentation of two reference checks.”

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 1, enrollment date 09/12/2023, lacked documentation of viewing proof of the child's identity and age. 2. The enrollment record for child 2, enrollment date 10/27/2023, lacked documentation of the following: a. Phone number for one parent; b. Work phone number for one parent; c. Work phone number and place of employment for the other parent. 3. The enrollment record for child 3, enrollment date 09/22/2023, lacked the work phone number for both parent's. 4, The enrollment record for child 4, enrollment date 10/20/2023, lacked the work phone number for one parent. 5. The enrollment record for child 5, enrollment date 02/23/2023, lacked the work phone number for both parents. 6. The program director confirmed the above information was not available.”

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 09/12/2023, lacked documentation of a physical exam. 2. The program director confirmed that documentation of a physical exam was not on file for child 1.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Immunization information was not on file for child 1 who has an enrollment date of 09/12/2023. 2. The program director confirmed that documentation of required immunizations were not on file for child 1.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to ensure that staff have a central registry finding within 30 days of employment. Evidence: 1. Staff 2, approximate hire date of 07/2023, lacks the results of a central registry check. 2. Staff 3, approximate hire date of 03/2024, lacks the results of a central registry check. 3. Staff 4, approximate hire date of 03/05/2024, lacks the results of a central registry check. 4. The program director confirmed that central registry checks were not on file for these staff.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. There was no TB screening on file for staff 3. Staff 3 was observed working in the facility during the inspection and has an approximate hire date of 03/2024. 2. There was no TB screening on file for staff 4. Staff 4 was observed working in the facility during the inspection and has an approximate hire date of 03/05/2024. 3. The program director confirmed that a TB screening was not on file for staff 3 and staff 4.”

8VAC20-770-60-B

“Based on record review and interview, the center failed to ensure that an employee of a child day program must not be employed until the agency or home has the person's completed sworn statement or affirmation. Evidence: 1. There was no sworn statement or affirmation on file for staff 4 who was observed working in the program during the inspection. 2. The sworn statement or affirmation for staff 1, staff 2, and staff 3 were not dated therefore, no determination could be made as to if each was completed at the time of employment. 3. The program director confirmed that the sworn statements were missing and / or incomplete.”

8VAC20-780-570-A

“Based on observation, the center failed to ensure that when a child is placed in an infant seat or high chair, the protective belt shall be fastened securely. Evidence: 1. Six children in the orange classroom were observed sitting inside of infant table seats without the safety belt fastened.”

8VAC20-780-560-G

“Based on observation, the center failed to ensure that when food is brought from home, the food container shall be clearly dated. Evidence: 1. 5 of 12 cans of infant formula lacked a date indicating when the formula was received into the infant classroom. 2. A bottle of juice, in the older infant classroom, was not dated.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that the diapering surface shall be cleaned with soap and at least room temperature water and sanitized after each use. The definition of sanitized means the surface of the item is sprayed with the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes. Evidence: 1. The diaper changing table in the two-year old classroom was not cleaned with soap and water after completion of a diaper change at 4:05 pm. 2. The diaper changing table was not allowed to air dry for at least two minutes after the completion of 2 diaper changes at approximately 3:55 pm in the orange classroom. a. The surface of the diaper changing table was immediately wiped with a paper towel after the bleach and water solution was sprayed.”

8VAC20-780-280-D

“Based on observation, the center failed to ensure that cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single-service articles and shall be stored in areas physically separate from food. Evidence: 1. In the silver classroom a spray bottle of bleach and water solution was observed stored inside of a cabinet near a container of unpropped popcorn.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to, 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 clothing or snag skin. Evidence: 1. The following safety hazards were observed in the infant classroom: a. Dangling cords from infant swings and infant seats are a trip hazard. b. One crib with a manufacture date of 04/2010 is not compliant with current CPSC guidelines which requires all cribs to be manufactured on or after 06/28/2011. c. Two additional cribs lacked any type of label or certificate to determine if they meet current CPSC guidelines. d. A significate rip was observed in the cloth seat of an infant bouncy seat. 2. The microwave oven placed on top of the refrigerator in the green classroom is a toppling hazard. 3. The cuppy storage unit in the silver classroom is a toppling hazard as it has not been secured to the wall. 4. The rubber / carpet at the entrance to the blue classroom is not secured creating a trip hazard. 5. Two bags of trash containing food and soiled diapers was observed on the floor of the bathroom for the green classroom at approximately 4:15 pm. 6. The large playground has areas of uneven ground which create a potential trip hazard. a. Multiple areas of weeds need to be cut. b. The plastic outdoor play cube has several areas of cracked plastic which creates a pinch point hazard.”

8VAC20-780-260-A

“Based on record review and interview, the center failed to provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: 1. The most recent inspection from the Norfolk Fire Marshall was conducted on 02/03/2023. 2. The program director confirmed this as the most recent inspection.”

