Children of America- Manassas Bull Run

8VAC20-790-600-D-1

“Based on review of 5 staff records, the center did not ensure that all staff who work directly with children shall have CPR training within 90 days of the date of employment or 90 days from subsidy vendor approval. Evidence: Staff #2 (start date 5/28/24) did not have documentation of CPR certification.”

8VAC20-790-600-D-2

“Based on review of 5 staff records, the center did not ensure that all staff who work directly with children shall have 1st aid training within 90 days of the date of employment or 90 days from subsidy vendor approval. Evidence: Staff #2 did not have documentation of 1st Aid certification.”

22.1-289.035-B-2

“Based on review of 5 staff records, the provider did not obtain documentation of the results of a national fingerprint background check prior to date of hire. Evidence: The record for Staff #1 did not contain documentation of a fingerprint background check completed prior to their date of hire.”

8VAC20-780-550-F

“Based on review of documentation, the center did not ensure they implement an annual practice lockdown drill. Evidence: There was no documentation for a lockdown drill since 7/12/23.”

8VAC20-780-510-E

“Based on review of 2 medications and medication authorizations, the center did not ensure they follow the policy for administration of medication that requires the duration of the parent authorization be renewed after 10 workdays and written medication authorization should be given from the child’s physician and parent for a long term medication. Evidence: For a medication for Child #1, there was no parent authorization and no authorization was given from the physician.”

8VAC20-780-340-D

“Based on interviews, the center did not ensure that each grouping of children had at least one staff member that met the qualifications of program leader or program director regularly present. Evidence: Staff stated that Staff #2 is the designated lead teacher and does not meet program lead qualifications.”

8VAC20-780-280-B

“(Repeat Violation) Based on observation, the center did not ensure that hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1)During inspection in the unlocked laundry room directly off the front hallway and where children have access, 1 container of detergent containing a label that stated ?Keep out of Reach of Children? and the word ?Caution? was stored on the floor. 2) During inspection in the unlocked laundry room directly off the front hallway and where children have access, 1 container of stainless steel cleaner containing a label that stated ?Keep out of Reach of Children? and the words ?Danger? and ?Caution? was stored on top of a trash can.”

8VAC20-780-160-A

“Based on review of 5 staff records, the center did not obtain documentation of a negative tuberculosis (TB) test or screening for staff at the time of employment and prior to contact with children and within 30 days prior to employment. Evidence: The file for Staff #1 (date of hire 4/28/23) did not contain documentation of a negative tuberculosis (TB) test or screening dated prior to hire.”

8VAC20-770-60-B

“Based on review of 5 staff records, the center did not obtain documentation of a completed sworn disclosure statement for each staff prior to date of hire. Evidence: The record for Staff #1 did not contain documentation of a completed sworn disclosure statement prior to the date of hire.”

8VAC20-780-550-E

“Based on review of documentation, the center did not ensure they implement a practice shelter in place drill twice per year. Evidence: There was no documentation for Shelter in place drills since 8/23/23.”

8VAC20-780-550-D

“(Repeat Violation) Based on review of documentation, the center did not ensure they implement a monthly practice evacuation drill. Evidence: There was no documentation for evacuation drills for March 2024 and April 2024.”

8VAC20-790-600-D-1

“Based on review of 5 staff records, the center did not ensure that all staff who work directly with children shall have CPR training within 90 days of the date of employment or 90 days from subsidy vendor approval. Evidence: Staff #2 (start date 5/28/24) did not have documentation of CPR certification.”

8VAC20-790-600-D-2

“Based on review of 5 staff records, the center did not ensure that all staff who work directly with children shall have 1st aid training within 90 days of the date of employment or 90 days from subsidy vendor approval. Evidence: Staff #2 did not have documentation of 1st Aid certification.”

22.1-289.035-B-2

“Based on review of 5 staff records, the provider did not obtain documentation of the results of a national fingerprint background check prior to date of hire. Evidence: The record for Staff #1 did not contain documentation of a fingerprint background check completed prior to their date of hire.”

8VAC20-780-550-F

“Based on review of documentation, the center did not ensure they implement an annual practice lockdown drill. Evidence: There was no documentation for a lockdown drill since 7/12/23.”

8VAC20-780-510-E

“Based on review of 2 medications and medication authorizations, the center did not ensure they follow the policy for administration of medication that requires the duration of the parent authorization be renewed after 10 workdays and written medication authorization should be given from the child’s physician and parent for a long term medication. Evidence: For a medication for Child #1, there was no parent authorization and no authorization was given from the physician.”

8VAC20-780-340-D

“Based on interviews, the center did not ensure that each grouping of children had at least one staff member that met the qualifications of program leader or program director regularly present. Evidence: Staff stated that Staff #2 is the designated lead teacher and does not meet program lead qualifications.”

