Celebree School of Ashburn Farm

8VAC20-780-550-P

“Based on a review of written injury reports for children's serious or minor injuries, all required information was not provided. Evidence: 1. Injury report was written on an Incident (behavior) report form. Missing information included: date/time/method of parent notification.”

8VAC20-780-520-B

“Based on a review of sunscreen products, all requirements for use were not in place. Evidence: 1. 4 containers of sunscreen in room 4 B were not labeled to show ownership. 2. Child #1 had no authorization available for a sunscreen product on site.”

8VAC20-780-560-G

“Based on observation, food brought from home was not labeled and date. Evidence: Lunch boxes in rooms 4 A and 4B were not labeled or date with today's date.”

8VAC20-780-40-M

“Based on a review of the allergy list for the center, the center did not maintain a current list of all children's allergies. Evidence: Child #5 has multiple food allergies and was not included on the allergy list for the facility.”

8VAC20-780-550-P

“Based on a review of written injury reports for children's serious or minor injuries, all required information was not provided. Evidence: 1. Injury report was written on an Incident (behavior) report form. Missing information included: date/time/method of parent notification.”

8VAC20-780-520-B

“Based on a review of sunscreen products, all requirements for use were not in place. Evidence: 1. 4 containers of sunscreen in room 4 B were not labeled to show ownership. 2. Child #1 had no authorization available for a sunscreen product on site.”

8VAC20-780-560-G

“Based on observation, food brought from home was not labeled and date. Evidence: Lunch boxes in rooms 4 A and 4B were not labeled or date with today's date.”

8VAC20-780-40-M

“Based on a review of the allergy list for the center, the center did not maintain a current list of all children's allergies. Evidence: Child #5 has multiple food allergies and was not included on the allergy list for the facility.”

8VAC20-780-500-B

“Based on observation, the diaper disposal container in use was not foot operated. Evidence: The diaper disposal container in the Infant B room had a broken foot pedal. The Staff member was observed using their hand to open the lid, twice, to dispose of a diaper and then a paper towel.”

8VAC20-780-510-I

“Based on a review of medications, one medication was not maintained in the original container with the label attached. Evidence: Child #4's Albuterol Inhaler was not in the original container with the label attached.”

8VAC20-780-210-A

“Based on a review of records, one staff record did not contain documentation of qualifications for a lead teacher. Evidence: Staff C's record did not contain documentation to show the person met lead teacher qualifications.”

8VAC20-780-160-C

“Based on a review of records, one staff record does not contain documentation of a negative result for a follow up tuberculosis screening result within the allowable two year time frame. Evidence: Staff B's record contained a negative screening result dated 1/12/22. (Expired).”

8VAC20-780-40-E

“Repeat Violation Systemic Deficiency Based on a review of medication authorizations, the center failed to follow its policy for medication administration, by not receiving an authorization for a prescription medication on site. Evidence: There is no authorization available for review for an Epi-pen present at the facility. (Child 1)”

8VAC20-780-50-B

“Based on a review of records, one staff record was not made available during the inspection. Evidence: Staff D's record was not available during the inspection. Staff stated the file was locked in the Owner's office.”

8VAC20-780-60-A

“Repeat Violation Systemic Deficiency Based on a review of records, child records did not contain al required information. Evidence: 1. Child #1's record did not contain documentation of parent's work and 2 emergency contacts information. 2. Child #1's record was not updated annually. File was dated 7/8/22.”

8VAC20-780-80-A

“Based on a review of attendance documentation, the center did not maintain a written record of attendance for each group of children. Evidence: 1. The Infant room attendance was not accurate. There were 4 infants present in the Infant B room. One infant had not been entered into the "app" system in use, and was not accounted for in attendance. 2. The 3's/4's rooms were combined for rest time. The "app" system showed 13 children present; however, there were 14 children present.”

8VAC20-780-240-A

“Based on a review of records, one staff record did not contain documentation of completion for the required Department of Education sponsored orientation course, within 90 days of employment. Evidence: Staff C's record had no documentation of completion of the 10 hour orientation course. (Date of Hire: 11/29/23)”

8VAC20-780-440-B

“Based on observation, cribs were not identified for use by a specific child. Evidence: 3 infants in the Infant B room were sleeping in cribs that were not identified for use by a specific child.”

