Children of America (Stephens City)

8VAC20-780-400-B Complaint related: Yes

“Based on interviews and review of documentation, the center failed to ensure that behavioral guidance was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. On the playground on July 25, 2024, Staff #1 picked Child #4, age three years old, up under the arms and "dropped" the child over a fence (approximately four feet high) as a means of behavioral guidance. Child #4 was left on the other side of the fence, crying for approximately five to ten minutes.”

8VAC20-780-410-1 Complaint related: Yes

“Based on staff interviews and review of documentation, the center failed to ensure that staff did not engage in forbidden actions of rough handling and physical punishment 1. On July 25, 2024, Staff #1 shoved Child #2, age three years old, at least four times. During the shoving, Child #2 fell down and Staff #1 continued to shove Child #2 down at least three more times and then shoved Child #2 in the face causing Child #2 to fall backwards. Child #2 cried. 2.On July 25, 2024, Staff #1 grabbed Child #3, age three years old, by the upper arm and sat Child #3 down with force against the playground fence. Child #3 cried.”

8VAC20-780-510-P

“Based on review of documentation, the center failed to ensure that when an authorization for medication expires, the parent either picked up the medication within 14 days or the parent renewed the authorization. Evidence: 1. Child #1?s authorization for albuterol expired on 12/9/2023 and the medication was still on site. There was no current medication authorization. 2. Child #2?s authorization for albuterol expired on 1/24/2023 and the medication was still on site. There was no current medication authorization.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas and equipment of the center were maintained in clean, safe, and operable condition. Evidence: 1. In the Toddler B classroom, in the back of the classroom on the wall, there was an approximately 1.5 inch long gash in the wall that exposed drywall and chipped, peeling paint. 2. In the School Age classroom, there were three different areas of chipped, flaking paint. On the back wall, the corner of the wall had four areas of chipped, flaking paint. On the window area, there was one large patch of missing, chipped, flaking paint on the right and there were two large patches of missing, chipped, flaking paint approximately six inches to eighteen inches long.”

8VAC20-780-510-P

“Based on review of documentation, the center failed to ensure that when an authorization for medication expires, the parent either picked up the medication within 14 days or the parent renewed the authorization. Evidence: 1. Child #1?s authorization for albuterol expired on 12/9/2023 and the medication was still on site. There was no current medication authorization. 2. Child #2?s authorization for albuterol expired on 1/24/2023 and the medication was still on site. There was no current medication authorization.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas and equipment of the center were maintained in clean, safe, and operable condition. Evidence: 1. In the Toddler B classroom, in the back of the classroom on the wall, there was an approximately 1.5 inch long gash in the wall that exposed drywall and chipped, peeling paint. 2. In the School Age classroom, there were three different areas of chipped, flaking paint. On the back wall, the corner of the wall had four areas of chipped, flaking paint. On the window area, there was one large patch of missing, chipped, flaking paint on the right and there were two large patches of missing, chipped, flaking paint approximately six inches to eighteen inches long.”

8VAC20-780-560-M

“Based on observation, the center failed to ensure that children weren?t permitted to walk around while eating or drinking. Evidence: In the Infant C classroom, Child #1 was observed walking around the classroom drinking from a cup of milk.”

8VAC20-780-40-E

“Based on review of documentation, the licensee failed to ensure that the center’s activities, services, and facilities are maintained in compliance with the center's own policies and procedures that are required by these standards. Evidence: 1. Child #2 had diphenhydramine on site and the parent’s authorization was signed 10/19/2023. 2. The authorization form stated that the duration of the authorization is 10 days. 3. The Child Day Center (CDC) standards require that parent authorization for medication expire after 10 days.”

8VAC20-770-60-C-2

“Based on review of documentation, the center failed to ensure that central registry background check results were obtained within 30 days of employment. Evidence: A completed report was not sent within 7 days to request the central registry finding for staff #3, hired on 10/02/2023. The results were not obtained within 30 days of employment and had not been obtained as of the date of the inspection.”