8VAC20-780-90-A

“Based on record review and interview, the center failed to ensure that a written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent. Evidence: 1. The written parent agreement was not on file for child 1 who has an enrollment date of 09/12/2013. 2. The program director confirmed that a signed parent agreement was not on file for child 1.”

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 record for staff 5 and staff 6 could not be located. 2. The employment record for staff 1, staff 2, staff 3 and staff 4 lacked documentation of the date of employment. 3. The employment record for staff 2, staff 3, staff 4 and staff 7 lacked documentation of a job title. 4. The employment record for staff 3 and staff 4 lacked documentation of completion of orientation training. 5. The employment record for staff 3 and staff 4 lacked documentation of two reference checks.”

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 1, enrollment date 09/12/2023, lacked documentation of viewing proof of the child's identity and age. 2. The enrollment record for child 2, enrollment date 10/27/2023, lacked documentation of the following: a. Phone number for one parent; b. Work phone number for one parent; c. Work phone number and place of employment for the other parent. 3. The enrollment record for child 3, enrollment date 09/22/2023, lacked the work phone number for both parent's. 4, The enrollment record for child 4, enrollment date 10/20/2023, lacked the work phone number for one parent. 5. The enrollment record for child 5, enrollment date 02/23/2023, lacked the work phone number for both parents. 6. The program director confirmed the above information was not available.”

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 09/12/2023, lacked documentation of a physical exam. 2. The program director confirmed that documentation of a physical exam was not on file for child 1.”

8VAC20-780-130-A

“Based on record review and interview, the center failed to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. Immunization information was not on file for child 1 who has an enrollment date of 09/12/2023. 2. The program director confirmed that documentation of required immunizations were not on file for child 1.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to ensure that staff have a central registry finding within 30 days of employment. Evidence: 1. Staff 2, approximate hire date of 07/2023, lacks the results of a central registry check. 2. Staff 3, approximate hire date of 03/2024, lacks the results of a central registry check. 3. Staff 4, approximate hire date of 03/05/2024, lacks the results of a central registry check. 4. The program director confirmed that central registry checks were not on file for these staff.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. There was no TB screening on file for staff 3. Staff 3 was observed working in the facility during the inspection and has an approximate hire date of 03/2024. 2. There was no TB screening on file for staff 4. Staff 4 was observed working in the facility during the inspection and has an approximate hire date of 03/05/2024. 3. The program director confirmed that a TB screening was not on file for staff 3 and staff 4.”

8VAC20-780-245-J-3

“Based on record review and interview the center failed to ensure that when any child for whom emergency medications have been prescribed will always be in the care of a staff member with the required medication administration training. Evidence: 1- There is emergency medication for a child in today. However, there is not any staff present who has received the required medication administration training. 2 - Staff #1 provided certificates for a medication training that is not a part of the department approved training.”

8VAC20-780-270-A

“Based on observation the center failed to ensure that areas and equipment are maintained in safe condition. Evidence: 1 - In the room where children 16months to 24months are napping the direct egress to outside is blocked by a safety gate that latched. a. The room was dark as it was nap time. b. Staff #1 entered the room by opening the bathroom door. 2 - In the two year old room the emergency egress has a dead bolt lock in place preventing the intended ease of exit in the event of an emergency. 1 - In the 4/5 year old room there is a set of cubbies that are not secured to the wall and create a toppling hazard. 2 - Staff #1 confirmed that the cubby is not secured to the wall.”

8VAC20-780-580-B

“Based on documentation review the center failed to ensure that any vehicle used by the center for the transportation of children shall meet all requirements including that the vehicle is insured with at least the minimum limits established by Virginia state statutes. Evidence: There continues to be no documentation of vehicle coverage from October 31, 220 through January 30, 2023.”

8VAC20-780-340-A

“Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. When the inspection entered the toddler/two year old nap room at approximately 12:50 pm the staff supervising the children was observed placing blankets over two children in such a way as to completely cover each child's face and head. 2. The inspector noted that all 14 children in this group were completely covered with a blanket to include the child's face and head. 3. This is a suffocation hazard when a child's face and head is completed covered with a blanket.”

8VAC20-780-240-I

“Based on record review and interview, the center failed to ensure that documentation of orientation training shall be kept by the center in a manner that allows for identification by individual staff member and is considered part of the staff member's record. Evidence: 1. There was no written documentation to demonstrate that staff 1 , hire date 08/01/2022, had completed orientation training as required within seven days of the first day of employment. 2. Administrative staff confirmed that documentation of orientation training was not on file for staff 1.”

8VAC20-820-120-E-2

“Based on observation, the center failed to ensure the findings of the most recent inspection of the facility were posted on the premises. Evidence: 1. The findings of the most recent monitoring inspection on 11/07/2022 were not posted. a. The findings of the 08/22/2022 complaint inspection were posted.”