8VAC20-780-550-E

“Based on a review of documentation, the center did not practice shelter-in-place procedures a minimum of twice a year. Evidence: There was only one Shelter-in-place drill conducted for 2023.”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of completion for the required annual update training course. Evidence: Staff B's record had no documentation of completion of the 3 hour annual update course.”

8VAC20-790-600-B

“Based on a review of records, one staff record did not contain documentation of completion for the required preservice training within 90 days of employment. Evidence: Staff B's record did not contain documentation of the required preservice course. (Date of Hire: 10/20/21)”

8VAC20-780-500-B

“Based on observation, the diaper disposal container in use was not foot operated. Evidence: The diaper disposal container in the Infant B room had a broken foot pedal. The Staff member was observed using their hand to open the lid, twice, to dispose of a diaper and then a paper towel.”

8VAC20-780-510-I

“Based on a review of medications, one medication was not maintained in the original container with the label attached. Evidence: Child #4's Albuterol Inhaler was not in the original container with the label attached.”

8VAC20-780-210-A

“Based on a review of records, one staff record did not contain documentation of qualifications for a lead teacher. Evidence: Staff C's record did not contain documentation to show the person met lead teacher qualifications.”

8VAC20-780-160-C

“Based on a review of records, one staff record does not contain documentation of a negative result for a follow up tuberculosis screening result within the allowable two year time frame. Evidence: Staff B's record contained a negative screening result dated 1/12/22. (Expired).”

8VAC20-780-40-E

“Repeat Violation Systemic Deficiency Based on a review of medication authorizations, the center failed to follow its policy for medication administration, by not receiving an authorization for a prescription medication on site. Evidence: There is no authorization available for review for an Epi-pen present at the facility. (Child 1)”

8VAC20-780-50-B

“Based on a review of records, one staff record was not made available during the inspection. Evidence: Staff D's record was not available during the inspection. Staff stated the file was locked in the Owner's office.”

8VAC20-780-60-A

“Repeat Violation Systemic Deficiency Based on a review of records, child records did not contain al required information. Evidence: 1. Child #1's record did not contain documentation of parent's work and 2 emergency contacts information. 2. Child #1's record was not updated annually. File was dated 7/8/22.”

8VAC20-780-80-A

“Based on a review of attendance documentation, the center did not maintain a written record of attendance for each group of children. Evidence: 1. The Infant room attendance was not accurate. There were 4 infants present in the Infant B room. One infant had not been entered into the "app" system in use, and was not accounted for in attendance. 2. The 3's/4's rooms were combined for rest time. The "app" system showed 13 children present; however, there were 14 children present.”

8VAC20-780-240-A

“Based on a review of records, one staff record did not contain documentation of completion for the required Department of Education sponsored orientation course, within 90 days of employment. Evidence: Staff C's record had no documentation of completion of the 10 hour orientation course. (Date of Hire: 11/29/23)”

8VAC20-780-440-B

“Based on observation, cribs were not identified for use by a specific child. Evidence: 3 infants in the Infant B room were sleeping in cribs that were not identified for use by a specific child.”

8VAC20-780-550-E

“Based on a review of documentation, the center did not practice shelter-in-place procedures a minimum of twice a year. Evidence: There was only one Shelter-in-place drill conducted for 2023.”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of completion for the required annual update training course. Evidence: Staff B's record had no documentation of completion of the 3 hour annual update course.”

8VAC20-790-600-B

“Based on a review of records, one staff record did not contain documentation of completion for the required preservice training within 90 days of employment. Evidence: Staff B's record did not contain documentation of the required preservice course. (Date of Hire: 10/20/21)”

8VAC20-790-600-F

“Based on a review of records, one staff record di not contain documentation of required annual training. Evidence: Staff A's record did not contain documentation of the required annual health and safety updated course.”

8VAC20-780-70

“Repeat Violation Based on a review of records, staff records did not contain all required information. Evidence: 3 staff records were reviewed. *Staff A's record included one reference that was provided by a relative (Not acceptable). *Staff C's record did not contain documentation of an emergency contact.”