8VAC20-780-280-B

“(Repeat Violation) Based on observation, the center did not ensure that hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1)During inspection in the unlocked laundry room directly off the front hallway and where children have access, 1 container of detergent containing a label that stated ?Keep out of Reach of Children? and the word ?Caution? was stored on the floor. 2) During inspection in the unlocked laundry room directly off the front hallway and where children have access, 1 container of stainless steel cleaner containing a label that stated ?Keep out of Reach of Children? and the words ?Danger? and ?Caution? was stored on top of a trash can.”

8VAC20-780-160-A

“Based on review of 5 staff records, the center did not obtain documentation of a negative tuberculosis (TB) test or screening for staff at the time of employment and prior to contact with children and within 30 days prior to employment. Evidence: The file for Staff #1 (date of hire 4/28/23) did not contain documentation of a negative tuberculosis (TB) test or screening dated prior to hire.”

8VAC20-770-60-B

“Based on review of 5 staff records, the center did not obtain documentation of a completed sworn disclosure statement for each staff prior to date of hire. Evidence: The record for Staff #1 did not contain documentation of a completed sworn disclosure statement prior to the date of hire.”

8VAC20-780-550-E

“Based on review of documentation, the center did not ensure they implement a practice shelter in place drill twice per year. Evidence: There was no documentation for Shelter in place drills since 8/23/23.”

8VAC20-780-550-D

“(Repeat Violation) Based on review of documentation, the center did not ensure they implement a monthly practice evacuation drill. Evidence: There was no documentation for evacuation drills for March 2024 and April 2024.”

8VAC20-780-550-D

“Based on review, the facility did not ensure that evacuation drills were practiced monthly. Evidence: reviewed the facility's emergency evacuation drill log and found that they did not conduct an emergency evacuation drill in October 2023.”

8VAC20-780-540-B

“Based on observation, the facility did not ensure that the first aid kit is easily accessible to staff and not to children. Evidence: observed that the first aid kit was in the bathroom, accessible to preschoolers to school-agers during the morning session.”

8VAC20-780-270-A

“Based on observation, the facility did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: observed in the Pre-K classroom, peeling paint on the wall and accessible to children.”

8VAC20-780-280-D

“Based on observation, the facility did not ensure that cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single service articles and shall be stored in areas physically separate from food. Evidence: observed in the Pre-K classroom, an unlocked cabinet with a cleaning spray and a disinfectant spray next to a bag of snacks for children.”

8VAC20-780-450-A

“Based on observation, the facility did not ensure that cribs, cots, mats and beds shall have linens consisting of a top cover and a bottom cover and a one-piece covering which is open on three edges. Evidence: observed in the Pre-K room, a child sleeping on a cot without a bottom cover.”

8VAC20-780-280-B

“Based on observation, the facility did not ensure that hazardous substances such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: observed cabinet with a safety lock that was not properly engaged in preschool 2a which had 1 cleaning agent and 1 disinfectant.”

8VAC20-780-550-D

“Based on review, the facility did not ensure that evacuation drills were practiced monthly. Evidence: reviewed the facility's emergency evacuation drill log and found that they did not conduct an emergency evacuation drill in October 2023.”

8VAC20-780-540-B

“Based on observation, the facility did not ensure that the first aid kit is easily accessible to staff and not to children. Evidence: observed that the first aid kit was in the bathroom, accessible to preschoolers to school-agers during the morning session.”

8VAC20-780-270-A

“Based on observation, the facility did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: observed in the Pre-K classroom, peeling paint on the wall and accessible to children.”

8VAC20-780-280-D

“Based on observation, the facility did not ensure that cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single service articles and shall be stored in areas physically separate from food. Evidence: observed in the Pre-K classroom, an unlocked cabinet with a cleaning spray and a disinfectant spray next to a bag of snacks for children.”

8VAC20-780-450-A

“Based on observation, the facility did not ensure that cribs, cots, mats and beds shall have linens consisting of a top cover and a bottom cover and a one-piece covering which is open on three edges. Evidence: observed in the Pre-K room, a child sleeping on a cot without a bottom cover.”

8VAC20-780-280-B

“Based on observation, the facility did not ensure that hazardous substances such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: observed cabinet with a safety lock that was not properly engaged in preschool 2a which had 1 cleaning agent and 1 disinfectant.”

8VAC20-780-500-B

“REPEAT VIOLATION Based on observation, the facility did not ensure that disposable diapers shall be disposed of in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: observed that the foot operated diaper pail in the Twos B classroom was not operating appropriately and and needed to be opened by hand. Observed in the Infant C classroom, the foot operated diaper pain had a lock on it, that was removed by hand during the diaper disposal process. Previously cited on 6/28/2023”

8VAC20-780-440-E

“Based on observation, the facility did not ensure that there shall be at least 12 inches of space between occupied cots, beds, and rest mats. Evidence: observed that 4 of the cots were within 12 inches of each other.”