8VAC20-820-120-E-1

“Based on observation, the center failed to ensure that any provisional license shall be posted at each public entrance of the facility and a notice shall be prominently displayed next to the license that states that a description of specific violations of licensing standards to be corrected and the deadline for completion of such corrections is available for inspection at the facility or on the facility. Evidence: 1. The provisional license, issued 09/07/2022, was not posted at the public entrance of the facility. a. The license was posted on the parent board which is not a prominent place near the public entrance into the facility.”

8VAC20-780-580-B

“Based on record review, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the following requirements: The vehicle shall be insured with at least the minimum limits established by Virginia state statutes: Evidence: 1. There is no written documentation to indicate that both facility vans, used to transport children to and from public school, had insurance in effect from 10/31/2022 through 01/31/2023. a. Policy 1 reviewed by the inspector, for both vans, expired on 10/31/2022. b. Policy 2 reviewed by the inspector, for both vans, began coverage on 01/31/2023.”

8VAC20-780-560-G

“Based on observation, the center failed to ensure that when food is brought from home the food container shall be labeled in a way that identifies the owner. Evidence: 1. Two packets of frozen breast milk were not labeled with the child's name. a. These packets were observed in the infant room refrigerator.”

8VAC20-780-350-I

“Based on observation and interview, the center failed to ensure for children ages 16 months through preschool age, during the designated rest period, when children are resting or in an inactive state, the following rest period ratios are permitted: *Children 16 through 24 months of age: one staff per 10 children; *Children two years of age: One staff per 16 children; *Children of preschool age: One staff per 20 children. Evidence: 1. There were a total of 14 children ages16 months - two years with 1 staff when this classroom was observed during naptime at approximately 12:50 pm. a. Classroom staff reported that 6 of the children in this group were under the age of 2 years. b. Two staff were needed to meet the toddler nap ratio of 1:10. 2. There were a total of 22 children, ages 2 years & 3 years, with one staff when this classroom was observed during naptime at approximately 1:00pm. a. Classroom staff reported that 7 children in this group were two years of age. b. Two staff were needed to meet the two-year old nap ratio of 1:16 3. Classroom staff confirmed to the inspector they were alone with the children during nap time.”

8VAC20-780-245-J-3

“Based on record review, the center failed to ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member who meets the requirements for medication administration (MAT) training. Evidence: 1. There is no documentation on file to verify that any staff have MAT certification. a. A child in care, child 1, has emergency medication on file for a diagnosed food allergy.”

8VAC20-780-340-A

“Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. When the inspection entered the toddler/two year old nap room at approximately 12:50 pm the staff supervising the children was observed placing blankets over two children in such a way as to completely cover each child's face and head. 2. The inspector noted that all 14 children in this group were completely covered with a blanket to include the child's face and head. 3. This is a suffocation hazard when a child's face and head is completed covered with a blanket.”

8VAC20-780-240-I

“Based on record review and interview, the center failed to ensure that documentation of orientation training shall be kept by the center in a manner that allows for identification by individual staff member and is considered part of the staff member's record. Evidence: 1. There was no written documentation to demonstrate that staff 1 , hire date 08/01/2022, had completed orientation training as required within seven days of the first day of employment. 2. Administrative staff confirmed that documentation of orientation training was not on file for staff 1.”

8VAC20-820-120-E-2

“Based on observation, the center failed to ensure the findings of the most recent inspection of the facility were posted on the premises. Evidence: 1. The findings of the most recent monitoring inspection on 11/07/2022 were not posted. a. The findings of the 08/22/2022 complaint inspection were posted.”

8VAC20-820-120-E-1

“Based on observation, the center failed to ensure that any provisional license shall be posted at each public entrance of the facility and a notice shall be prominently displayed next to the license that states that a description of specific violations of licensing standards to be corrected and the deadline for completion of such corrections is available for inspection at the facility or on the facility. Evidence: 1. The provisional license, issued 09/07/2022, was not posted at the public entrance of the facility. a. The license was posted on the parent board which is not a prominent place near the public entrance into the facility.”

8VAC20-780-580-B

“Based on record review, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the following requirements: The vehicle shall be insured with at least the minimum limits established by Virginia state statutes: Evidence: 1. There is no written documentation to indicate that both facility vans, used to transport children to and from public school, had insurance in effect from 10/31/2022 through 01/31/2023. a. Policy 1 reviewed by the inspector, for both vans, expired on 10/31/2022. b. Policy 2 reviewed by the inspector, for both vans, began coverage on 01/31/2023.”

8VAC20-780-560-G

“Based on observation, the center failed to ensure that when food is brought from home the food container shall be labeled in a way that identifies the owner. Evidence: 1. Two packets of frozen breast milk were not labeled with the child's name. a. These packets were observed in the infant room refrigerator.”