8VAC20-780-60-A

“Repeat Violation Based on a review of records, child records do not contain all required information. Evidence: 4 child records were reviewed. *1 of 4 records did not contain an allergy action plan for a diagnosed food allergy. (Child 2) *2 of 4 records did not contain updated information in the child's record. Allergy action plans are date 9/29/22. (Children # 3, 4)”

8VAC20-780-40-E

“Repeat Violation Based on a review of medications, the center failed to follow their policy for and procedure required by the standards.. Evidence: The center did not follow the policy for prevention of use of outdated medications. An Avi-Q present at the center was expired. (10/10/23).”

8VAC20-780-510-P

“Based on a review of medications, parents were not notified that medication needed to be picked up after the medication authorization expired. After 14 days the medication was not disposed of. Evidence: Child #3's medication authorization for Motrin expired in January 2023. the medication was present in the center today.”

8VAC20-780-530-A

“Based on a review of records, one staff record did not contain documentation of first aid and cardiopulmonary resuscitation certification. Evidence: Staff B, working alone with children, did not have current first aid/CPR certifications.”

8VAC20-780-550-G

“Based on a review of documentation, documentation of monthly emergency evacuation drills has not been maintained. Evidence: There was no documentation of a monthly emergency evacuation drill having been conducted in September 2023.”

8VAC20-780-560-M

“Based on observation a child was allowed to drink while walking around. Evidence: One infant in the Infant B room was observed walking around while drinking from a bottle.”

8VAC20-780-240-B

“Repeat Violation Based on a review of orientation, one staff record did not contain documentation of orientation prior to working alone with children or within seven days of assuming job responsibilities. Evidence: Staff B's record did not contain documentation of orientation. (Date of Hire (DOH): 1/17/22)”

8VAC20-780-245-J-3

“Based on a review of documentation and staff statement, children with emergency medications were not always in the care of a staff member who meets the requirements for medication administration. Evidence: There is one staff person currently certified in Medication Administration Training (MAT). The staff stated they are present at the center from approximately 10:00 am - 2:25 PM daily. There are multiple emergency medications on site. On 10/11/23 the staff member left the center at approximately 2:25PM. Children with emergency medications were present at the center at that time.”

8VAC20-780-240-C

“Repeat Violation Based on a review of orientation documentation, documentation did not contain all required information. Evidence: 2 of 3 staff records reviewed did not contain documentation of the required Child Abuse and Neglect training. (Staff B.C).”

8VAC20-780-510-L

“Based on observation, one child's medication was not stored locked. Evidence: One medication in the infant room was stored in the medication notebook, not locked in the Infant A room. (Child 1)”

8VAC20-780-340-A

“Based on observation, a staff person did not ensure care, protection and guidance of a child in care. Evidence: A staff member was observed picking up at pacifier off the floor and placing it in the mouth of an infant. The staff member had just completed a diaper change and had not washed their hands before picking up the pacifier.”

8VAC20-780-160-A

“Repeat Violation Based on a review of records, one staff record did not contain documentation of a negative tuberculosis screening submitted at the time of employment and conducted within the previous 30 calendar days. Evidence: Staff A's record contain a TB result dated 11/03/22. (DOH: 11/1/22)”

8VAC20-790-600-F

“Based on a review of records, one staff record di not contain documentation of required annual training. Evidence: Staff A's record did not contain documentation of the required annual health and safety updated course.”

8VAC20-780-70

“Repeat Violation Based on a review of records, staff records did not contain all required information. Evidence: 3 staff records were reviewed. *Staff A's record included one reference that was provided by a relative (Not acceptable). *Staff C's record did not contain documentation of an emergency contact.”

8VAC20-780-60-A

“Repeat Violation Based on a review of records, child records do not contain all required information. Evidence: 4 child records were reviewed. *1 of 4 records did not contain an allergy action plan for a diagnosed food allergy. (Child 2) *2 of 4 records did not contain updated information in the child's record. Allergy action plans are date 9/29/22. (Children # 3, 4)”

8VAC20-780-40-E

“Repeat Violation Based on a review of medications, the center failed to follow their policy for and procedure required by the standards.. Evidence: The center did not follow the policy for prevention of use of outdated medications. An Avi-Q present at the center was expired. (10/10/23).”

