Ballad Health Center for Early Learning - Abingdon

8VAC20-780-370-4 Complaint related: No

“There shall be a daily schedule for infants based on their individual needs. During the day, infants shall be provided with comfort as needed. During the inspection an eight month old was crying, for approximately two minutes, while in a bouncy seat and no one attempted to console or proved comfort for the child. The child threw up when staff #1 finally picked up the child.”

8VAC20-790-600-D-2

“All staff who work directly with children shall have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. Staff #1, who has been actively working with the children for five months did not have documentation showing certification in first aid.”

8VAC20-790-600-D-1

“All staff who work directly with children shall have within 90 days of the date of employment, current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Staff #1, who had been actively working at the center for five months, did not have documentation of receiving CPR certification.”

8VAC20-780-410-1

“The following acts are forbidden: striking and roughly handling a child. On 5/22/25, Staff #1, popped Child #1 (age 15 months) on the hand. Video footage observed from 5/22/25 showed that Staff #1, pulled Child #1 by the leg, sliding the child forcefully away from the other children.”

8VAC20-780-370-4 Complaint related: No

“There shall be a daily schedule for infants based on their individual needs. During the day, infants shall be provided with comfort as needed. During the inspection an eight month old was crying, for approximately two minutes, while in a bouncy seat and no one attempted to console or proved comfort for the child. The child threw up when staff #1 finally picked up the child.”

8VAC20-790-600-D-2

“All staff who work directly with children shall have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. Staff #1, who has been actively working with the children for five months did not have documentation showing certification in first aid.”

8VAC20-790-600-D-1

“All staff who work directly with children shall have within 90 days of the date of employment, current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Staff #1, who had been actively working at the center for five months, did not have documentation of receiving CPR certification.”

8VAC20-780-410-1

“The following acts are forbidden: striking and roughly handling a child. On 5/22/25, Staff #1, popped Child #1 (age 15 months) on the hand. Video footage observed from 5/22/25 showed that Staff #1, pulled Child #1 by the leg, sliding the child forcefully away from the other children.”

8VAC20-780-370-4 Complaint related: No

“There shall be a daily schedule for infants based on their individual needs. During the day, infants shall be provided with comfort as needed. During the inspection an eight month old was crying, for approximately two minutes, while in a bouncy seat and no one attempted to console or proved comfort for the child. The child threw up when staff #1 finally picked up the child.”

8VAC20-790-600-D-2

“All staff who work directly with children shall have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. Staff #1, who has been actively working with the children for five months did not have documentation showing certification in first aid.”

8VAC20-790-600-D-1

“All staff who work directly with children shall have within 90 days of the date of employment, current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Staff #1, who had been actively working at the center for five months, did not have documentation of receiving CPR certification.”

8VAC20-780-410-1

“The following acts are forbidden: striking and roughly handling a child. On 5/22/25, Staff #1, popped Child #1 (age 15 months) on the hand. Video footage observed from 5/22/25 showed that Staff #1, pulled Child #1 by the leg, sliding the child forcefully away from the other children.”

8VAC20-780-370-4 Complaint related: No

“There shall be a daily schedule for infants based on their individual needs. During the day, infants shall be provided with comfort as needed. During the inspection an eight month old was crying, for approximately two minutes, while in a bouncy seat and no one attempted to console or proved comfort for the child. The child threw up when staff #1 finally picked up the child.”

8VAC20-790-600-D-2

“All staff who work directly with children shall have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. Staff #1, who has been actively working with the children for five months did not have documentation showing certification in first aid.”

8VAC20-790-600-D-1

“All staff who work directly with children shall have within 90 days of the date of employment, current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Staff #1, who had been actively working at the center for five months, did not have documentation of receiving CPR certification.”

8VAC20-780-410-1

“The following acts are forbidden: striking and roughly handling a child. On 5/22/25, Staff #1, popped Child #1 (age 15 months) on the hand. Video footage observed from 5/22/25 showed that Staff #1, pulled Child #1 by the leg, sliding the child forcefully away from the other children.”

8VAC20-780-450-A

“Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. The rest mats being used during nap time in the Leopards and Pandas classrooms did not have a bottom cover.”