8VAC20-780-350-I

“Based on observation and interview, the center failed to ensure for children ages 16 months through preschool age, during the designated rest period, when children are resting or in an inactive state, the following rest period ratios are permitted: *Children 16 through 24 months of age: one staff per 10 children; *Children two years of age: One staff per 16 children; *Children of preschool age: One staff per 20 children. Evidence: 1. There were a total of 14 children ages16 months - two years with 1 staff when this classroom was observed during naptime at approximately 12:50 pm. a. Classroom staff reported that 6 of the children in this group were under the age of 2 years. b. Two staff were needed to meet the toddler nap ratio of 1:10. 2. There were a total of 22 children, ages 2 years & 3 years, with one staff when this classroom was observed during naptime at approximately 1:00pm. a. Classroom staff reported that 7 children in this group were two years of age. b. Two staff were needed to meet the two-year old nap ratio of 1:16 3. Classroom staff confirmed to the inspector they were alone with the children during nap time.”

8VAC20-780-245-J-3

“Based on record review, the center failed to ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member who meets the requirements for medication administration (MAT) training. Evidence: 1. There is no documentation on file to verify that any staff have MAT certification. a. A child in care, child 1, has emergency medication on file for a diagnosed food allergy.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. The mesh safety gate located in the doorway of classroom A3 ( toddler/2's) was torn and dirty. Dried food was on the mesh side of the gate facing inside the classroom. 2. An air purifier placed on a table in the SA classroom is a toppling hazard. This purifier is within easy reach of a SA child. 3. The outdoor play house on the preschool playground has areas of cracked and sharp plastic around the doorway areas and the window. 4. The water play/sensory table on the preschool playground was filled with approximately 6 inches of standing water and debris. 5. The power strip in the four-year old classroom was accessible and multiple electrical cords were dangling from this strip.”

8VAC20-780-350-B-1

“Based on observation, the center failed to ensure that the required staff-to-child ratio was maintained whenever children are in care: *Birth up to 16 months- ratio 1:4 (staff: children) Evidence: 1. Five (5) infants were observed on the playground with one staff at approximately 10:00 am a. The staff present with this group of 5 infants confirmed there was not a second staff present with this group of infants.”

8VAC20-780-550-P

“Based on record review, the center failed to ensure that written injury reports contain all required information. Evidence: 1. Three injury reports reviewed lacked documentation of "any future action to prevent recurrence of the injury." 2. One injury report reviewed lacked documentation of the time and method the parent was notified of the injury.”

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 1, age 15 months, were administered on 10/13/2021. 2. The program director confirmed that an updated immunization record had not been obtained for child 1.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to ensure that staff have a central registry finding within 30 days of employment or volunteer service. Evidence: 1. Staff 1, hire date 08/01/2022, lacks the findings of a central registry check. 2. Staff 2, hire date 09/28/2022, lacks the findings of a central registry check. 3. Staff 3, hire date 09/08/2022, lacks the findings of a central registry check. 4. Staff 4, hire date 08/29/2022, lacks the findings of a central registry check. 5. The program director confirmed that the results of a central registry check was not on file for these four staff.”

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 2, enrollment date 4/6/2022, lacks documentation of a physical exam. 2. The program director confirmed that a physical exam was not on file for child 2.”

8VAC20-820-120-E-2

“Based on observation, the center failed to ensure the findings of the most recent inspection of the facility were posted on the premises. Evidence: 1. The findings of the most recent complaint inspection on 08/22/2022 were not posted. a. The findings of the 09/23/2021 monitoring inspection were posted.”

8VAC20-820-120-E-1

“Based on observation, the center failed to ensure that any provisional license shall be posted at each public entrance of the facility and a notice shall be prominently displayed next to the license that states that a description of specific violations of licensing standards to be corrected and the deadline for completion of such corrections is available for inspection at the facility. Evidence: 1. The provisional license, issued 09/07/2022, was not posted at the public entrance of the facility. a. The license was posted on the parent board which is not a prominent place near the public entrance into the facility.”

8VAC20-770-60-B

“Based on record review and interview, the center failed to ensure that staff must not be employed or provide volunteer service until the center has the person's completed sworn statement or affirmation. Evidence: 1. Staff 2, hire date 09/28/2022, lacks a completed sworn statement or affirmation. 1. Staff 3, hire date 09/08/2022, lacks a completed sworn statement or affirmation. 2. The program director confirmed that a sworn statement or affirmation was not on file for staff 2 and staff 3.”

8VAC20-780-245-J-3

“Based on record review and interview, the center failed to ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member who meets the requirements for medication administration (MAT) training. Evidence: 1. The program director stated that no one on staff had current MAT certification. a. A child in care, child 3. has emergency medications on file for a diagnosed food allergy.”

8VAC20-780-510-G

“Based on review, the center failed to ensure that medication shall be labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: 1. One emergency medication for child 3 lacked any name label nor was a prescription label attached to indicate the dosage amount and the times to be given. a. The program director verified that this medication had been accepted into the facility without the prescription label or name label.”