8VAC20-780-240-C

“Based on review, the facility did not ensure that orientation training was complete. Evidence: reviewed the orientation forms of 9 staff members and found that 6 staff members (1, 2, 3, 6, 8 and 9) did not have documentation of updated orientation training, and 2 staff members (4 and 5) did not have documentation of orientation training.”

8VAC20-780-60-A

“REPEAT VIOLATION Based on review, the facility did not ensure that children's records were maintained with the required documentation. Evidence: Reviewed 5 children's records and found: 1) Child 5 did not have documentation of a second emergency contact and the first emergency contact did not have an address. 2) Child 3 did not have documentation of viewing the original proof of identity Previously cited on 6/28/2023”

8VAC20-780-40-J

“Based on documentation, the facility did not ensure that they had documentation of an injury prevention procedures that were updated annually based on documentation of injuries and a review of the activities and services. Evidence: reviewed the facility's records and found that they did not have documentation of an annually reviewed injury prevention plan.”

8VAC20-780-150-B

“Based on review, the facility did not ensure that children's immunizations records were signed by a physician or their designee. Evidence: reviewed 5 children's records and found that Child 5's immunization record was not signed.”

8VAC20-780-210-A

“Based on review, the facility did not ensure that program leaders had documentation of meeting one of the required qualifications. Evidence: Reviewed 9 program leader staff files and found that 8 Staff members (1, 2, 3, 4, 6, 7, 8, and 9) did not have documentation of having program leader qualifications.”

8VAC20-780-410-1

“Based on review of documentation and interviews, it was determined that a staff engaged in a forbidden action of rough handling when caring for children. Evidence: Staff #1 was observed by Staff #2 roughly handing Child #1, 4 years old. Staff #1 grabbed Child #1 by the right arm and sat Child #1 in their seat. Child #1 said ?ouch? and grabbed their arm. Staff #2 observed red marks on Child #1?s arm. Child #1 reported that Staff #1 ?had a grumpy face? when Staff #1 grabbed their arm.”

63.2-1509-A

“Based on interview and observation, the center failed to report any suspected incident of child abuse as required. Evidence: The center self-reported a rough handling incident to the licensing office but failed to notify the local department of social services as required. Documentation reviewed revealed the center labeled the incident as alleged child abuse.”

8VAC20-780-60-A-8

“Based on review of documentation and medication authorizations, the center failed to obtain a written care plan for each child with a diagnosed food allergy that includes the instructions from the physician regarding which the child is allergic and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: Child #8 had an epi pen on site with an authorization that indicated a "Severe Food Allergy Reaction" and there was not documentation of a written care plan for the diagnosed food allergy nor the food to which the child was allergic to. Child #9 had an Auvi Q on site and authorization indicated a Food Allergy and there was no documentation of an allergy care plan nor the food to which the child was allergic. Child #10 had an epi pen and authorization indicated egg and peanut allergy and there was no written care plan. Child #11 has diagnosed food allergies to walnut, egg and peanut and there was no written care plan.”

8VAC20-780-40-M

“Based on review of documentation, the center failed to maintain a current written list of children's allergies, sensitivities and dietary restrictions. Evidence: On June 28, 2023, the center's allergy list was not current and did not include the allergies of Child #8, the allergy of Child #9, Child #10's egg allergy or Child #11's walnut allergy”

8VAC20-780-40-L

“Based on review of documentation, medications and interview with staff, the center failed to ensure that all staff who work with children were informed of children’s allergies. Evidence: Child #8, has an epi pen on site with an authorization that indicates ?give for a food allergy? signed off by the physician and parent in March 27, 2023. Staff were unable to inform the licensing inspector of the food the child was allergic to and the parent was called during the inspection. During the call with the parent, the parent reminded staff that the documents in question were emailed in March 2023.”

8VAC20-780-130-E

“Based on review of documentation, the center did not obtain documentation of additional immunizations every six months for children under the age for two years old. Evidence: Child #5, age 10 months, most recent immunizations were dated 8/2/2022. Child #7, age 10 months, most recent immunizations were dated 10/12/2022.”

8VAC20-780-130-A

“Based on review of documentation, the center failed to obtain immunizations for each child enrolled by the first day of attendance. Evidence: Child #1, enrolled 6/12/2023, Child #2, enrolled 6/12/2023, Child #4, enrolled 1/5/2023 did not have documentation of immunizations on file.”