8VAC20-780-500-B

“5. Disposable diapers shall be disposed system that is either foot-operated or used in such a way that staff member's hand nor the soiled diaper touches the outer surface of the disposal container. In the Foxes room a diaper was disposed of by staff lifting the trash can lid with their hand. 7. The diapering surface shall be cleaned with soap and water and sanitized after each use. The diapering surface in the Foxes room was sprayed with bleach/water solution and wiped dry.”

8VAC20-780-450-A

“Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. The rest mats being used during nap time in the Leopards and Pandas classrooms did not have a bottom cover.”

8VAC20-780-500-B

“5. Disposable diapers shall be disposed system that is either foot-operated or used in such a way that staff member's hand nor the soiled diaper touches the outer surface of the disposal container. In the Foxes room a diaper was disposed of by staff lifting the trash can lid with their hand. 7. The diapering surface shall be cleaned with soap and water and sanitized after each use. The diapering surface in the Foxes room was sprayed with bleach/water solution and wiped dry.”

8VAC20-780-280-B

“REPEAT VIOLATION Hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. A spray bottle containing bleach and water was in an unlocked cabinet in the Does room. Two spray cans of sunscreen + bug spray were in the cubbies used by the children, not locked.”

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

“Children under 10 years of age always shall be within actual sight and sound supervision of staff. On 11/4/24, at approximately 9:00 a.m. one, twenty-three-month-old child was left alone in the receptionist area for approximately one minute. On 11/15/24, at approximately 2:08 p.m., one child, three years of age, was left alone in the Panda’s room for four minutes.”

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

“When staff are supervising children, they shall always ensure their care, protection, and guidance. On 11/4/24 and 11/15/24 two children were left alone for approximately one to four minutes by two different staff.”

8VAC20-780-500-B

“Disposable diapers shall be disposed in a leakproof or plastic line storage system that is either foot-operated or used in such a way the neither the staff member’s hand not the soiled diaper touches an exterior surface of the storage system during disposal. There were no foot pedal operated trash cans in the Badger rooms.”

8VAC20-780-280-B

“Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A spray bottle containing bleach and water was in an unlocked closet in the Elephant room. Bleach and laundry detergent were on the counter in the laundry room, and the door was not locked.”

8VAC20-780-240-B

“Staff shall complete orientation training prior to working alone with children and no later than seven days of the date of assuming job responsibilities. Staff #1-4, who have been actively working with children for two months, do not have documentation of orientation training on file.”

8VAC20-780-90-A

“SYSTEMIC DEFICIENCY 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. Child’s records # 2 & 3 did not have a written agreement with the center on file. Child #2 & 3 have been in care for two months.”

8VAC20-780-70

“SYSTEMIC DEFICIENCY The following staff records shall be kept for each staff person. 4-Staff #1-5, who has been actively working at the center for the past one to four months, did not have documentation to demonstrate that the individual possesses the education and experience required by the job description. Staff # 1-5, who have been actively working with children for up to four months, do not have documentation on file that they meet the qualifications to be a program leader. 2-Documentation of a least two references to character, reputation, and competency are to be checked prior to employment. Staff #1-4, who have been actively working at the center for the past two months, did not have any completed reference verifications on file. 7-Information, to be kept at the center, about any health problems that may interfere with job responsibilities. Staff #1-5, who have been actively working at the center for the past two to four months, did not have information at the center regarding any health problems.”

8VAC20-780-60-A

“SYSTEMIC DEFICIENCY Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain. Child’s record # 3 was missing the sex and address of the child. Child record #2 was missing the parents place of work and work phone. Child record’s #2 & 3 are missing the physician’s name and phone number. Child records # 3 & # do not have the first day of attendance listed. Child records # 2, 3, and 4 does not address allergies. Child's record #2 did not have documentation of viewing proof of child's identity and age. All children listed have been in care one to two months.”

8VAC20-780-40-M

“SYSTEMIC DEFICIENCY The center shall maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. The Badger and Panda rooms had food allergies listed. However, the lists were not dated.”

8VAC20-780-160-A

“SYSTEMIC DEFICIENCY Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Staff #2 and #5, who have been actively working with children for the past two to four months, did not have documentation of a negative TB screening on file.”