8VAC20-780-330-B

“Based on observation and review of documentation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with the minimum safety standards as described in American Society for Testing Materials standard F1292-99 as shown in the Compressed Loose Fill Synthetic Materials Depth Chart Evidence: The surfacing material ?softlawn garden rye synthetic turf? installed on the playground is not listed in the Compressed Loose Fill Synthetic Materials Depth Chart.”

8VAC20-780-340-A

“REPEAT VIOLATION Based on observation, the staff of the center failed to always ensure the care, protection and guidance of all children in care. 1. Upon suggestion by the Licensing Administrator, additional staff were called upon to assist in the Preschool 1 classroom as the following was observed taking place: child standing in the doorway of the restroom facing the classroom with his pants down around his ankles; children walking around the classroom with soiled hands touching the cots and linens of other children; a child stepping on the back of a sleeping child while walking to the restroom; a child spinning in circles while lying on her back, nearly hitting her head on a bookcase, then climbing into the bottom of the bookcase; cots placed with less than 12 inches of space between in preparation to be occupied for naps. One staff voiced frustration by stating ?I?m not okay?, to which the director replied ?You?re okay?. 2. The following was observed taking place in the two’s classroom: children walking onto and standing on different children’s cots; a child walking around in a visibly soaked t-shirt; a child with walking around the room with a blanket on his head; a child crawling under the fitted sheet on the cot; and a child eating food off the floor.”

8VAC20-780-500-B

“REPEAT VIOLATION Based on observation, the center failed to ensure that a nonabsorbent surface for diapering or changing was used, and that for children younger than three years, this surface shall be a changing table or countertop designated for changing. Evidence: 1. In the preschool 1 classroom that serves older two year olds, the diapering pad was observed on the floor in the bathroom.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas of the center were maintained in clean, safe, operable condition. Evidence: 1. In the Infant C classroom, there were two broken plastic storage bins (orange and blue) that were cracked and had jagged edges creating a scratching hazard. 2. On the playground, the chain-link fence was missing several areas of connectors, creating an entrapment hazard from the bottom rail of the fence.”

8VAC20-780-80-A

“Based on review of documentation, the center failed to maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occur Evidence: At approximately 10:44am, there were seven children present in the Infant C Classroom and the arrival of only five of those children had been documented on the attendance record.”

8VAC20-780-500-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that staff washed their hands after coming into contact with body fluids. Evidence: In the two year old room, Staff #1 was observed wiping the noses of several children and Staff #1 did not wash their hands in between or after wiping each child’s nose.”

8VAC20-780-560-M

“Based on observation, the center failed to ensure that children weren?t permitted to walk around while eating or drinking. Evidence: In the Infant C classroom, Child #1 was observed walking around the classroom drinking from a cup of milk.”

8VAC20-780-40-E

“Based on review of documentation, the licensee failed to ensure that the center’s activities, services, and facilities are maintained in compliance with the center's own policies and procedures that are required by these standards. Evidence: 1. Child #2 had diphenhydramine on site and the parent’s authorization was signed 10/19/2023. 2. The authorization form stated that the duration of the authorization is 10 days. 3. The Child Day Center (CDC) standards require that parent authorization for medication expire after 10 days.”

8VAC20-770-60-C-2

“Based on review of documentation, the center failed to ensure that central registry background check results were obtained within 30 days of employment. Evidence: A completed report was not sent within 7 days to request the central registry finding for staff #3, hired on 10/02/2023. The results were not obtained within 30 days of employment and had not been obtained as of the date of the inspection.”

8VAC20-780-330-B

“Based on observation and review of documentation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with the minimum safety standards as described in American Society for Testing Materials standard F1292-99 as shown in the Compressed Loose Fill Synthetic Materials Depth Chart Evidence: The surfacing material ?softlawn garden rye synthetic turf? installed on the playground is not listed in the Compressed Loose Fill Synthetic Materials Depth Chart.”

