Baby, Toddler and Preschool Land

8VAC20-780-500-B Complaint related: No

“Based on review of video footage, the diapering surface was not cleaned with soap and at least room temperature water and sanitized after each use. Evidence: 1. Teacher #1 changes a child's diaper and does not clean the surface with soap and water and sanitized after each use.”

8VAC20-780-500-A Complaint related: No

“Based on observation of video footage, staff did not wash their hands with soap and running water before and after a diaper change. Evidence: 1. Teacher #1 in the Toddler classroom did not wash their hands before and after a diaper change. REPEAT VIOLATION”

8VAC20-780-380-A-2 Complaint related: No

“Based on observation of video footage and interviews, a child who falls asleep in a place other than their designated sleeping location was not moved promptly to a designated sleeping space. Evidence: 1. Child #1 was laying on the carpet in the middle of the classroom with their eyes closed at 3:25pm, and was not moved to a safer location. Child was picked up off the floor at 3:32pm. 2. Staff #1 stated Child #1 appeared to be sleeping and did not pick the child up until 3:32pm when she realized something was wrong with the child. 3, Staff #2 walked beside Child #1 and did not check on the child nor move child to a safer location.”

8VAC20-780-340-A Complaint related: Yes

“Based on review of video footage, interviews, and a tour of the classroom, it was determined the center did not ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. In the Toddler classroom, Child #1 laid on the carpet in the pathway of walking with their eyes closed for approximately seven (7) minutes before the teachers checked to see if the child was okay or move the child to a safer location. 2. Teacher #1 was facing Child #1 while changing another child's diaper. Child #1 was approximately 6 feet from the changing table, laying on their back on the carpet with their eyes closed and an occasional jerking motion of their feet and hands. After changing the child, Teacher #1 walked past Child #1 and did not check on the child or move child to a safer location. 3. Teacher #2 walked past Child #1 laying on the carpet and did not stop to check on the child or move child to a safer location. 4. A parent enters the classroom and walks around Child #1 laying on the carpet. 5. Teacher #3 walks past Child #1 laying on the carpet with their eyes closed and does not check on the child or move child to a safer location. COMPLAINT RELATED”

8VAC20-780-80-B-2 Complaint related: No

“Based on record review and interview, the center failed to inform the department's representative as soon as practicable, but not to exceed two business days of any inury to a child that occurs while the child is under the supervision of the center and requires medical attention. Evidence: 1. Injury report is dated 01/31/24 for Child #1 2. The Director confirmed the center did not inform the department's representative. 3. Received notification on 2/15/24 from another agency”

8VAC20-770-60-C-2

“Based on record review and interview, the central registry finding was not received by the 30th day of employment. Evidence: 1. Staff #2 (DOH 11/07/23) did not have documentation of a central registry results at the time of inspection (02/20/24). 2. The director acknowledged Staff #2 did not have documentation of a central registry results.”

22.1-289.035-B-2

“Based on record review, the provider did not obtain a criminal history record check prior to the 1st day of employment. Evidence: 1. The criminal history check (dated 11/07/23) was not obtained for Staff #2 prior to the first day of employment (DOH 11/7/23). 2. The criminal history check (dated 02/12/24) was not obtained for Staff #4 prior to the first day of employment (DOH 02/01/24).”

8VAC20-770-60-B

“Based on record review, the provider did not obtain a completed sworn statement prior to the first day of employment. Evidence: 1. Documentation of the completed sworn statement for Staff #2 (DOH 11/01/23) was dated 11/07/23. 2. Documentation of the completed sworn statement for Staff #4 (DOH 02/01/24) was dated 02/12/24.”

8VAC20-780-240-A

“Based on record review and interview, the Virginia Department of Education (VDOE)-sponsored orientation course was not completed within 90 calendar days of employment. Evidence: 1. Staff #2 (DOH 11/01/23) has not completed the VDOE-sponsored orientation course at the time of inspection (02/20/24) 2. The director confirmed Staff #2 has not completed the VDOE-sponsored orientation course.”