8VAC20-780-570-E

“Prepared infant formula shall be refrigerated, dated and labeled with the child’s name. Two prepared bottles in the Badgers room did not have the date listed.”

8VAC20-780-560-F

“Centers providing meals and snacks shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Three of the five required nutritional components were not present at breakfast. Five of the required nutritional components were not present at lunch. Two of the five required nutritional components were not present at snack. The Pandas classroom had Goldfish and water for snack. The breakfast menu listed: waffle & juice or muffin & orange juice. The lunch menu listed juice on various days. The snack menu listed water or juice and one other component.”

22.1-289.011-F

“The license and any other documents required by the Superintendent shall be posted in a conspicuous place on the licensed premises. The current Conditional license and the Violation Notice dated 9/4/24 was not posted in a conspicuous place.”

22.1-289.035-B-3

“The center must request a search of the central registry prior to the employee’s first day of employment. Staff #2, who had been employed for two months, Staff #4,who had been employed two and a half months, and Staff # 5 who had been employed for four months, did not have a central registry search requested. Staff #2 & 5 were working with the children in the same classroom.”

8VAC20-780-550-I

“The center shall have posted in a visible place at each telephone, a 911 or local dial number for police, fire and emergency medical services and the number of the regional poison control center. No emergency numbers were posted at the center.”

8VAC20-780-550-D

“SYSTEM DEFICIENCY The center shall implement a monthly practice evacuation drill. There were no monthly evacuation drills practiced for September or October 2024.”

8VAC20-780-550-C

“SYSTEMIC DEFICIENCY Emergency evacuation and shelter-in-place procedures or maps shall be posted in a location conspicuous to staff and children. There were no emergency evacuation and shelter-in-place procedures or maps posted at the center.”

8VAC20-780-540-E

“The following non-medical emergency supplies shall be required on each floor of the building: one working, battery operated flashlight and one working, battery operated radio. The center did not have a radio or flashlight.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #3, employed for two months, did not have documentation of requesting a central registry check from one state they resided in the past five years and no documentation of requesting a central registry check or criminal history check from a different state.”

22.1-289.035-B-2

“Providers must obtain a completed national criminal background check prior to the employees? first day of employment. Staff #1, who had been employed for two months, did not have a completed national criminal background check.”

8VAC20-780-140-A

“SYSTEMIC DEFICIENCY Each child shall have a physical examination by or under the direction of a physician: before the child’s attendance; or within 30 days after the first day of attendance. Child record #5, did not have a physical examination on file. Child #5 has been in care for two months.”

8VAC20-780-130-A

“SYSTEMIC DEFICIENCY The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Child record #5 did not have an immunization record on file. Child #5 has been in care for two months.”

8VAC20-780-500-B

“Disposable diapers shall be disposed in a leakproof or plastic line storage system that is either foot-operated or used in such a way the neither the staff member’s hand not the soiled diaper touches an exterior surface of the storage system during disposal. There were no foot pedal operated trash cans in the Badger rooms.”

8VAC20-780-280-B

“Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A spray bottle containing bleach and water was in an unlocked closet in the Elephant room. Bleach and laundry detergent were on the counter in the laundry room, and the door was not locked.”

8VAC20-780-240-B

“Staff shall complete orientation training prior to working alone with children and no later than seven days of the date of assuming job responsibilities. Staff #1-4, who have been actively working with children for two months, do not have documentation of orientation training on file.”

8VAC20-780-90-A

“SYSTEMIC DEFICIENCY 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. Child’s records # 2 & 3 did not have a written agreement with the center on file. Child #2 & 3 have been in care for two months.”

8VAC20-780-70

“SYSTEMIC DEFICIENCY The following staff records shall be kept for each staff person. 4-Staff #1-5, who has been actively working at the center for the past one to four months, did not have documentation to demonstrate that the individual possesses the education and experience required by the job description. Staff # 1-5, who have been actively working with children for up to four months, do not have documentation on file that they meet the qualifications to be a program leader. 2-Documentation of a least two references to character, reputation, and competency are to be checked prior to employment. Staff #1-4, who have been actively working at the center for the past two months, did not have any completed reference verifications on file. 7-Information, to be kept at the center, about any health problems that may interfere with job responsibilities. Staff #1-5, who have been actively working at the center for the past two to four months, did not have information at the center regarding any health problems.”