8VAC20-780-280-B

“Based on observation, not all potentially hazardous substances such as cleaning materials were kept in a locked place. Evidence: In the preschool 2 b classroom, there was a container of disinfectant spray on the counter behind the sink faucet and in the under the sink cabinet, the sanitizer was unlocked. In the toddler classroom, there were sanitizing tablets that were labeled keep out of reach of children/irritant in a high unlocked cabinet.”

8VAC20-780-340-A

“Based on observation, review of documentation and staff interview, staff of the center did not always ensure the care, protection and guidance of children in care. Evidence: 1. On the two’s playground, preschool 2a was on the playground and the attendance and movement sheet documented 7 children and the staff assigned reported having 7 children in care. There were physically 8 children present. 2. During transition time after water play, children were observed playing with the hose that was turned off, stretching it across the playground area, creating a tripping hazard and `whipping it? around. This continued for several minutes before staff intervened to redirect children.”

8VAC20-780-500-B

“Based on observation, not all diapering requirements were met including a disposal system that has a foot operated and the diapering surface only being used for diapering. Evidence: In the Preschool 2B classroom, disposable diapers were observed in an open trash can in the bathroom. In the toddler room, there were two boxes of gloves, a box of plastic bags, a container of blocks and clothing stored on the diapering pad.”

8VAC20-780-520-C

“Based on observation, the center did not follow requirements for diaper ointments. Evidence: In the two’s classroom, in the diaper changing table, the doors are removed and there are eight diaper ointments accessible to children in care. There were two diaper ointments that were not labeled with the child's name.”

8VAC20-780-550-F

“Based on review of documentation, the center did not ensure lockdown procedures were practiced at least annually. Evidence: There was no documentation of a lockdown drill for 2022.”

8VAC20-780-270-A

“Based on observation, not all areas and equipment were maintained in clean, safe and operable condition. Evidence: 1.On the two’s playground, there is a plastic, composite storage shed that is open and filled with supplies, cobwebs and has a broken door that is jagged and rough on the top that creates a scratching hazard. After waterplay on the two’s playground, the hose was left stretched out on the concrete walkway and it created a tripping hazard. 2.In the two’s classroom, there are two small holes in the carpeted wall and the drywall is exposed/accessible and flakes off. 3.In the two’s room and preschool 2a classroom, the majority of the books in the bookcases are ripped, missing covers and pages and in poor condition”

8VAC20-780-245-J-3

“Based on review of medication, review of documentation and interview with staff, the center did not ensure there was a staff current in required Medication Administration Training (MAT) for AuviQ injector. Evidence: Child #9 has an AuviQ medication on site as of 6/6/2023 and no staff were currently trained in AuviQ MAT.”

8VAC20-780-80-A

“Based on observation, not all children were recorded on the attendance record. Evidence: In the infant room, there were three infants but only two were on the attendance sheet. In the two's room during outdoor play, there were seven children on the attendance sheet and eight children present.”

8VAC20-780-60-A

“Based on review of documentation, the center failed to maintain a complete record with all required information. Evidence: Child #1, enrolled 6/12/2023, did not have full addresses for two emergency contacts. Child #3, no start date recorded, did not have a second emergency contact, phone number and full address. Child #4, enrolled 1/5/2023, did not have a full address for a second emergency contact. Child #6, enrolled 1/23/2023, did not have two emergency contacts, telephone numbers and addresses.”

8VAC20-780-60-A-8

“Based on review of documentation and medication authorizations, the center failed to obtain a written care plan for each child with a diagnosed food allergy that includes the instructions from the physician regarding which the child is allergic and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: Child #8 had an epi pen on site with an authorization that indicated a "Severe Food Allergy Reaction" and there was not documentation of a written care plan for the diagnosed food allergy nor the food to which the child was allergic to. Child #9 had an Auvi Q on site and authorization indicated a Food Allergy and there was no documentation of an allergy care plan nor the food to which the child was allergic. Child #10 had an epi pen and authorization indicated egg and peanut allergy and there was no written care plan. Child #11 has diagnosed food allergies to walnut, egg and peanut and there was no written care plan.”

8VAC20-780-40-M

“Based on review of documentation, the center failed to maintain a current written list of children's allergies, sensitivities and dietary restrictions. Evidence: On June 28, 2023, the center's allergy list was not current and did not include the allergies of Child #8, the allergy of Child #9, Child #10's egg allergy or Child #11's walnut allergy”

8VAC20-780-40-L

“Based on review of documentation, medications and interview with staff, the center failed to ensure that all staff who work with children were informed of children’s allergies. Evidence: Child #8, has an epi pen on site with an authorization that indicates ?give for a food allergy? signed off by the physician and parent in March 27, 2023. Staff were unable to inform the licensing inspector of the food the child was allergic to and the parent was called during the inspection. During the call with the parent, the parent reminded staff that the documents in question were emailed in March 2023.”