8VAC20-780-340-A

“REPEAT VIOLATION Based on observation, the staff of the center failed to always ensure the care, protection and guidance of all children in care. 1. Upon suggestion by the Licensing Administrator, additional staff were called upon to assist in the Preschool 1 classroom as the following was observed taking place: child standing in the doorway of the restroom facing the classroom with his pants down around his ankles; children walking around the classroom with soiled hands touching the cots and linens of other children; a child stepping on the back of a sleeping child while walking to the restroom; a child spinning in circles while lying on her back, nearly hitting her head on a bookcase, then climbing into the bottom of the bookcase; cots placed with less than 12 inches of space between in preparation to be occupied for naps. One staff voiced frustration by stating ?I?m not okay?, to which the director replied ?You?re okay?. 2. The following was observed taking place in the two’s classroom: children walking onto and standing on different children’s cots; a child walking around in a visibly soaked t-shirt; a child with walking around the room with a blanket on his head; a child crawling under the fitted sheet on the cot; and a child eating food off the floor.”

8VAC20-780-500-B

“REPEAT VIOLATION Based on observation, the center failed to ensure that a nonabsorbent surface for diapering or changing was used, and that for children younger than three years, this surface shall be a changing table or countertop designated for changing. Evidence: 1. In the preschool 1 classroom that serves older two year olds, the diapering pad was observed on the floor in the bathroom.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas of the center were maintained in clean, safe, operable condition. Evidence: 1. In the Infant C classroom, there were two broken plastic storage bins (orange and blue) that were cracked and had jagged edges creating a scratching hazard. 2. On the playground, the chain-link fence was missing several areas of connectors, creating an entrapment hazard from the bottom rail of the fence.”

8VAC20-780-80-A

“Based on review of documentation, the center failed to maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occur Evidence: At approximately 10:44am, there were seven children present in the Infant C Classroom and the arrival of only five of those children had been documented on the attendance record.”

8VAC20-780-500-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that staff washed their hands after coming into contact with body fluids. Evidence: In the two year old room, Staff #1 was observed wiping the noses of several children and Staff #1 did not wash their hands in between or after wiping each child’s nose.”

8VAC20-780-140-A

“Based on review of documentation, the center failed to obtain documentation of a physical exam within 30 days of attendance. Evidence: The record for Child #1, first day of attendance 11/7/2022, did not contain documentation of a physical exam.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that all areas of the center inside and outside were maintained in a clean, safe, operable manner. Evidence: On the playground near the composite tree house, there is a large divot approximately eight inches in lenght in the ground underneath the artificial grass covering that creates a tripping hazard.”

8VAC20-780-60-A

“Based on review of documentation, the center failed to ensure that children’s records contained all required information. Evidence: The record for Child #1, first day of attendance 11/7/2022 did not contain written authorization/written objection for emergency medical care should an emergency occur.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas and equipment of the center were maintained in clean, safe, and operable condition. Evidence: 1.In the toddler room, the stripping was missing from the underside of the cubbies and exposed the rough particle board and created a scratching hazard. 2.In the two’s room, the stripping from the underside of the cubbies was missing in some areas and exposed the rough particle board and created a scratching hazard. There was also broken stripping that was jagged and created a scratching hazard. The cabinet under the diapering area had a broken door that created a pinch, crush and shearing hazard and a sharp metal bracket was exposed created a scratch and puncture hazard. 3.In the preschool 2 classroom, there was a thick gray film observed in and around the sink drain in the front of the classroom. The play kitchen was missing a door and had a metal hinge the entire length of the kitchen that created a pinching and scratching hazard. The play kitchen was missing several handles and exposed rough wood inside creating a scratching hazard. 4.In the PreK classroom, a light cover in the ceiling was not connected in two corners and was loosely hanging. A thick coating of dust was observed on the light. 5.In the infant c classroom, the lid of the trash can was visibly dirty and covered in orange colored dried on food debris. 6.In City Place, the stripping was missing on the underside of the cubbies and exposed the rough particle board creating a scratching hazard.”