8VAC20-780-510-P

“Based on a review of medications, parents were not notified that medication needed to be picked up after the medication authorization expired. After 14 days the medication was not disposed of. Evidence: Child #3's medication authorization for Motrin expired in January 2023. the medication was present in the center today.”

8VAC20-780-530-A

“Based on a review of records, one staff record did not contain documentation of first aid and cardiopulmonary resuscitation certification. Evidence: Staff B, working alone with children, did not have current first aid/CPR certifications.”

8VAC20-780-550-G

“Based on a review of documentation, documentation of monthly emergency evacuation drills has not been maintained. Evidence: There was no documentation of a monthly emergency evacuation drill having been conducted in September 2023.”

8VAC20-780-560-M

“Based on observation a child was allowed to drink while walking around. Evidence: One infant in the Infant B room was observed walking around while drinking from a bottle.”

8VAC20-780-240-B

“Repeat Violation Based on a review of orientation, one staff record did not contain documentation of orientation prior to working alone with children or within seven days of assuming job responsibilities. Evidence: Staff B's record did not contain documentation of orientation. (Date of Hire (DOH): 1/17/22)”

8VAC20-780-245-J-3

“Based on a review of documentation and staff statement, children with emergency medications were not always in the care of a staff member who meets the requirements for medication administration. Evidence: There is one staff person currently certified in Medication Administration Training (MAT). The staff stated they are present at the center from approximately 10:00 am - 2:25 PM daily. There are multiple emergency medications on site. On 10/11/23 the staff member left the center at approximately 2:25PM. Children with emergency medications were present at the center at that time.”

8VAC20-780-240-C

“Repeat Violation Based on a review of orientation documentation, documentation did not contain all required information. Evidence: 2 of 3 staff records reviewed did not contain documentation of the required Child Abuse and Neglect training. (Staff B.C).”

8VAC20-780-510-L

“Based on observation, one child's medication was not stored locked. Evidence: One medication in the infant room was stored in the medication notebook, not locked in the Infant A room. (Child 1)”

8VAC20-780-340-A

“Based on observation, a staff person did not ensure care, protection and guidance of a child in care. Evidence: A staff member was observed picking up at pacifier off the floor and placing it in the mouth of an infant. The staff member had just completed a diaper change and had not washed their hands before picking up the pacifier.”

8VAC20-780-160-A

“Repeat Violation Based on a review of records, one staff record did not contain documentation of a negative tuberculosis screening submitted at the time of employment and conducted within the previous 30 calendar days. Evidence: Staff A's record contain a TB result dated 11/03/22. (DOH: 11/1/22)”

8VAC20-790-600-F

“Based on a review of records, one staff record di not contain documentation of required annual training. Evidence: Staff A's record did not contain documentation of the required annual health and safety updated course.”

8VAC20-780-70

“Repeat Violation Based on a review of records, staff records did not contain all required information. Evidence: 3 staff records were reviewed. *Staff A's record included one reference that was provided by a relative (Not acceptable). *Staff C's record did not contain documentation of an emergency contact.”

8VAC20-780-60-A

“Repeat Violation Based on a review of records, child records do not contain all required information. Evidence: 4 child records were reviewed. *1 of 4 records did not contain an allergy action plan for a diagnosed food allergy. (Child 2) *2 of 4 records did not contain updated information in the child's record. Allergy action plans are date 9/29/22. (Children # 3, 4)”

8VAC20-780-40-E

“Repeat Violation Based on a review of medications, the center failed to follow their policy for and procedure required by the standards.. Evidence: The center did not follow the policy for prevention of use of outdated medications. An Avi-Q present at the center was expired. (10/10/23).”

8VAC20-780-510-P

“Based on a review of medications, parents were not notified that medication needed to be picked up after the medication authorization expired. After 14 days the medication was not disposed of. Evidence: Child #3's medication authorization for Motrin expired in January 2023. the medication was present in the center today.”