8VAC20-780-130-E

“Based on review of documentation, the center did not obtain documentation of additional immunizations every six months for children under the age for two years old. Evidence: Child #5, age 10 months, most recent immunizations were dated 8/2/2022. Child #7, age 10 months, most recent immunizations were dated 10/12/2022.”

8VAC20-780-130-A

“Based on review of documentation, the center failed to obtain immunizations for each child enrolled by the first day of attendance. Evidence: Child #1, enrolled 6/12/2023, Child #2, enrolled 6/12/2023, Child #4, enrolled 1/5/2023 did not have documentation of immunizations on file.”

8VAC20-780-280-B

“Based on observation, not all potentially hazardous substances such as cleaning materials were kept in a locked place. Evidence: In the preschool 2 b classroom, there was a container of disinfectant spray on the counter behind the sink faucet and in the under the sink cabinet, the sanitizer was unlocked. In the toddler classroom, there were sanitizing tablets that were labeled keep out of reach of children/irritant in a high unlocked cabinet.”

8VAC20-780-340-A

“Based on observation, review of documentation and staff interview, staff of the center did not always ensure the care, protection and guidance of children in care. Evidence: 1. On the two’s playground, preschool 2a was on the playground and the attendance and movement sheet documented 7 children and the staff assigned reported having 7 children in care. There were physically 8 children present. 2. During transition time after water play, children were observed playing with the hose that was turned off, stretching it across the playground area, creating a tripping hazard and `whipping it? around. This continued for several minutes before staff intervened to redirect children.”

8VAC20-780-500-B

“Based on observation, not all diapering requirements were met including a disposal system that has a foot operated and the diapering surface only being used for diapering. Evidence: In the Preschool 2B classroom, disposable diapers were observed in an open trash can in the bathroom. In the toddler room, there were two boxes of gloves, a box of plastic bags, a container of blocks and clothing stored on the diapering pad.”

8VAC20-780-520-C

“Based on observation, the center did not follow requirements for diaper ointments. Evidence: In the two’s classroom, in the diaper changing table, the doors are removed and there are eight diaper ointments accessible to children in care. There were two diaper ointments that were not labeled with the child's name.”

8VAC20-780-550-F

“Based on review of documentation, the center did not ensure lockdown procedures were practiced at least annually. Evidence: There was no documentation of a lockdown drill for 2022.”

8VAC20-780-270-A

“Based on observation, not all areas and equipment were maintained in clean, safe and operable condition. Evidence: 1.On the two’s playground, there is a plastic, composite storage shed that is open and filled with supplies, cobwebs and has a broken door that is jagged and rough on the top that creates a scratching hazard. After waterplay on the two’s playground, the hose was left stretched out on the concrete walkway and it created a tripping hazard. 2.In the two’s classroom, there are two small holes in the carpeted wall and the drywall is exposed/accessible and flakes off. 3.In the two’s room and preschool 2a classroom, the majority of the books in the bookcases are ripped, missing covers and pages and in poor condition”

8VAC20-780-245-J-3

“Based on review of medication, review of documentation and interview with staff, the center did not ensure there was a staff current in required Medication Administration Training (MAT) for AuviQ injector. Evidence: Child #9 has an AuviQ medication on site as of 6/6/2023 and no staff were currently trained in AuviQ MAT.”

8VAC20-780-80-A

“Based on observation, not all children were recorded on the attendance record. Evidence: In the infant room, there were three infants but only two were on the attendance sheet. In the two's room during outdoor play, there were seven children on the attendance sheet and eight children present.”

8VAC20-780-60-A

“Based on review of documentation, the center failed to maintain a complete record with all required information. Evidence: Child #1, enrolled 6/12/2023, did not have full addresses for two emergency contacts. Child #3, no start date recorded, did not have a second emergency contact, phone number and full address. Child #4, enrolled 1/5/2023, did not have a full address for a second emergency contact. Child #6, enrolled 1/23/2023, did not have two emergency contacts, telephone numbers and addresses.”

8VAC20-790-570-2

“Based on interviews with staff, it was determined that the vendor failed to inform the department's representative no more than two business days of any injury to a child while under the vendor's supervision when a referral is made for outside medical treatment from a medical professional. Evidence: On 2/10/2023, Child A sustained an injury to their nose that caused bleeding and swelling. Child A's parent took the child to the pediatrician for follow up and reported this to at least two staff of the center the day of the injury.”

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

“Based on interviews it was determined that staff did not always ensure the care, protection, and guidance of children under their supervision. Evidence: On 2/10/2023, there were approximately 17 children on the playground ages three and four years old with two staff supervising, who were reportedly grouped together in conversation. Interviews revealed that Child A sustained an injury to their nose which caused swelling and bleeding but staff could not determine the exact cause of the injury.”