8VAC20-780-400-A

“Based on observation, the center failed to ensure that staff interacted with children to provide needed help, comfort and support as required. Evidence: While in the director’s office, the licensing inspector (LI) overheard a child crying for several minutes and then overheard Staff #2 using a loud, harsh voice tone saying ?Why are you crying now, (Child #3)??”

8VAC20-780-340-A

“Based on observation, staff of the center failed to always ensure the care, protection and guidance of all children in care. Evidence: In the Preschool 2 classroom, two staff were observed in the bathroom together and a group of 16 children were observed in the back of the classroom across from the bathroom in the dress up center and play kitchen. Two children were observed climbing on top of and sitting on the play kitchen and one child was observed picking up an approximately four-feet-tall dress up mirror and moving it across the play area. The licensing inspector (LI) was in the classroom for several minutes before staff noticed the LI. No staff intervened in the behaviors engaged in by the children for several minutes.”

8VAC20-780-500-A

“REPEAT VIOLATION Based on observation, staff of the center failed to ensure children’s hands were washed with soap and water after eating. Evidence: In the toddler room, Child #2?s hands were not washed after eating breakfast.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal, a nonabsorbent surface for diapering or changing was used, and that for children younger than three years, this surface shall be a changing table or countertop designated for changing. Evidence: Evidence: 2. In the infant b classroom, the diapering pad had cracks in the nonabsorbent cover and exposed the absorbent material inside. 1. In the infant 2 classroom, there was not a foot operated disposal system but a blue trash can in which the staff’s hand and diaper touch the outside/lid during disposal. 3. In the preschool 1 classroom that serves older two year olds, the diapering pad was observed on the floor in the bathroom.”

8VAC20-780-520-A

“Based on observation, the center failed to ensure that nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Evidence: 1.In the two’s classroom, there was an expired Aquaphor healing ointment (expired 3/23).”

8VAC20-780-520-C

“Based on observation, the center failed to ensure all diaper ointment was labeled with the child’s name. Evidence: An Aquaphor healing ointment was not labeled with the child’s name”

8VAC20-780-570-A

“Based on observation, the center failed to ensure that high chairs, infant carrier seats, or feeding tables were used for children under 12 months who were not held while being fed and that protective belts were not fastened securely when children were placed in an infant seat or high chair. Evidence: 1. In the infant b classroom, Infant #3, 11- month -olds, was observed lying in a boppy pillow on the floor drinking a bottle. 2. In the infant a classroom, Infant #1, age 6 months and Infant #2, age 11 months were observed sitting in the feeding table and were not strapped in. There were no straps installed on the feeding table.”

8VAC20-780-130-A

“Based on review of children’s records, not all records contained documentation of immunizations by the first day of attendance. Evidence: 1. The record for Child #6, first day of attendance 12/19/2022, did not have documentation of immunizations in the record.”

8VAC20-780-60-A

“Based on review of children’s records, not all records contained required information. Evidence: 1. The record for Child #4, first day of attendance 8/29/2022, did not have parent’s place of employment and telephone number for parent/guardian #1 and #2. 2. The record for Child #6, first day of attendance 12/19/2022, did not have parent’s place of employment and telephone number for parent/guardian #1. 3. The record for Child #7, first day of attendance 11/14/2022, did not have a second emergency contact name, full address and telephone number that was not the parent.”

8VAC20-780-270-A

“REPEAT VIOLATION Based on observation, the center failed to ensure that all areas and equipment of the center were maintained in clean, safe, and operable condition. Evidence: 1.In the toddler room, the stripping was missing from the underside of the cubbies and exposed the rough particle board and created a scratching hazard. 2.In the two’s room, the stripping from the underside of the cubbies was missing in some areas and exposed the rough particle board and created a scratching hazard. There was also broken stripping that was jagged and created a scratching hazard. The cabinet under the diapering area had a broken door that created a pinch, crush and shearing hazard and a sharp metal bracket was exposed created a scratch and puncture hazard. 3.In the preschool 2 classroom, there was a thick gray film observed in and around the sink drain in the front of the classroom. The play kitchen was missing a door and had a metal hinge the entire length of the kitchen that created a pinching and scratching hazard. The play kitchen was missing several handles and exposed rough wood inside creating a scratching hazard. 4.In the PreK classroom, a light cover in the ceiling was not connected in two corners and was loosely hanging. A thick coating of dust was observed on the light. 5.In the infant c classroom, the lid of the trash can was visibly dirty and covered in orange colored dried on food debris. 6.In City Place, the stripping was missing on the underside of the cubbies and exposed the rough particle board creating a scratching hazard.”