8VAC20-770-60-B Complaint related: No

“Based on interview and record review, the center failed to ensure that an employee of a child day program must not be employed or provide volunteer service until the center has the person's completed sworn statement or affirmation. Evidence: 1. Staff 1, staff 2, staff 3 and staff 4 , did not have a completed sworn statement or affirmation on file. a. All four staff were observed caring for children during the inspection. 2. Administrative staff stated all of these staff began employment on 08/22/2022 and confirmed they had not completed a sworn statement or affirmation.”

8VAC20-780-70 Complaint related: No

“Based on record review and interview, the center failed to obtain for staff documentation that two or more references as to character and reputation as well as competency were checked before employment or volunteering. Evidence: 1. Documentation of two or more reference checks were not on file for staff 1, staff 2, staff 3 and staff 4. a. All four staff began employment on 08/23/2022. 2. Administrative staff confirmed that reference checks had not been obtained for any of these staff.”

22.1-289.035-A Complaint related: No

“Based on record review and interview, the center failed to ensure that all applicants for employment, employees, applicants to serve as volunteers, and volunteers shall undergo a background check prior to employment or beginning to serve as a volunteer. Evidence: 1. Staff 1, staff 2 , staff 3 and staff 4 lack the results of a fingerprint background check. a. All four staff were observed working in a classroom with children during the inspection. 2. Administrative staff confirmed that a fingerprint background check had not been obtained for these four staff who began employment on 08/22/2022.”

8VAC20-780-160-A Complaint related: No

“Based on record review and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. Staff 1, staff 2, staff 3 and staff 4 lack documentation of a negative tuberculosis screening. a. All four staff were observed caring for children during the inspection. 2. Administrative staff stated these staff began employment on 08/22/2022 and confirmed a TB screening had not been obtained prior to employment and contact with children.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that documentation of the required tuberculosis screening shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The TB screening for staff 1 was completed on 02/24/2022 which is more than 30 days before her hire date of 05/09/2022. 2. The TB screening for staff 2 was completed on 04/01/2022 which is more than 30 days before her hire date of 05/16/2022. The TB screening for staff 3 was completed on 04/01/2022 which is more than 30 days before her hire date of 05/10/2022.”

8VAC20-780-160-C

“Based on record review, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 4 was conducted on 07/31/2020. 2. The most recent TB screening for staff 5 was conducted on 07/31/2020. 3. Administrative staff confirmed that staff 4 and staff 5 had not obtained a current TB screening.”

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 1 lacked documentation of viewing proof of the child's age and identity. 2. Administrative staff confirmed that proof of age and identity had not been obtained for child 1.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: The water play/sensory table, on the playground, contained approximately 4 inches of standing water, leaves and assorted debris.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided fall zones shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. *A six foot fall zone is required around stationary equipment and equipment with moving parts. Evidence: The blue spring rocker airplane has been placed approximately two feet from the wooden landscaping border.”

8VAC20-780-330-C

“Based on observation, the center failed to ensure that ground supports shall be covered with materials that protect children from injury. Evidence: The ground supports for the blue airplane spring rocker were not covered.”

8VAC20-780-340-A

“Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. An infant , child 2 - age 5 months, was observed napping in a swing with a folder blanket covering her entire face. a. This is a suffocation hazard.”

8VAC20-780-350-A

“Based on observation the center failed to adhere to the required group size for each age group. *When children are in ongoing mixed age groups, the group size applicable to the youngest child in the group shall apply to the entire group. Evidence: 1. There were 13 infants present in the infant classroom which exceeded the maximum group size of 12 for this age group. 2. There were 16 toddler/two year old children present in the bay 2 classroom which exceeded the maximum group size of 15 for this age group.”

8VAC20-780-350-B-1

“Based on observation, the center failed to ensure the staff-to-child ratio are required whenever children are in care: *Birth up to 16 months : 1:4 (staff : children) Evidence: 1. There were 13 infants in care with 3 staff when the infant room was reviewed at 10:00 am. a. Four staff were needed.”

8VAC20-780-350-B-2

“Based on observation, the center failed to ensure that the required staff-to-child ratio was maintained whenever children are in care: * 16 months up to 24 months : 1:5 (staff : children) *When children are in ongoing mixed age groups, the staff-to-child ratio to the youngest child in the group shall apply to the entire group. Evidence: 1. There were 16 children ranging in age from 17 months - 2 years in the bay 3 classroom with 2 staff at approximately 10:10am. 6 of the children in the group were under the age of two years. a. Four staff were needed. 2. 16 toddler/two year old children remained with 2 staff when the inspection last viewed the classroom at approximately 12:00 pm.”

8VAC20-780-350-B-3

“Based on observation, the center failed to ensure the following staff-to-child ratio was maintained whenever children are in care: *2 year olds : 1:8 (staff : children) Evidence: 1. There were 10 two- year old children in care with 1 staff when the two-year old classroom was reviewed at approximately 10:10 am. a. Two staff were needed. 2. The two- year old class were reviewed again at approximately 12:00 pm and there were 10 children with one staff.”