8VAC20-780-160-A

“Based on record review, the documentation of tuberculosis screening was not submitted at the time of employment. Evidence: 1. Staff #2 (DOH 11/01/23) TB screening was conducted on 11/07/23. 2. Staff #4 (DOH 02/01/24) TB screening was conducted on 02/12/24. Repeat Violation”

8VAC20-780-500-B Complaint related: No

“Based on review of video footage, the diapering surface was not cleaned with soap and at least room temperature water and sanitized after each use. Evidence: 1. Teacher #1 changes a child's diaper and does not clean the surface with soap and water and sanitized after each use.”

8VAC20-780-500-A Complaint related: No

“Based on observation of video footage, staff did not wash their hands with soap and running water before and after a diaper change. Evidence: 1. Teacher #1 in the Toddler classroom did not wash their hands before and after a diaper change. REPEAT VIOLATION”

8VAC20-780-380-A-2 Complaint related: No

“Based on observation of video footage and interviews, a child who falls asleep in a place other than their designated sleeping location was not moved promptly to a designated sleeping space. Evidence: 1. Child #1 was laying on the carpet in the middle of the classroom with their eyes closed at 3:25pm, and was not moved to a safer location. Child was picked up off the floor at 3:32pm. 2. Staff #1 stated Child #1 appeared to be sleeping and did not pick the child up until 3:32pm when she realized something was wrong with the child. 3, Staff #2 walked beside Child #1 and did not check on the child nor move child to a safer location.”

8VAC20-780-340-A Complaint related: Yes

“Based on review of video footage, interviews, and a tour of the classroom, it was determined the center did not ensure that when staff are supervising children, they shall always ensure their care and protection. Evidence: 1. In the Toddler classroom, Child #1 laid on the carpet in the pathway of walking with their eyes closed for approximately seven (7) minutes before the teachers checked to see if the child was okay or move the child to a safer location. 2. Teacher #1 was facing Child #1 while changing another child's diaper. Child #1 was approximately 6 feet from the changing table, laying on their back on the carpet with their eyes closed and an occasional jerking motion of their feet and hands. After changing the child, Teacher #1 walked past Child #1 and did not check on the child or move child to a safer location. 3. Teacher #2 walked past Child #1 laying on the carpet and did not stop to check on the child or move child to a safer location. 4. A parent enters the classroom and walks around Child #1 laying on the carpet. 5. Teacher #3 walks past Child #1 laying on the carpet with their eyes closed and does not check on the child or move child to a safer location. COMPLAINT RELATED”

8VAC20-780-80-B-2 Complaint related: No

“Based on record review and interview, the center failed to inform the department's representative as soon as practicable, but not to exceed two business days of any inury to a child that occurs while the child is under the supervision of the center and requires medical attention. Evidence: 1. Injury report is dated 01/31/24 for Child #1 2. The Director confirmed the center did not inform the department's representative. 3. Received notification on 2/15/24 from another agency”

8VAC20-770-60-C-2

“Based on record review and interview, the central registry finding was not received by the 30th day of employment. Evidence: 1. Staff #2 (DOH 11/07/23) did not have documentation of a central registry results at the time of inspection (02/20/24). 2. The director acknowledged Staff #2 did not have documentation of a central registry results.”

22.1-289.035-B-2

“Based on record review, the provider did not obtain a criminal history record check prior to the 1st day of employment. Evidence: 1. The criminal history check (dated 11/07/23) was not obtained for Staff #2 prior to the first day of employment (DOH 11/7/23). 2. The criminal history check (dated 02/12/24) was not obtained for Staff #4 prior to the first day of employment (DOH 02/01/24).”

8VAC20-770-60-B

“Based on record review, the provider did not obtain a completed sworn statement prior to the first day of employment. Evidence: 1. Documentation of the completed sworn statement for Staff #2 (DOH 11/01/23) was dated 11/07/23. 2. Documentation of the completed sworn statement for Staff #4 (DOH 02/01/24) was dated 02/12/24.”