8VAC20-780-400-A

“Based on observation, the center failed to ensure that staff interacted with children to provide needed help, comfort and support as required. Evidence: While in the director’s office, the licensing inspector (LI) overheard a child crying for several minutes and then overheard Staff #2 using a loud, harsh voice tone saying ?Why are you crying now, (Child #3)??”

8VAC20-780-340-A

“Based on observation, staff of the center failed to always ensure the care, protection and guidance of all children in care. Evidence: In the Preschool 2 classroom, two staff were observed in the bathroom together and a group of 16 children were observed in the back of the classroom across from the bathroom in the dress up center and play kitchen. Two children were observed climbing on top of and sitting on the play kitchen and one child was observed picking up an approximately four-feet-tall dress up mirror and moving it across the play area. The licensing inspector (LI) was in the classroom for several minutes before staff noticed the LI. No staff intervened in the behaviors engaged in by the children for several minutes.”

8VAC20-780-500-A

“REPEAT VIOLATION Based on observation, staff of the center failed to ensure children’s hands were washed with soap and water after eating. Evidence: In the toddler room, Child #2?s hands were not washed after eating breakfast.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal, a nonabsorbent surface for diapering or changing was used, and that for children younger than three years, this surface shall be a changing table or countertop designated for changing. Evidence: Evidence: 2. In the infant b classroom, the diapering pad had cracks in the nonabsorbent cover and exposed the absorbent material inside. 1. In the infant 2 classroom, there was not a foot operated disposal system but a blue trash can in which the staff’s hand and diaper touch the outside/lid during disposal. 3. In the preschool 1 classroom that serves older two year olds, the diapering pad was observed on the floor in the bathroom.”

8VAC20-780-520-A

“Based on observation, the center failed to ensure that nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Evidence: 1.In the two’s classroom, there was an expired Aquaphor healing ointment (expired 3/23).”

8VAC20-780-520-C

“Based on observation, the center failed to ensure all diaper ointment was labeled with the child’s name. Evidence: An Aquaphor healing ointment was not labeled with the child’s name”

8VAC20-780-570-A

“Based on observation, the center failed to ensure that high chairs, infant carrier seats, or feeding tables were used for children under 12 months who were not held while being fed and that protective belts were not fastened securely when children were placed in an infant seat or high chair. Evidence: 1. In the infant b classroom, Infant #3, 11- month -olds, was observed lying in a boppy pillow on the floor drinking a bottle. 2. In the infant a classroom, Infant #1, age 6 months and Infant #2, age 11 months were observed sitting in the feeding table and were not strapped in. There were no straps installed on the feeding table.”

8VAC20-780-130-A

“Based on review of children’s records, not all records contained documentation of immunizations by the first day of attendance. Evidence: 1. The record for Child #6, first day of attendance 12/19/2022, did not have documentation of immunizations in the record.”

8VAC20-780-60-A

“Based on review of children’s records, not all records contained required information. Evidence: 1. The record for Child #4, first day of attendance 8/29/2022, did not have parent’s place of employment and telephone number for parent/guardian #1 and #2. 2. The record for Child #6, first day of attendance 12/19/2022, did not have parent’s place of employment and telephone number for parent/guardian #1. 3. The record for Child #7, first day of attendance 11/14/2022, did not have a second emergency contact name, full address and telephone number that was not the parent.”