8VAC20-780-520-C

“Based on review, the center failed to ensure that if diaper ointment is used the product shall be labeled with the child's name. Evidence: 1. One diaper ointment, in the infant classroom, was not labeled with the child's name.”

8VAC20-820-120-E-2

“Based on observation, the center failed to ensure the findings of the most recent inspection of the facility were posted on the premises. Evidence: 1. The findings from the most recent complaint inspection on 06/24/2022 were not posted. a. The findings from the monitoring inspection conducted on 09/23/2021 were posted.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain documentation to demonstrate that the individual possess the education required by the job position. Evidence: 1. Staff 2 is listed as a program leader for the infant class however, there is no written documentation to demonstrate that staff 2 has fulfilled a high school program or equivalent. 2. Administrative staff confirmed that verification had not been obtained that staff 2 had completed high school or an equivalent program.”

8VAC20-790-600-D-1

“Based on record review, the vendor failed to ensure that staff have Current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Evidence: The CPR certification for staff 1 expired on 03/27/2022 according to written documentation on file at the facility.”

8VAC20-790-600-D-2

“Based on record review, the vendor failed to ensure that staff have current certification in first aid appropriate to the ages of children in care. Evidence: The first aid certification for staff 1 expired on 03/27/2022 according to written documentation on file at the facility.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that documentation of the required tuberculosis screening shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The TB screening for staff 1 was completed on 02/24/2022 which is more than 30 days before her hire date of 05/09/2022. 2. The TB screening for staff 2 was completed on 04/01/2022 which is more than 30 days before her hire date of 05/16/2022. The TB screening for staff 3 was completed on 04/01/2022 which is more than 30 days before her hire date of 05/10/2022.”

8VAC20-780-160-C

“Based on record review, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 4 was conducted on 07/31/2020. 2. The most recent TB screening for staff 5 was conducted on 07/31/2020. 3. Administrative staff confirmed that staff 4 and staff 5 had not obtained a current TB screening.”

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 1 lacked documentation of viewing proof of the child's age and identity. 2. Administrative staff confirmed that proof of age and identity had not been obtained for child 1.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean and safe condition. Evidence: The water play/sensory table, on the playground, contained approximately 4 inches of standing water, leaves and assorted debris.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided fall zones shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. *A six foot fall zone is required around stationary equipment and equipment with moving parts. Evidence: The blue spring rocker airplane has been placed approximately two feet from the wooden landscaping border.”

8VAC20-780-330-C

“Based on observation, the center failed to ensure that ground supports shall be covered with materials that protect children from injury. Evidence: The ground supports for the blue airplane spring rocker were not covered.”

8VAC20-780-340-A

“Based on observation, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. An infant , child 2 - age 5 months, was observed napping in a swing with a folder blanket covering her entire face. a. This is a suffocation hazard.”

8VAC20-780-350-A

“Based on observation the center failed to adhere to the required group size for each age group. *When children are in ongoing mixed age groups, the group size applicable to the youngest child in the group shall apply to the entire group. Evidence: 1. There were 13 infants present in the infant classroom which exceeded the maximum group size of 12 for this age group. 2. There were 16 toddler/two year old children present in the bay 2 classroom which exceeded the maximum group size of 15 for this age group.”

8VAC20-780-350-B-1

“Based on observation, the center failed to ensure the staff-to-child ratio are required whenever children are in care: *Birth up to 16 months : 1:4 (staff : children) Evidence: 1. There were 13 infants in care with 3 staff when the infant room was reviewed at 10:00 am. a. Four staff were needed.”

8VAC20-780-350-B-2

“Based on observation, the center failed to ensure that the required staff-to-child ratio was maintained whenever children are in care: * 16 months up to 24 months : 1:5 (staff : children) *When children are in ongoing mixed age groups, the staff-to-child ratio to the youngest child in the group shall apply to the entire group. Evidence: 1. There were 16 children ranging in age from 17 months - 2 years in the bay 3 classroom with 2 staff at approximately 10:10am. 6 of the children in the group were under the age of two years. a. Four staff were needed. 2. 16 toddler/two year old children remained with 2 staff when the inspection last viewed the classroom at approximately 12:00 pm.”

8VAC20-780-350-B-3

“Based on observation, the center failed to ensure the following staff-to-child ratio was maintained whenever children are in care: *2 year olds : 1:8 (staff : children) Evidence: 1. There were 10 two- year old children in care with 1 staff when the two-year old classroom was reviewed at approximately 10:10 am. a. Two staff were needed. 2. The two- year old class were reviewed again at approximately 12:00 pm and there were 10 children with one staff.”

8VAC20-780-520-C

“Based on review, the center failed to ensure that if diaper ointment is used the product shall be labeled with the child's name. Evidence: 1. One diaper ointment, in the infant classroom, was not labeled with the child's name.”