8VAC20-780-240-A

“Based on record review and interview, the Virginia Department of Education (VDOE)-sponsored orientation course was not completed within 90 calendar days of employment. Evidence: 1. Staff #2 (DOH 11/01/23) has not completed the VDOE-sponsored orientation course at the time of inspection (02/20/24) 2. The director confirmed Staff #2 has not completed the VDOE-sponsored orientation course.”

8VAC20-780-160-A

“Based on record review, the documentation of tuberculosis screening was not submitted at the time of employment. Evidence: 1. Staff #2 (DOH 11/01/23) TB screening was conducted on 11/07/23. 2. Staff #4 (DOH 02/01/24) TB screening was conducted on 02/12/24. Repeat Violation”

8VAC20-780-80-A

“Based on observation and interview, the center did not maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Repeat Violation. Evidence: 1. There was no written record of daily attendance that documented the arrival and departure of each child in care as it occurred in 3 classrooms (Infants, Toddlers and Twos). 2. The director confirmed the teachers had not documented the arrival and departure of each child as it occurred.”

8VAC20-780-350-B-1

“Based on observation, the center did not maintain the required supervision ratio of one staff member for every four children for children ages birth up to 16 months. Evidence: 1. At the time of observation (10:10am) the infant classroom had 10 children with two (2) staff supervising. Staff #7 arrived in the classroom at 10:21am. 2. Staff #6 acknowledged they were over ratio because Staff #7 had taken the garbage out. Repeat Violation”

8VAC20-780-80-A

“Based on observation and interview, the center did not maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Repeat Violation. Evidence: 1. There was no written record of daily attendance that documented the arrival and departure of each child in care as it occurred in 3 classrooms (Infants, Toddlers and Twos). 2. The director confirmed the teachers had not documented the arrival and departure of each child as it occurred.”

8VAC20-780-350-B-1

“Based on observation, the center did not maintain the required supervision ratio of one staff member for every four children for children ages birth up to 16 months. Evidence: 1. At the time of observation (10:10am) the infant classroom had 10 children with two (2) staff supervising. Staff #7 arrived in the classroom at 10:21am. 2. Staff #6 acknowledged they were over ratio because Staff #7 had taken the garbage out. Repeat Violation”

8VAC20-780-560-J

“Based on observation, tables were not sanitized before and after each use for feeding. Evidence: The tables in the PreK classroom were not sanitized before children were served breakfast.”

8VAC20-780-550-I

“Based on observation and interview, the center did not have a 911 or local dial number for police, fire and emergency medical services posted in a visible place at each telephone. Evidence: 1. At the time of inspection, emergency telephone numbers were not posted at each telephone.”

8VAC20-780-520-C

“Based on observation, diaper ointment or cream was not labeled with the child's name. Evidence: The Infant class had three diaper ointments/creams (Desitin, A& D and Vaseline) not labeled with child's name.”

8VAC20-780-510-B

“Based on observation and record review, the facility did not obtain written parent authorization as required for prescription and nonprescription medication. Evidence: 1. There was no written authorization for diaper cream ointment for child #3, and #4. 2. Staff # 6 confirmed they did not have authorization forms.”

8VAC20-780-500-A

“Based on observation, staff did not wash their hands with soap and running water before preparing or serving food or beverages. Evidence: 1. Staff #1 did not wash their hands by using a germicidal cleansing agent when preparing and serving food or beverages outside picnic table. 2. Staff #2 did not wash their hands with soap and running water before preparing and service food or beverages (Breakfast) in the Pre-K classroom”

8VAC20-780-350-B-4

“Based on observation and interview, the center did not maintain the required supervision ratio of one staff member for every ten (10) children for children ages 3 year olds up to school age. Evidence: 1. The Threes, Fours, and School-age were combined on the playground with 34 children present with 2 teachers supervising (8:20 - 8:35am). 2. At 8:35 am the group increased to 44 children present with 3 teachers supervising.”