8VAC20-780-500-A Complaint related: Yes

“REPEAT VIOLATION Based on interview and observation, the center failed to ensure that children and staff’s hands were washed with soap and running water after a diaper change. 1. In the toddler classroom, Staff #1 was observed changing a child’s diaper and did not wash the child’s hands or their hands after the diaper change. 2. Staff #1 confirmed that neither the child’s hands nor Staff #1?s hands were washed after the diaper change.”

8VAC20-780-490-B Complaint related: Yes

“COMPLAINT RELATED Based on interview, the center failed to ensure that arrangements are made for children to leave the center as soon as possible after the signs or symptoms are noticed of a communicable disease or fever and that children remain in the designated quiet area until they leave the center. Evidence 1. When asked, six of eight staff members interviewed stated that when children have a fever or symptoms of a communicable disease, they remain in the classroom until picked up by the parent. 2. When asked, six of eight staff members interviewed revealed that although they have reported signs and symptoms of fever or symptoms of a communicable disease to management, it has been a common occurrence for the children to remained in the classroom till until the end of the day. 2. When asked, six of the eight staff members interviewed confirmed that arrangements are not always made for children to be picked up as soon as possible after fever or the signs or symptoms of a communicable disease are noticed.”

8VAC20-780-350-B-2 Complaint related: No

“Based on observation, the center failed to ensure that the required staff-to-child ratios were met whenever children are in care. 1. In the toddler room, there were 10 children in care and only two staff members. 2. Staff #1 confirmed that the youngest child in care was Child #1 and that Child #1 was 14 months old. 3. Staff #2 confirmed that Child #1 was 14 months old and was in the toddler classroom.”

8VAC20-780-270-A Complaint related: Yes

“COMPLAINT RELATED Based on observation and interview, the center failed to maintain areas and equipment in a clean, safe and operable manner. Evidence: 1. In the toddler room, there was visible dirt on the inside and the outside of the refrigerator. The handle of the refrigerator was sticky to touch.(CDC-1105994(06-09-2023)P1, CDC-1105994(06-09-2023)P2) 2. In the PreK 2 classroom, there was visible dirt on and around the light switch (CDC-1105994(06-09-2023)P3) and in toy bins (CDC-1105994(06-09-2023)P4). There was visible dirt and dried substance on the tables (CDC-1105994(06-09-2023)P5) and on and around the trash can (CDC-1105994(06-09-2023)P6). 3. In the Two’s classroom, there was visible dirt on the toys (CDC-1105994(06-09-2023)P7.jpg, CDC-1105994(06-09-2023)P8.jpg) and on the rug (CDC-1105994(06-09-2023)P9.jpg). 4. In the PreK 1 room, there was visible dirt and dried substance on the counter (CDC-1105994(06-09-2023)P10.jpg) and on the tables (CDC-1105994(06-09-2023)P15) and there was visible dirt in the toy bins (CDC-1105994(06-09-2023)P11.jpg) and on the toys (CDC-1105994(06-09-2023)P12.jpg, CDC-1105994(06-09-2023)P13.jpg, CDC-1105994(06-09-2023)P14.jpg).”

8VAC20-780-550-P

“Based on interview, the center failed to maintain a written record of children’s serious and minor injuries in which entries are made on the day of occurrence. Evidence: 1. Interview with Staff #1 on 3/22/2023 confirmed that Child #1 was injured on 03/14/2023. Interviews with Staff #1 on 3/22/2023 and Staff #2 on 3/15/2023 confirmed that the injury report was not completed until 03/15/2023”

8VAC20-780-550-O

“Based on interview, the center failed to notify parents by end of the day of any known minor injuries. Evidence: 1. Interview with Staff #1 on 3/22/2023 confirmed that Child #1 had fallen and hit their head on the floor and then vomited on 03/14/2023 and that the parents were not notified on the day of the injury. 2. Interview with Staff #2 on 3/15/2023 confirmed that the parents of Child #1 were not notified of the injury until 03/15/2023.”