8VAC20-820-120-E-2

“Based on observation, the center failed to ensure the findings of the most recent inspection of the facility were posted on the premises. Evidence: 1. The findings from the most recent complaint inspection on 06/24/2022 were not posted. a. The findings from the monitoring inspection conducted on 09/23/2021 were posted.”

8VAC20-780-70

“Based on record review and interview, the center failed to ensure that staff records contain documentation to demonstrate that the individual possess the education required by the job position. Evidence: 1. Staff 2 is listed as a program leader for the infant class however, there is no written documentation to demonstrate that staff 2 has fulfilled a high school program or equivalent. 2. Administrative staff confirmed that verification had not been obtained that staff 2 had completed high school or an equivalent program.”

8VAC20-790-600-D-1

“Based on record review, the vendor failed to ensure that staff have Current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Evidence: The CPR certification for staff 1 expired on 03/27/2022 according to written documentation on file at the facility.”

8VAC20-790-600-D-2

“Based on record review, the vendor failed to ensure that staff have current certification in first aid appropriate to the ages of children in care. Evidence: The first aid certification for staff 1 expired on 03/27/2022 according to written documentation on file at the facility.”

8VAC20-780-550-P Complaint related: No

“Based on interview, the center failed to maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. Evidence: 1. The facility failed to document a scratch to the face and neck of child 1 occurring on 01/06/2022. 2. The facility failed to document a scratch to the face, in addition to a red mark on the nose, of child 1 occurring on 06/03/2022. 3. Administrative staff and classroom staff, responsible for the care of child 1, confirmed that injury reports had not been written for these injuries.”

8VAC20-780-340-A Complaint related: No

“Based on interview, the center failed to ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. A scratch and area of redness, on the nose, was noted on the face of child 1 at pick-up at approximately 3:50 pm on 06/03/2022 by an individual authorized to pick-up. a. Administrative staff stated they had not noted the scratch and area of redness when the child was released to the authorized pick-up. 2. Staff 1 and staff 2 , who were responsible for the care of child 1, stated they had not noticed the scratch or the area of redness and did not know how or when the injury occurred.”

8VAC20-780-430-C Complaint related: No

“Based on observation, the center failed to ensure that play equipment used by children shall have no protrusions. Evidence: 1. The bolt, attached to the toddler metal fence gate, is a protrusion. The bolt protrudes outward 1 1/2 inches and has 23 threads. a. This bolt is potentially at face level for toddler and young preschool age children.”

8VAC20-780-330-B Complaint related: No

“Based on observation, the facility failed to ensure where playground equipment is provided fall zones shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. The use zone for stationary equipment is six feet on all sides of the equipment. Evidence: 1. Two outdoor play structures, on the toddler outdoor play area, lacked the required 6 foot fall zone. a. The play structure with aqua slide was placed 16 inches from the adjacent play structure. The fall zone on the left side measured 29 1/2 inches, the fall zone in the front measured 34 inches and the fall zone in the rear measured 46 inches. b. The fall zone for the play structure with the blue slide measured 39 inches in the front, 41 inches in the rear and 39 inches on the right side.”

8VAC20-770-60-B

“Based on record review and interview, the center failed ensure that staff have an original criminal history record report within 30 days of employment. Evidence: 1. The criminal history record report for staff 3 was obtained on 11/23/2021 after her employment date of 10/21/2021. 2. Administrative staff confirmed that the criminal history record report for staff 3 was obtained after her first day of employment.”

8VAC20-780-160-A-1

“Based on record review, the center failed to ensure that documentation of the TB screening shall be submitted at the time of employment and prior to coming into contact with children. Evidence: 1. The TB screening for staff 1, hire date 03/28/2022, was conducted on 10/01/2021.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The record for child 1 lacked the following required information: a. The name, address and phone number for a second emergency contact; b. The first emergency contact listed lacked an address.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that outside equipment of the center shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to: chipped or peeling paint. Evidence: 1. Areas of peeling paint and exposed rust was observed on the bottom areas of the merry-go-round seats.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Where steps are used for accessibility, resilient surfacing is not required. Evidence: 1. A small plastic moveable play structure, with slide, was placed over grass. a. Grass is not considered resilient surfacing.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that a nonabsorbent surface for diapering or changing shall be used. Evidence: 1. The diaper changing pads in the infant classroom and the "waddler" classroom have areas of ripped/torn plastic.”

8VAC20-780-530-A-1

“Based on record review and interview, the center failed to ensure there is at least one staff in each classroom or area where children are present shall have current CPR certification. Evidence: 1. CPR certification for all staff present has expired as of 03/27/2022. 2. Administrative staff confirmed that CPR had recently expired for all staff.”

8VAC20-780-530-A-2

“Based on record review and interview, the center failed to ensure there is at least one staff in each classroom or area where children are present shall have current certification in first aid. Evidence: 1. First aid certification for all staff present has expired as of 03/27/2022. 2. Administrative staff confirmed that first aid had recently expired for all staff.”