8VAC20-780-350-B-3

“Based on observation and interview, the center did not maintain the required supervision ratio of one staff member for every eight children for 2 year olds. Evidence: 1. The Twos classroom had 17 children present with 2 staff supervising. 2. Staff # 1 acknowledged the class had 17 children and were over-ratio.”

8VAC20-780-350-B-1

“Based on observation, interviews, and review of daily attendance record, the center did not maintain the required supervision ratio of one staff member for every four children for children ages birth up to 16 months. Evidence: 1. The infant classroom had 9 children with two staff supervising 2. Staff #6 acknowledged there were 9 infants due to a new child attending for a few hours.”

8VAC20-780-350-A

“Based on observation and interview, the maximum group size limitations for 3 year olds up to school age was not followed whenever children are in care. Evidence: 1. At the time of inspection, (8:20 - 9:00 am) the threes, fours and school-age children were combined on the outside playground. There were 47 children present. 2. The maximum group size for 3 years old up to school age is 30 children.”

8VAC20-780-290-A-3

“Based on observation, electrical outlets did not have protective covers that are a size that cannot be swallowed by children. Evidence: There were 5 electrical outlets located on the back wall in the Pre-K classroom that did not have protective covers.”

8VAC20-780-280-B

“Based on observation, potentially poisonous materials are accessible to children. Evidence: 1. Bleach solution in the Two's classroom was not in a locked cabinet. 2. Various cleaning products (Bleach, Clorox, Dawn) were accessible to children in the PreK classroom. The door in the PreK classroom that goes into the kitchen was left open for approximately 30 minutes. The products were on a low open shelf.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure all required information was kept for each enrolled child. Evidence: 1. The record for Child #1 did not have documentation that the child's proof of identity and age had been viewed. 2. The director confirmed the child's proof of identity and age had not been viewed.”

8VAC20-780-160-C

“Based on record review and interview, staff did not submit documentation of a negative tuberculosis (TB) test or screening every two years from the date of the initial screening. Evidence: 1. The record for Staff #3 did not have updated documentation of a TB test or screening . Last documentation is dated 11/2021. 2. The director acknowledged there was not an updated TB test/screening on Staff #3.”

22.1-289.035-A

“Based on record review, the provider did not obtain documentation for a 5 year criminal history repeat check. Evidence: 1. Four out of five staff records had expired criminal history searches. 2. Staff #1 record did not have documentation of an updated criminal history search (expired 03/30/23). 3. Staff #2 record did not have documentation of an updated criminal history search (expired 3/18/23). 4. Staff #4 record did not have documentation of an updated criminal history search (expired 3/26/23). 5. Staff #5 record did not have documentation of an updated criminal history search (expired 3/39/23). 6. The provider acknowledged a large percentage of staff criminal history searches expired in March 2023.”

8VAC20-780-80-A

“Based on observation and interview, the center did not maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: 1. There was no documentation of daily attendance in five (5) classrooms (Twos, Threes, PreK and School-age). 2. The director acknowledged the classes had not been completing a written record of daily attendance as it occurs in the classrooms.”

8VAC20-780-560-J

“Based on observation, tables were not sanitized before and after each use for feeding. Evidence: The tables in the PreK classroom were not sanitized before children were served breakfast.”

8VAC20-780-550-I

“Based on observation and interview, the center did not have a 911 or local dial number for police, fire and emergency medical services posted in a visible place at each telephone. Evidence: 1. At the time of inspection, emergency telephone numbers were not posted at each telephone.”

8VAC20-780-520-C

“Based on observation, diaper ointment or cream was not labeled with the child's name. Evidence: The Infant class had three diaper ointments/creams (Desitin, A& D and Vaseline) not labeled with child's name.”

8VAC20-780-510-B

“Based on observation and record review, the facility did not obtain written parent authorization as required for prescription and nonprescription medication. Evidence: 1. There was no written authorization for diaper cream ointment for child #3, and #4. 2. Staff # 6 confirmed they did not have authorization forms.”