8VAC20-780-550-P

“Based on interview, the center failed to maintain a written record of children’s serious and minor injuries in which entries are made on the day of occurrence. Evidence: 1. Interview with Staff #1 on 3/22/2023 confirmed that Child #1 was injured on 03/14/2023. Interviews with Staff #1 on 3/22/2023 and Staff #2 on 3/15/2023 confirmed that the injury report was not completed until 03/15/2023”

8VAC20-780-500-A Complaint related: Yes

“COMPLAINT RELATED Based on interview and observation, the center failed to ensure that children’s hands were washed with soap and running water after toileting. 1. In the two year olds? classroom, the inspector observed a staff member change a child’s diaper without washing the child’s hands after the diaper change. 2. The staff member confirmed that they did not wash the child’s hands after the diaper change.”

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

“Based on observation, the licensee failed to ensure that the center’s activities, services and facilities were maintained in compliance with the center’s own policies and procedures that are required by these standards. Evidence: 1. In Infant Room A, one child was observed asleep in a bouncy seat with a blanket covering the infant’s body and another child was observed asleep in a crib, wrapped in a blanket, and laying on a Boppy pillow. 2. The center’s safe sleep policy states ?Infants are placed in a crib on their backs as recommended by the American Academy of Pediatrics.?”

8VAC20-780-490-E Complaint related: Yes

“COMPLAINT RELATED Based on interview, the center failed to ensure that surfaces were cleaned and sanitized after being contaminated with body fluids. Evidence: 1. Two of the ten staff interviewed stated they do not clean toys after they have been contaminated with body fluids. 2. Three of the ten staff interviewed said when toys are contaminated with body fluids, they wash them, but they do not sanitize the toys.”

8VAC20-780-560-G

“Based on observation and interview, the center failed to ensure that food brought from home was clearly dated and labeled in a way that identifies the owner. Evidence: 1. In Classroom #4, there were three cups that were not labeled with a name or a date. 2. Staff #13 confirmed that the cups and it contents were brought from home and were not labelled with a name or a date.”

22.1-289.035-B-4

“Based on review of records and interview, the center failed to ensure that out of state criminal history name checks were completed before the first day of employment and out of state abuse and neglect search requests were sent by the end of the 30th day of employment Evidence: 1. Staff #1?s start date was 9/26/2022. Staff #12 confirmed that Staff #1 had lived in Maryland within the last five years. Staff #12 confirmed there was no out of state criminal history name check for Staff #1. 2. Staff #1 had a West Virginia driver’s license on file. Staff #12 confirmed that Staff #1 had lived in West Virginia within the last five years. There was no out of state child abuse and neglect search on file for Staff #1. Staff #12 confirmed that the out of state abuse and neglect search had not been sent. 3. Staff #2?s start date was 8/22/2022. Staff #2 had a West Virginia driver’s license on file. Staff #12 confirmed that Staff #2 had lived in West Virginia within the last five years. There was no out of state child abuse and neglect search on file for Staff #1. Staff #12 confirmed that the out of state abuse and neglect search had not been sent.”

8VAC20-780-240-A

“Based on review of records and interview, the center failed to ensure that each staff member completed the Virginia Department of Education sponsor orientation course within 90 days of employment. Evidence: 1. Staff #1?s start date was 09/26/2022. There was no Virginia Department of Education sponsor orientation course certificate in Staff #1?s file. 2. Staff #11 confirmed that Staff #1 did not complete the Virginia Department of Education sponsor orientation course within 90 days of employment.”

8VAC20-780-320-B

“Based on observation and interview, the center failed to ensure that each restroom was equipped with soap, toilet paper and paper towels. Evidence: 1. In Classroom #1, there was no soap, toilet paper or paper towels in the restroom. Staff #6 confirmed the bathroom was missing the required items. 2. In Classroom #2, there was no paper towels in the restroom. Staff #2 and Staff #3 confirmed there was no paper towels in the bathroom.”

8VAC20-780-510-F

“Based on review of records and interview, the center failed to ensure that the medication authorization was available to staff during the entire time it is effective. Evidence: 1. Medication #2 there was an allergy action plan signed by a doctor on file which indicated that the Epi Pen was to be used for an allergic reaction. There was no medication authorization form for Medication #2. 2. Staff #12 confirmed there was no medication authorization form for Medication #2.”