8VAC20-780-530-A

“Based on a review of records, one staff record did not contain documentation of first aid and cardiopulmonary resuscitation certification. Evidence: Staff B, working alone with children, did not have current first aid/CPR certifications.”

8VAC20-780-550-G

“Based on a review of documentation, documentation of monthly emergency evacuation drills has not been maintained. Evidence: There was no documentation of a monthly emergency evacuation drill having been conducted in September 2023.”

8VAC20-780-560-M

“Based on observation a child was allowed to drink while walking around. Evidence: One infant in the Infant B room was observed walking around while drinking from a bottle.”

8VAC20-780-240-B

“Repeat Violation Based on a review of orientation, one staff record did not contain documentation of orientation prior to working alone with children or within seven days of assuming job responsibilities. Evidence: Staff B's record did not contain documentation of orientation. (Date of Hire (DOH): 1/17/22)”

8VAC20-780-245-J-3

“Based on a review of documentation and staff statement, children with emergency medications were not always in the care of a staff member who meets the requirements for medication administration. Evidence: There is one staff person currently certified in Medication Administration Training (MAT). The staff stated they are present at the center from approximately 10:00 am - 2:25 PM daily. There are multiple emergency medications on site. On 10/11/23 the staff member left the center at approximately 2:25PM. Children with emergency medications were present at the center at that time.”

8VAC20-780-240-C

“Repeat Violation Based on a review of orientation documentation, documentation did not contain all required information. Evidence: 2 of 3 staff records reviewed did not contain documentation of the required Child Abuse and Neglect training. (Staff B.C).”

8VAC20-780-510-L

“Based on observation, one child's medication was not stored locked. Evidence: One medication in the infant room was stored in the medication notebook, not locked in the Infant A room. (Child 1)”

8VAC20-780-340-A

“Based on observation, a staff person did not ensure care, protection and guidance of a child in care. Evidence: A staff member was observed picking up at pacifier off the floor and placing it in the mouth of an infant. The staff member had just completed a diaper change and had not washed their hands before picking up the pacifier.”

8VAC20-780-160-A

“Repeat Violation Based on a review of records, one staff record did not contain documentation of a negative tuberculosis screening submitted at the time of employment and conducted within the previous 30 calendar days. Evidence: Staff A's record contain a TB result dated 11/03/22. (DOH: 11/1/22)”

8VAC20-780-420-E-1

“Based on a review of infant daily records, documentation did not contain all required information. Evidence: 1 of 1 infants that required 30 minutes of time spent on their stomach daily, there was no record of "tummy time" documented time for 3/28/2023.”

8VAC20-780-40-E

“Based on a review of policies and procedures regarding medication, the facility failed to follow its own medication policy regarding authorization form completion. Evidence: The facility policy for medication states: "A medication authorization form may be obtained from the School Director. This form must be completed for each medication the child will need." There are 2 medications present at the center with no authorization available for review. (Child 1)”

8VAC20-780-70

“Based on a review of records, staff records do not contain all required information. Evidence: 1 of 1 record reviewed did not contain documentation of 2 references prior to employment. (Staff A: date of Hire (DOH): 3/8/23).”

8VAC20-770-60-B

“Based on a review of records, one staff record does not contain documentation of a completed Sworn Disclosure Statement (SDS), prior to employment. Evidence: 1 of 1 records reviewed did not contain documentation of a complete SDS. (Staff A: Date of Hire: 3/8/23).”

8VAC20-780-160-A

“Based on a review of records, one staff record does not contain documentation of a negative tuberculosis screening, submitted at the time of employment and completed within the last 30 calendar days. Evidence: 1 of 1 records reviewed did not contain documentation of a negative screening result. (Staff A - DOH: 3/8/23)”

8VAC20-780-240-B

“Based on a review of records, one staff record does not contain documentation of orientation prior to working alone with children or within 7 days of assuming job responsibilities. Evidence: 1 of 1 records reviewed had no orientation documentation available for review. (Staff A- DOH: 3/8/23).”

8VAC20-780-420-E-1

“Based on a review of infant daily records, documentation did not contain all required information. Evidence: 1 of 1 infants that required 30 minutes of time spent on their stomach daily, there was no record of "tummy time" documented time for 3/28/2023.”