8VAC20-780-500-A

“Based on observation, staff did not wash their hands with soap and running water before preparing or serving food or beverages. Evidence: 1. Staff #1 did not wash their hands by using a germicidal cleansing agent when preparing and serving food or beverages outside picnic table. 2. Staff #2 did not wash their hands with soap and running water before preparing and service food or beverages (Breakfast) in the Pre-K classroom”

8VAC20-780-350-B-4

“Based on observation and interview, the center did not maintain the required supervision ratio of one staff member for every ten (10) children for children ages 3 year olds up to school age. Evidence: 1. The Threes, Fours, and School-age were combined on the playground with 34 children present with 2 teachers supervising (8:20 - 8:35am). 2. At 8:35 am the group increased to 44 children present with 3 teachers supervising.”

8VAC20-780-350-B-3

“Based on observation and interview, the center did not maintain the required supervision ratio of one staff member for every eight children for 2 year olds. Evidence: 1. The Twos classroom had 17 children present with 2 staff supervising. 2. Staff # 1 acknowledged the class had 17 children and were over-ratio.”

8VAC20-780-350-B-1

“Based on observation, interviews, and review of daily attendance record, the center did not maintain the required supervision ratio of one staff member for every four children for children ages birth up to 16 months. Evidence: 1. The infant classroom had 9 children with two staff supervising 2. Staff #6 acknowledged there were 9 infants due to a new child attending for a few hours.”

8VAC20-780-350-A

“Based on observation and interview, the maximum group size limitations for 3 year olds up to school age was not followed whenever children are in care. Evidence: 1. At the time of inspection, (8:20 - 9:00 am) the threes, fours and school-age children were combined on the outside playground. There were 47 children present. 2. The maximum group size for 3 years old up to school age is 30 children.”

8VAC20-780-290-A-3

“Based on observation, electrical outlets did not have protective covers that are a size that cannot be swallowed by children. Evidence: There were 5 electrical outlets located on the back wall in the Pre-K classroom that did not have protective covers.”

8VAC20-780-280-B

“Based on observation, potentially poisonous materials are accessible to children. Evidence: 1. Bleach solution in the Two's classroom was not in a locked cabinet. 2. Various cleaning products (Bleach, Clorox, Dawn) were accessible to children in the PreK classroom. The door in the PreK classroom that goes into the kitchen was left open for approximately 30 minutes. The products were on a low open shelf.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure all required information was kept for each enrolled child. Evidence: 1. The record for Child #1 did not have documentation that the child's proof of identity and age had been viewed. 2. The director confirmed the child's proof of identity and age had not been viewed.”

8VAC20-780-160-C

“Based on record review and interview, staff did not submit documentation of a negative tuberculosis (TB) test or screening every two years from the date of the initial screening. Evidence: 1. The record for Staff #3 did not have updated documentation of a TB test or screening . Last documentation is dated 11/2021. 2. The director acknowledged there was not an updated TB test/screening on Staff #3.”

22.1-289.035-A

“Based on record review, the provider did not obtain documentation for a 5 year criminal history repeat check. Evidence: 1. Four out of five staff records had expired criminal history searches. 2. Staff #1 record did not have documentation of an updated criminal history search (expired 03/30/23). 3. Staff #2 record did not have documentation of an updated criminal history search (expired 3/18/23). 4. Staff #4 record did not have documentation of an updated criminal history search (expired 3/26/23). 5. Staff #5 record did not have documentation of an updated criminal history search (expired 3/39/23). 6. The provider acknowledged a large percentage of staff criminal history searches expired in March 2023.”

8VAC20-780-80-A

“Based on observation and interview, the center did not maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: 1. There was no documentation of daily attendance in five (5) classrooms (Twos, Threes, PreK and School-age). 2. The director acknowledged the classes had not been completing a written record of daily attendance as it occurs in the classrooms.”

8VAC20-790-600-F

“Based on staff record review, staff have not completed the annual department's health and safety update training. Evidence: Staff #3 has not completed the annual 3 hour health and safety update training, the last training dated 4/23/2020.”