8VAC20-780-580-B

“Based on observation, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the following requirements: The vehicle shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The Virginia State Inspection Sticker on the van used for transporting children to and from public school had expired as of March 31, 2022. 2. Administrative staff confirmed that the state inspection for this vehicle had expired.”

8VAC20-780-130-E

“Based on record review, 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 2 were administered on 10/30/2019. a. Child 2 is under the age of two years.”

8VAC20-770-60-B

“Based on record review and interview, the center failed ensure that staff have an original criminal history record report within 30 days of employment. Evidence: 1. The criminal history record report for staff 3 was obtained on 11/23/2021 after her employment date of 10/21/2021. 2. Administrative staff confirmed that the criminal history record report for staff 3 was obtained after her first day of employment.”

8VAC20-780-160-A-1

“Based on record review, the center failed to ensure that documentation of the TB screening shall be submitted at the time of employment and prior to coming into contact with children. Evidence: 1. The TB screening for staff 1, hire date 03/28/2022, was conducted on 10/01/2021.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The record for child 1 lacked the following required information: a. The name, address and phone number for a second emergency contact; b. The first emergency contact listed lacked an address.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that outside equipment of the center shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to: chipped or peeling paint. Evidence: 1. Areas of peeling paint and exposed rust was observed on the bottom areas of the merry-go-round seats.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Where steps are used for accessibility, resilient surfacing is not required. Evidence: 1. A small plastic moveable play structure, with slide, was placed over grass. a. Grass is not considered resilient surfacing.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that a nonabsorbent surface for diapering or changing shall be used. Evidence: 1. The diaper changing pads in the infant classroom and the "waddler" classroom have areas of ripped/torn plastic.”

8VAC20-780-530-A-1

“Based on record review and interview, the center failed to ensure there is at least one staff in each classroom or area where children are present shall have current CPR certification. Evidence: 1. CPR certification for all staff present has expired as of 03/27/2022. 2. Administrative staff confirmed that CPR had recently expired for all staff.”

8VAC20-780-530-A-2

“Based on record review and interview, the center failed to ensure there is at least one staff in each classroom or area where children are present shall have current certification in first aid. Evidence: 1. First aid certification for all staff present has expired as of 03/27/2022. 2. Administrative staff confirmed that first aid had recently expired for all staff.”

8VAC20-780-580-B

“Based on observation, the center failed to ensure that any vehicle used by the center for the transportation of children shall meet the following requirements: The vehicle shall meet the safety standards set by the Department of Motor Vehicles. Evidence: 1. The Virginia State Inspection Sticker on the van used for transporting children to and from public school had expired as of March 31, 2022. 2. Administrative staff confirmed that the state inspection for this vehicle had expired.”

8VAC20-780-130-E

“Based on record review, 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 2 were administered on 10/30/2019. a. Child 2 is under the age of two years.”

22VAC40-185-500-B

“Based on operation, the center failed to ensure that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: A tied plastic grocery bag, containing a soiled diaper, was observed on the floor of the toddler bathroom during a virtual tour of the facility on 09/23/2021.”

22VAC40-185-160-C

“Based on record review and interview, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 1 was conducted on 03/29/2019. 2. The program director confirmed that an updated TB screening had not been obtained for staff 1.”

22VAC40-80-160-D

“Based on interview, the center failed to ensure that the licensee shall at all times afford the department's representative reasonable opportunity to inspect all of the facility's records. Evidence: 1. The inspector called the facility at 8:57 am on 10/07/2021 to request review of several children and staff records. The individual who stated that she was in charge during the director's absence - indicated she did not have access to any of the children or staff records. a. This individual further stated that no one had access to any of the children and staff records. 2. The program director confirmed, by telephone call at 9:55 am, that she had left the facility without giving the key to the records file cabinet to the designated person in charge.”

22VAC40-185-500-B

“Based on operation, the center failed to ensure that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: A tied plastic grocery bag, containing a soiled diaper, was observed on the floor of the toddler bathroom during a virtual tour of the facility on 09/23/2021.”

22VAC40-185-160-C

“Based on record review and interview, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 1 was conducted on 03/29/2019. 2. The program director confirmed that an updated TB screening had not been obtained for staff 1.”

22VAC40-80-160-D

“Based on interview, the center failed to ensure that the licensee shall at all times afford the department's representative reasonable opportunity to inspect all of the facility's records. Evidence: 1. The inspector called the facility at 8:57 am on 10/07/2021 to request review of several children and staff records. The individual who stated that she was in charge during the director's absence - indicated she did not have access to any of the children or staff records. a. This individual further stated that no one had access to any of the children and staff records. 2. The program director confirmed, by telephone call at 9:55 am, that she had left the facility without giving the key to the records file cabinet to the designated person in charge.”