8VAC20-780-40-N Complaint related: No

“Based on interviews with staff and review of documentation, it was determined that staff did not follow the center’s written playground safety procedures regarding active supervision on the playground. Evidence: On 2/10/2023, the three year old and four year old classrooms were combined and on the playground. Interviews revealed that staff on the playground were grouped together, talking and did not position themselves in strategic locations to ensure active supervision. Child A sustained an injury to their nose which resulted in swelling and a bloody nose. Staff interviews speculated that Child A could have fallen down or they could have been hit by running into another child, but could not definitively determine how Child A sustained the injury.”

8VAC20-790-570-2

“Based on interviews with staff, it was determined that the vendor failed to inform the department's representative no more than two business days of any injury to a child while under the vendor's supervision when a referral is made for outside medical treatment from a medical professional. Evidence: On 2/10/2023, Child A sustained an injury to their nose that caused bleeding and swelling. Child A's parent took the child to the pediatrician for follow up and reported this to at least two staff of the center the day of the injury.”

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

“Based on interviews it was determined that staff did not always ensure the care, protection, and guidance of children under their supervision. Evidence: On 2/10/2023, there were approximately 17 children on the playground ages three and four years old with two staff supervising, who were reportedly grouped together in conversation. Interviews revealed that Child A sustained an injury to their nose which caused swelling and bleeding but staff could not determine the exact cause of the injury.”

8VAC20-780-40-N Complaint related: No

“Based on interviews with staff and review of documentation, it was determined that staff did not follow the center’s written playground safety procedures regarding active supervision on the playground. Evidence: On 2/10/2023, the three year old and four year old classrooms were combined and on the playground. Interviews revealed that staff on the playground were grouped together, talking and did not position themselves in strategic locations to ensure active supervision. Child A sustained an injury to their nose which resulted in swelling and a bloody nose. Staff interviews speculated that Child A could have fallen down or they could have been hit by running into another child, but could not definitively determine how Child A sustained the injury.”

8VAC20-770-60-C-2

“Based on review of documentation, it was determined that the center did not obtain central registry background checks within 30 days of employment. Evidence: Staff #4, start date 3/2/2022, did not have documentation of a central registry background check in the file. Staff #5, start date 10/17/2022, was dated 11/28/2022.”

8VAC20-780-130-A

“Based on review of children's records, the center did not obtain immunizations before the child attended the center. Evidence: Child #2, first day of attendance 3/12/22, immunizations were dated 11/19/2022.”

8VAC20-780-140-A

“Based on review of children's records, the center did not obtain documentation of a physical exam within 30 days of attendance. Evidence: Child #2, start date 3/12/22, physical was dated 11/19/2022. Child #3, start date 10/26/22, had no documentation of a physical in the record. Child #5, start date 6/20/22, did not have documentation of a physical in the record.”

8VAC20-780-60-A

“Based on review of children's records, the center did not ensure children's records contained required information. Evidence: Child #2, start date 3/12/22, did not have documentation of two emergency contacts in the record.”

8VAC20-780-570-E

“Based on observation, not all prepared infant bottles were dated and labeled with the child's name. Evidence: In the infant classroom, individual bottles in the fridge were not labeled and dated as required and were kept in a basket labeled for child #7.”

8VAC20-780-500-B

“Based on observation, not all diapering surfaces were nonabsorbent. Evidence: In the toddler classroom, the diapering pad was crack at the end and no longer nonabsorbent.”

8VAC20-770-60-C-2

“Based on review of documentation, it was determined that the center did not obtain central registry background checks within 30 days of employment. Evidence: Staff #4, start date 3/2/2022, did not have documentation of a central registry background check in the file. Staff #5, start date 10/17/2022, was dated 11/28/2022.”

8VAC20-780-130-A

“Based on review of children's records, the center did not obtain immunizations before the child attended the center. Evidence: Child #2, first day of attendance 3/12/22, immunizations were dated 11/19/2022.”

8VAC20-780-140-A

“Based on review of children's records, the center did not obtain documentation of a physical exam within 30 days of attendance. Evidence: Child #2, start date 3/12/22, physical was dated 11/19/2022. Child #3, start date 10/26/22, had no documentation of a physical in the record. Child #5, start date 6/20/22, did not have documentation of a physical in the record.”

8VAC20-780-60-A

“Based on review of children's records, the center did not ensure children's records contained required information. Evidence: Child #2, start date 3/12/22, did not have documentation of two emergency contacts in the record.”

8VAC20-780-570-E

“Based on observation, not all prepared infant bottles were dated and labeled with the child's name. Evidence: In the infant classroom, individual bottles in the fridge were not labeled and dated as required and were kept in a basket labeled for child #7.”