8VAC20-780-60-A

“SYSTEMIC DEFICIENCY Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain. Child’s record # 3 was missing the sex and address of the child. Child record #2 was missing the parents place of work and work phone. Child record’s #2 & 3 are missing the physician’s name and phone number. Child records # 3 & # do not have the first day of attendance listed. Child records # 2, 3, and 4 does not address allergies. Child's record #2 did not have documentation of viewing proof of child's identity and age. All children listed have been in care one to two months.”

8VAC20-780-40-M

“SYSTEMIC DEFICIENCY The center shall maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. The Badger and Panda rooms had food allergies listed. However, the lists were not dated.”

8VAC20-780-160-A

“SYSTEMIC DEFICIENCY Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Staff #2 and #5, who have been actively working with children for the past two to four months, did not have documentation of a negative TB screening on file.”

8VAC20-780-570-E

“Prepared infant formula shall be refrigerated, dated and labeled with the child’s name. Two prepared bottles in the Badgers room did not have the date listed.”

8VAC20-780-560-F

“Centers providing meals and snacks shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Three of the five required nutritional components were not present at breakfast. Five of the required nutritional components were not present at lunch. Two of the five required nutritional components were not present at snack. The Pandas classroom had Goldfish and water for snack. The breakfast menu listed: waffle & juice or muffin & orange juice. The lunch menu listed juice on various days. The snack menu listed water or juice and one other component.”

22.1-289.011-F

“The license and any other documents required by the Superintendent shall be posted in a conspicuous place on the licensed premises. The current Conditional license and the Violation Notice dated 9/4/24 was not posted in a conspicuous place.”

22.1-289.035-B-3

“The center must request a search of the central registry prior to the employee’s first day of employment. Staff #2, who had been employed for two months, Staff #4,who had been employed two and a half months, and Staff # 5 who had been employed for four months, did not have a central registry search requested. Staff #2 & 5 were working with the children in the same classroom.”

8VAC20-780-550-I

“The center shall have posted in a visible place at each telephone, a 911 or local dial number for police, fire and emergency medical services and the number of the regional poison control center. No emergency numbers were posted at the center.”

8VAC20-780-550-D

“SYSTEM DEFICIENCY The center shall implement a monthly practice evacuation drill. There were no monthly evacuation drills practiced for September or October 2024.”

8VAC20-780-550-C

“SYSTEMIC DEFICIENCY Emergency evacuation and shelter-in-place procedures or maps shall be posted in a location conspicuous to staff and children. There were no emergency evacuation and shelter-in-place procedures or maps posted at the center.”

8VAC20-780-540-E

“The following non-medical emergency supplies shall be required on each floor of the building: one working, battery operated flashlight and one working, battery operated radio. The center did not have a radio or flashlight.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #3, employed for two months, did not have documentation of requesting a central registry check from one state they resided in the past five years and no documentation of requesting a central registry check or criminal history check from a different state.”

22.1-289.035-B-2

“Providers must obtain a completed national criminal background check prior to the employees? first day of employment. Staff #1, who had been employed for two months, did not have a completed national criminal background check.”

8VAC20-780-140-A

“SYSTEMIC DEFICIENCY Each child shall have a physical examination by or under the direction of a physician: before the child’s attendance; or within 30 days after the first day of attendance. Child record #5, did not have a physical examination on file. Child #5 has been in care for two months.”

8VAC20-780-130-A

“SYSTEMIC DEFICIENCY The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Child record #5 did not have an immunization record on file. Child #5 has been in care for two months.”

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, safe and operable condition. Evidence: The exterior wall of the outdoor play area has metal with sharp edges and siding with pinch points. The interior wall of the outdoor play area has sharp edged screws protruding that are accessible to children in care. The pipes in the concrete flooring has insulation coming out that is accessible to children.”

8VAC20-780-540-C

“Based on observation the center failed to ensure all the required items are in the first aid kit. Evidence: The first aid kit did not have triangular bandages.”