8VAC20-780-245-L

“Based on record review and interview with the provider, there was not at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: 1. All staff (6/6) last documented daily health instruction was 11/18/19. 2. The provider acknowledged no one in the center has a current daily health observation training.”

8VAC20-780-160-C

“Based on record review, 1 of 5 staff records did not contain documentation of a current TB test or screening, conducted every two years from the date of the first initial screening or test. Evidence: 1. Staff #1 (DOH 11/28/16) most recent documented TB test was dated 01/10/2020.”

8VAC20-780-160-A

“Based on record review, the provider did not obtain documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: Staff #3 (DOH 11/12/19) does not have documentation on file of a TB screening.”

22.1-289.035-A

“Based on record review, the provider did not obtain documentation for a 5 year repeat check. Evidence: 1. Staff #1?s record did not have documentation of an updated central registry search (expired on 11/2020).”

8VAC20-780-450-A

“Based on observation, cots and mats used by children during the designated rest period did not have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Evidence: 1. Two (2) mats in the Pre-K class did not have bottom covers. 2. Two (2) mats in the Toddler class did not have bottom covers. 3. One (1) mat in the Two's class did not have a bottom cover. 4. Two (2) mats in the Three's class did not have bottom covers.”

8VAC20-790-600-F

“Based on staff record review, staff have not completed the annual department's health and safety update training. Evidence: Staff #3 has not completed the annual 3 hour health and safety update training, the last training dated 4/23/2020.”

8VAC20-780-245-L

“Based on record review and interview with the provider, there was not at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: 1. All staff (6/6) last documented daily health instruction was 11/18/19. 2. The provider acknowledged no one in the center has a current daily health observation training.”

8VAC20-780-160-C

“Based on record review, 1 of 5 staff records did not contain documentation of a current TB test or screening, conducted every two years from the date of the first initial screening or test. Evidence: 1. Staff #1 (DOH 11/28/16) most recent documented TB test was dated 01/10/2020.”

8VAC20-780-160-A

“Based on record review, the provider did not obtain documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: Staff #3 (DOH 11/12/19) does not have documentation on file of a TB screening.”

22.1-289.035-A

“Based on record review, the provider did not obtain documentation for a 5 year repeat check. Evidence: 1. Staff #1?s record did not have documentation of an updated central registry search (expired on 11/2020).”

8VAC20-780-450-A

“Based on observation, cots and mats used by children during the designated rest period did not have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Evidence: 1. Two (2) mats in the Pre-K class did not have bottom covers. 2. Two (2) mats in the Toddler class did not have bottom covers. 3. One (1) mat in the Two's class did not have a bottom cover. 4. Two (2) mats in the Three's class did not have bottom covers.”

8VAC20-780-280-B

“Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. A cabinet under the sink in the two year old class (16 - 36 months) was unlocked with 5 different types of cleaning products inside. 2. The diapering cabinet in the two-year-old class was unlocked that had diaper cream inside it.”

8VAC20-780-500-B

“Based on observation and interview, staff did not clean the diapering surface with soap and water and then sanitize after each use. Evidence: 1. Cleaning bottles were not available in the Toddler (16-24 months) class. 2. Staff #4 acknowledged only cleaning the diapering surface with a bleach solution.”

8VAC20-780-500-A

“Based on observation, staff did not wash their hands with soap and running water after contact with body fluids and before feeding children. Evidence: 1. Staff #2 did not wash their hands after cleaning a child’s runny nose. 2. Staff #2 did not wash their hands before bottle feeding an infant.”

8VAC20-780-290-A-3

“Based on observation, electrical outlets did not have protective covers. Evidence: 1. The Infant room had an electrical outlet uncovered. 2. The Toddler room (ages 16-24 months) had an electrical outlet uncovered that was beside a small table. 3. The Pre-K class had an outlet uncovered in the circle area.”