8VAC20-780-500-B

“Based on observation, not all diapering surfaces were nonabsorbent. Evidence: In the toddler classroom, the diapering pad was crack at the end and no longer nonabsorbent.”

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

“Based on review of documentation, it was determined that the center failed to obtain Tuberculosis (TB) screening by the 1st day of employment. Evidence: Staff #2, start date 5/9/2022, did not have documentation of a TB screening in the record.”

8VAC20-780-70 Complaint related: No

“Based on review of documentation, it was determined that the center failed to obtain two references for each staff prior to employment. Evidence: Staff #2, start date 5/9/2022, did not have documentation of two references in the record.”

22.1-289.035-B-2 Complaint related: No

“Based on review of documentation, it was determined that the center failed to obtain documentation of national fingerprint background check results by the first day of employment. Evidence: Staff #2, start date 5/9/2022, did not have documentation of fingerprint background check in the record.”

8VAC20-780-550-P Complaint related: Yes

“Based on interviews and review of documentation, it was determined that the center failed to maintain a written record of children’s serious and minor injuries as required. Evidence: On June 8, 2022, Child #1, age 4, hit her head on the playground structure resulting in large knot on her head and no injury report was completed. Staff confirmed the child had injured her head. Staff interviews revealed that staff was unaware of the accident/injury reporting requirements and did not know they were supposed to complete documentation. There was no documentation of the child’s minor injury on record at the center.”

8VAC20-780-550-O Complaint related: Yes

“Based on interview with both parent and staff of the center, it was determined that the center failed to notify the parent by the end of the day of any known minor injuries. Evidence: On June 8, 2022 at approximately 3:30 p.m., Child #1, age 4, hit her head on the playground structure behind the slide. Child #1 reported this injury to staff and staff sat the child down. Staff interviews revealed that no staff member notified the parent at pick up or by the end of the day of the injury.”

8VAC20-770-60-C-2 Complaint related: No

“Based on review of documentation, it was determined that the center failed to obtain central registry background check results within 30 days of employment. Evidence: Staff #2, start date 5/9/2022, did not have documentation of central registry background check results in the record.”

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

“Based on review of documentation, it was determined that the center failed to obtain a completed sworn statement by the 1st day of employment. Evidence: Staff #2, start date 5/9/2022, sworn statement was dated 5/13/2022.”

8VAC20-780-70

“Based on review of documentation, the center failed to ensure staff records contained required information. Evidence: Staff #2, hired 5/31/2022, did not have references in the file and no documentation of orientation. Staff #3, hired 3/31/2022, references were dated 4/1/2022. Staff #4, hired 6/13/2022, did not have documentation of two references in the file. Staff #6, hired 3/22/2022, did not have documentation of two references in the file.”

8VAC20-780-160-A

“Based on review of documentation, the center did not obtain documentation of a negative Tuberculosis (TB) screening for all staff before coming into contact with children. The TB screening shall be conducted within the last 30 calendar days before hire. Evidence: 1. Staff #2, hired 5/27/2022, Staff #4, hired 6/13/2022, Staff #6, hired 3/22/2022 did not have documentation of a TB screening in the record. 2. Staff #3, hired 3/31/2022, TB was dated 6/6/2022. 3. Staff #5, hired 3/1/2022, TB was dated 5/24/2021.”

8VAC20-780-140-A

“Based on review of documentation, it was determined that the center did not obtain documentation of physical exam within 30 days of attendance for all children. Evidence: Child #3, enrolled 5/6/2022, did not have a physical in the file.”

8VAC20-770-60-C-2

“Based on review of documentation, it was determined that the center did not obtain central registry background checks within 30 days of employment. Evidence: Staff #1, start date 5/3/2022, did not have documentation of a central registry background check in the file. Staff #3, start date 3/31/2022, was dated 5/7/2022. Staff #6, start date 3/22/2022, did not have documentation of a central registry background check in the record.”

8VAC20-770-60-B

“Based on review of documentation, it was determined that the center did not obtain sworn statement before the first day of employment. Evidence: Staff #2, start date 5/31/2022, sworn statement was dated 6/15/2022. Staff #3, start date 3/31/2022, did not have documentation of a sworn statement in the record. Staff #4, start date 6/13/2022, did not have documentation of a sworn statement in the record.”

8VAC20-780-290-A-3

“Based on observation, not all outlets were equipped with child protective covers. Evidence: In City Place, there were five toddlers observed playing and three uncovered outlets. In the fours class, there was one uncovered outlet in the back of the room.”

8VAC20-780-500-A

“Based on observation and staff interview, not all children's hands were washed after diapering. Evidence: In the older infant room, after diapering a child's hands were not washed. Interview revealed that the staff member did not know that hand washing was a requirement.”