8VAC20-780-40-E

“Based on a review of policies and procedures regarding medication, the facility failed to follow its own medication policy regarding authorization form completion. Evidence: The facility policy for medication states: "A medication authorization form may be obtained from the School Director. This form must be completed for each medication the child will need." There are 2 medications present at the center with no authorization available for review. (Child 1)”

8VAC20-780-70

“Based on a review of records, staff records do not contain all required information. Evidence: 1 of 1 record reviewed did not contain documentation of 2 references prior to employment. (Staff A: date of Hire (DOH): 3/8/23).”

8VAC20-770-60-B

“Based on a review of records, one staff record does not contain documentation of a completed Sworn Disclosure Statement (SDS), prior to employment. Evidence: 1 of 1 records reviewed did not contain documentation of a complete SDS. (Staff A: Date of Hire: 3/8/23).”

8VAC20-780-160-A

“Based on a review of records, one staff record does not contain documentation of a negative tuberculosis screening, submitted at the time of employment and completed within the last 30 calendar days. Evidence: 1 of 1 records reviewed did not contain documentation of a negative screening result. (Staff A - DOH: 3/8/23)”

8VAC20-780-240-B

“Based on a review of records, one staff record does not contain documentation of orientation prior to working alone with children or within 7 days of assuming job responsibilities. Evidence: 1 of 1 records reviewed had no orientation documentation available for review. (Staff A- DOH: 3/8/23).”

8VAC20-780-160-A

“Based on a review of records, one staff record does not contain documentation of an acceptable Tuberculosis screening. Evidence: 1 of 3 staff records reviewed did not contain documentation of a TB screening result within 30 days of employment. The screening is dated 3/14/22. Date of employment is documented as 06/20/22. (Staff A)”

8VAC20-780-70

“Based on a review of records, one staff record does not contain documentation of 2 references. Evidence: 1 of 3 staff records reviewed did not contain documentation of a second reference. (Staff A)”

8VAC20-780-240-C

“Based on a review of records, staff records do not include documentation of all required orientation documentation prior to working alone with children. Evidence: 1 of 3 records reviewed did not contain documentation of all required policies and procedures prior to working alone with children. Staff was observed alone with children during the renewal inspection. Orientation documentation does not include training on: Playground safety, Shaken Baby Syndrome and Abusive Head Trauma prevention, Policies for medication administration, Emergency preparedness plan, Confidential treatment of personal information about children in care. (Staff A)”

8VAC20-780-510-I

“Based on a review of medications, one medication is not in the original box with a prescription label attached. Evidence: One medication is not in the original box, with a prescription label attached. (Child #1)”

8VAC20-780-580-B

“Based on observation there is no documentation available to ensure that the vehicle used to transport children meets the safety standards set by Department of Motor Vehicles. Evidence: The vehicle is registered in Virginia with Virginia license plates; however, no annual safety inspection has been conducted.”

8VAC20-780-580-C

“Based on a review of the information kept in the transportation vehicle, all required information is not available. Evidence: The notebook used for the vehicle transporting children does not include documentation of emergency numbers, regional poison control .”

8VAC20-780-60-A

“Based on a review of records, child records do not include all required information. Evidence: 3 child records were reviewed. Missing information includes: *Emergency contact address (Child 2) *Documented viewing a Proof of Birth document (Child 2) *No allergy action plan for documented food allergies. (Child 3)”

8VAC20-780-160-A

“Based on a review of records, one staff record does not contain documentation of an acceptable Tuberculosis screening. Evidence: 1 of 3 staff records reviewed did not contain documentation of a TB screening result within 30 days of employment. The screening is dated 3/14/22. Date of employment is documented as 06/20/22. (Staff A)”

8VAC20-780-70

“Based on a review of records, one staff record does not contain documentation of 2 references. Evidence: 1 of 3 staff records reviewed did not contain documentation of a second reference. (Staff A)”