8VAC20-780-160-A

“Based on record review, staff record did not contain documentation of a negative tuberculosis (TB) test or screening at the time of employment. Evidence: Staff #2?s date of hire is 11/12/19 and at the time of inspection (10/20/22) there was no documentation of a TB screening on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to maintain and keep at the center a separate record for each child enrolled the following information: Evidence: 1.The record for Child #3 did not have documentation of viewing proof of the child’s identity and age.”

8VAC20-780-280-B

“Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. A cabinet under the sink in the two year old class (16 - 36 months) was unlocked with 5 different types of cleaning products inside. 2. The diapering cabinet in the two-year-old class was unlocked that had diaper cream inside it.”

8VAC20-780-500-B

“Based on observation and interview, staff did not clean the diapering surface with soap and water and then sanitize after each use. Evidence: 1. Cleaning bottles were not available in the Toddler (16-24 months) class. 2. Staff #4 acknowledged only cleaning the diapering surface with a bleach solution.”

8VAC20-780-500-A

“Based on observation, staff did not wash their hands with soap and running water after contact with body fluids and before feeding children. Evidence: 1. Staff #2 did not wash their hands after cleaning a child’s runny nose. 2. Staff #2 did not wash their hands before bottle feeding an infant.”

8VAC20-780-290-A-3

“Based on observation, electrical outlets did not have protective covers. Evidence: 1. The Infant room had an electrical outlet uncovered. 2. The Toddler room (ages 16-24 months) had an electrical outlet uncovered that was beside a small table. 3. The Pre-K class had an outlet uncovered in the circle area.”

8VAC20-780-160-A

“Based on record review, staff record did not contain documentation of a negative tuberculosis (TB) test or screening at the time of employment. Evidence: Staff #2?s date of hire is 11/12/19 and at the time of inspection (10/20/22) there was no documentation of a TB screening on file.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to maintain and keep at the center a separate record for each child enrolled the following information: Evidence: 1.The record for Child #3 did not have documentation of viewing proof of the child’s identity and age.”

8VAC20-780-140-A

“Based on a review of children's records, it was determined that the center did not obtain documentation showing that each child had a physical examination under by a physician within 30 days after the first day of attendance. Evidence: Child B entered care on 11/20/2021. There is no documentation of a completed physical exam in this child's file.”

8VAC20-780-130-A

“Based on a review of children's health records, it was determined that the center did not obtain documentation that each child received the immunizations required by the State Board of Health before allowing each child to attend the center. Evidence: Child B entered care on 11/20/2021. As of the date of this inspection there is no immunization record in this child's file.”

8VAC20-780-160-C

“Based on a review of staff health records, it was determined that two staff did not obtain a repeat Tuberculosis Health Screening at least every two years from the date of their most recent screenings. Evidence: Staff A and Staff B both have expired TB Health Screenings. For each of the,m their most recent screening was completed on 11/19/2019.”

8VAC20-780-140-A

“Based on a review of children's records, it was determined that the center did not obtain documentation showing that each child had a physical examination under by a physician within 30 days after the first day of attendance. Evidence: Child B entered care on 11/20/2021. There is no documentation of a completed physical exam in this child's file.”

8VAC20-780-130-A

“Based on a review of children's health records, it was determined that the center did not obtain documentation that each child received the immunizations required by the State Board of Health before allowing each child to attend the center. Evidence: Child B entered care on 11/20/2021. As of the date of this inspection there is no immunization record in this child's file.”

8VAC20-780-160-C

“Based on a review of staff health records, it was determined that two staff did not obtain a repeat Tuberculosis Health Screening at least every two years from the date of their most recent screenings. Evidence: Staff A and Staff B both have expired TB Health Screenings. For each of the,m their most recent screening was completed on 11/19/2019.”

8VAC20-780-160-C

“Based on a review of staff health records, it was determined that at least every two years from the date of the first initial screening or testing, all staff members did not obtain and submit the results of a follow-up tuberculosis screening. Evidence: The TB screening for staff person A expired on 12/13/2019.”