22VAC40-185-280-B

“Based on observation, not all potentially hazardous substances were kept in a locked place. Evidence: In the older infant classroom, a can of "Rid home, lice, bed bug, dust mite" spray was in a high unlocked shelf above the counter.”

8VAC20-780-500-B

“Based on observation and interview with staff, it was determined that diapering requirements were not followed. Evidence: In the older infant classroom, after a child was diapered, the diapering surface was not cleaned and sanitized after.”

8VAC20-780-510-E

“Based on review of documentation and medications, the center failed to follow it's procedures for administering medication. Evidence: Child #8 has ephinephrine on site and there was no authorization from the parent or physician.”

8VAC20-780-510-L

“Based on observation, medication was not kept in a locked place. Evidence: Medication was kept in an orange Children of America bag on top of a bookshelf in the director's office.”

8VAC20-780-80-A

“Based on review of documentation, it was determined that the center did not ensure a written record of daily attendance for each group of children was completed. Evidence: In the two's classroom, there were 10 children present and three children recorded as present on the attendance sheet.”

8VAC20-780-70

“Based on review of documentation, the center failed to ensure staff records contained required information. Evidence: Staff #2, hired 5/31/2022, did not have references in the file and no documentation of orientation. Staff #3, hired 3/31/2022, references were dated 4/1/2022. Staff #4, hired 6/13/2022, did not have documentation of two references in the file. Staff #6, hired 3/22/2022, did not have documentation of two references in the file.”

8VAC20-780-160-A

“Based on review of documentation, the center did not obtain documentation of a negative Tuberculosis (TB) screening for all staff before coming into contact with children. The TB screening shall be conducted within the last 30 calendar days before hire. Evidence: 1. Staff #2, hired 5/27/2022, Staff #4, hired 6/13/2022, Staff #6, hired 3/22/2022 did not have documentation of a TB screening in the record. 2. Staff #3, hired 3/31/2022, TB was dated 6/6/2022. 3. Staff #5, hired 3/1/2022, TB was dated 5/24/2021.”

8VAC20-780-140-A

“Based on review of documentation, it was determined that the center did not obtain documentation of physical exam within 30 days of attendance for all children. Evidence: Child #3, enrolled 5/6/2022, did not have a physical in the file.”

8VAC20-770-60-C-2

“Based on review of documentation, it was determined that the center did not obtain central registry background checks within 30 days of employment. Evidence: Staff #1, start date 5/3/2022, did not have documentation of a central registry background check in the file. Staff #3, start date 3/31/2022, was dated 5/7/2022. Staff #6, start date 3/22/2022, did not have documentation of a central registry background check in the record.”

8VAC20-770-60-B

“Based on review of documentation, it was determined that the center did not obtain sworn statement before the first day of employment. Evidence: Staff #2, start date 5/31/2022, sworn statement was dated 6/15/2022. Staff #3, start date 3/31/2022, did not have documentation of a sworn statement in the record. Staff #4, start date 6/13/2022, did not have documentation of a sworn statement in the record.”

8VAC20-780-290-A-3

“Based on observation, not all outlets were equipped with child protective covers. Evidence: In City Place, there were five toddlers observed playing and three uncovered outlets. In the fours class, there was one uncovered outlet in the back of the room.”

8VAC20-780-500-A

“Based on observation and staff interview, not all children's hands were washed after diapering. Evidence: In the older infant room, after diapering a child's hands were not washed. Interview revealed that the staff member did not know that hand washing was a requirement.”

22VAC40-185-280-B

“Based on observation, not all potentially hazardous substances were kept in a locked place. Evidence: In the older infant classroom, a can of "Rid home, lice, bed bug, dust mite" spray was in a high unlocked shelf above the counter.”

8VAC20-780-500-B

“Based on observation and interview with staff, it was determined that diapering requirements were not followed. Evidence: In the older infant classroom, after a child was diapered, the diapering surface was not cleaned and sanitized after.”

8VAC20-780-510-E

“Based on review of documentation and medications, the center failed to follow it's procedures for administering medication. Evidence: Child #8 has ephinephrine on site and there was no authorization from the parent or physician.”

8VAC20-780-510-L

“Based on observation, medication was not kept in a locked place. Evidence: Medication was kept in an orange Children of America bag on top of a bookshelf in the director's office.”

8VAC20-780-80-A

“Based on review of documentation, it was determined that the center did not ensure a written record of daily attendance for each group of children was completed. Evidence: In the two's classroom, there were 10 children present and three children recorded as present on the attendance sheet.”

8VAC20-780-160-A-1 Complaint related: No

“Based on review of documentation, the facility failed to obtain documentation of Tuberculosis (TB) screening for staff prior to coming into contact with children. Evidence: Staff #1, start date 3/1/2022, did not have documentation of a TB screening in the file.”