8VAC20-780-240-C

“Based on a review of records, staff records do not include documentation of all required orientation documentation prior to working alone with children. Evidence: 1 of 3 records reviewed did not contain documentation of all required policies and procedures prior to working alone with children. Staff was observed alone with children during the renewal inspection. Orientation documentation does not include training on: Playground safety, Shaken Baby Syndrome and Abusive Head Trauma prevention, Policies for medication administration, Emergency preparedness plan, Confidential treatment of personal information about children in care. (Staff A)”

8VAC20-780-510-I

“Based on a review of medications, one medication is not in the original box with a prescription label attached. Evidence: One medication is not in the original box, with a prescription label attached. (Child #1)”

8VAC20-780-580-B

“Based on observation there is no documentation available to ensure that the vehicle used to transport children meets the safety standards set by Department of Motor Vehicles. Evidence: The vehicle is registered in Virginia with Virginia license plates; however, no annual safety inspection has been conducted.”

8VAC20-780-580-C

“Based on a review of the information kept in the transportation vehicle, all required information is not available. Evidence: The notebook used for the vehicle transporting children does not include documentation of emergency numbers, regional poison control .”

8VAC20-780-60-A

“Based on a review of records, child records do not include all required information. Evidence: 3 child records were reviewed. Missing information includes: *Emergency contact address (Child 2) *Documented viewing a Proof of Birth document (Child 2) *No allergy action plan for documented food allergies. (Child 3)”

8VAC20-780-550-P

“Based on a review of injury reports, the injury report form does not contain all required components. Evidence: 1 of 1 report reviewed did not contain documentation of the "future action to prevent recurrence"”

8VAC20-780-60-A

“Based on a review of records, one child record does not contain documentation of all required components. Evidence: 1 of 3 records reviewed did not contain documentation of the first date of attendance. (Child 1)”

8VAC20-780-70

“Based on a review of records, one staff record does not contain documentation of all required components. Evidence: 1 of 1 records reviewed did not contain documentation of 2 references. 1 reference was provided by a relative which is not acceptable. (Staff A)”

22.1-289.035-B-4

“Based on a review of records, one staff record does not contain documentation of a completed Sex Offender search, or Child Abuse and Neglect search for a residence outside of the state of Virginia in the past 5 years. Evidence: *1 of 1 staff records reviewed did not contain documentation of the results of a Sex Offender search for an out of state residence, prior to employment. The result is dated 1/11/22. * 1 of 1 staff records reviewed did not contain documentation of an out of state Child Abuse and Neglect Search within 45 day of employment. (Staff A - Date of Hire:1/3/22). There is no documentation to show a search was submitted.”

22.1-289.035-B-4

“Based on a review of records, staff records do not contain documentation, prior to employment, of a completed Criminal History Check and a completed Sex Offender Search for staff who have resided outside of the state of Virginia within the past 5 years. Evidence: *2 of 2 records requiring a completed Sex Offender search result, do not have the results on file. (Staff A, B) *1 of 2 records requiring a completed Criminal History Search, does not have documentation on file. (Staff B)”

8VAC20-770-60-B

“Based on a review of records, staff records do not contain documentation of a completed Sworn Disclosure Statement (SDS) prior to employment. Evidence: *SDS for Staff A is dated 9/30/21. (DOH: 9/27/21). *SDS for Staff D is dated 12/3/21. (DOH:12/1/21).”

8VAC20-780-160-A

“Based on a review of records, one staff record did not contain documentation of an acceptable TB screening result. At the time of employment the screening could not have been completed more than 12 months prior. Evidence: Staff E's TB screening result is dated 2/08/20. (DOH: 12/3/21)”

8VAC20-780-70

“Based on a review of records, there is no appropriate documentation for references taken over the phone. Evidence: 2 of 5 records reviewed did not contain documentation of the signature of the person completing the phone reference. (Staff C,D)”

8VAC20-780-240-B

“Based on a review of records, documentation of orientation is not complete. Evidence: 5 of 5 records reviewed did not contain documentation of all required, policies and procedures at the time of employment for staff. A certificate stating "Orientation completed" is all that is on file.”

22.1-289.035-B-2

“Based on a review of records, one staff record does not contain documentation of nationwide fingerprint search having been completed prior to employment. Evidence: *Staff A's Fingerprint results are dated 10/19/2021. (Date of Hire (DOH) 9/27/21)”