8VAC20-780-560-G

“Based on observation and interview, the center failed to ensure that food brought from home was clearly dated and labeled in a way that identifies the owner. Evidence: 1. In Classroom #4, there were three cups that were not labeled with a name or a date. 2. Staff #13 confirmed that the cups and it contents were brought from home and were not labelled with a name or a date.”

22.1-289.035-B-4

“Based on review of records and interview, the center failed to ensure that out of state criminal history name checks were completed before the first day of employment and out of state abuse and neglect search requests were sent by the end of the 30th day of employment Evidence: 1. Staff #1?s start date was 9/26/2022. Staff #12 confirmed that Staff #1 had lived in Maryland within the last five years. Staff #12 confirmed there was no out of state criminal history name check for Staff #1. 2. Staff #1 had a West Virginia driver’s license on file. Staff #12 confirmed that Staff #1 had lived in West Virginia within the last five years. There was no out of state child abuse and neglect search on file for Staff #1. Staff #12 confirmed that the out of state abuse and neglect search had not been sent. 3. Staff #2?s start date was 8/22/2022. Staff #2 had a West Virginia driver’s license on file. Staff #12 confirmed that Staff #2 had lived in West Virginia within the last five years. There was no out of state child abuse and neglect search on file for Staff #1. Staff #12 confirmed that the out of state abuse and neglect search had not been sent.”

8VAC20-780-240-A

“Based on review of records and interview, the center failed to ensure that each staff member completed the Virginia Department of Education sponsor orientation course within 90 days of employment. Evidence: 1. Staff #1?s start date was 09/26/2022. There was no Virginia Department of Education sponsor orientation course certificate in Staff #1?s file. 2. Staff #11 confirmed that Staff #1 did not complete the Virginia Department of Education sponsor orientation course within 90 days of employment.”

8VAC20-780-320-B

“Based on observation and interview, the center failed to ensure that each restroom was equipped with soap, toilet paper and paper towels. Evidence: 1. In Classroom #1, there was no soap, toilet paper or paper towels in the restroom. Staff #6 confirmed the bathroom was missing the required items. 2. In Classroom #2, there was no paper towels in the restroom. Staff #2 and Staff #3 confirmed there was no paper towels in the bathroom.”

8VAC20-780-510-F

“Based on review of records and interview, the center failed to ensure that the medication authorization was available to staff during the entire time it is effective. Evidence: 1. Medication #2 there was an allergy action plan signed by a doctor on file which indicated that the Epi Pen was to be used for an allergic reaction. There was no medication authorization form for Medication #2. 2. Staff #12 confirmed there was no medication authorization form for Medication #2.”

8VAC20-780-400-A

“Based on interviews, the center failed to provide needed help, comfort and support to a child. Evidence: 1. A relative of child #1 reported to the center that she observed, on the center’s camera system, Child #1 crying and being ignored by Staff #5. 2. Interview with Staff #4 confirmed that Child #1 was crying and ignored by Staff #5, as witnessed by Staff #4. 3. The CPS Representative stated that during an interview with Staff #5, Staff #5 admitted to being irritated with and ignoring Child #1.”

8VAC20-770-60-C-2

“Based on review of records and interview, the center failed to ensure that Central Registry results were received by the end of the 30 days of employment. Evidence: 1. Staff #1 start date on file was 3/24/2022. 2. The record showed the central registry was sent on 4/21/2022. Staff #6 confirmed the central registry check had been sent within 7 days of employment.”

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

“Based on interviews, the center failed to implement a monthly practice evacuation drill. Evidence: 1. 10 of the 10 staff interviews confirmed that the center was not implementing monthly practice evacuation drills.”

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

“Based on interviews, the center failed to ensure lockdown procedures had been practiced at least annually. 1. 10 of the 10 staff interviewed stated they had not practiced lockdown procedures since being employed at the center.”

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

“Based on interviews, the center failed to ensure that shelter in place procedures were practiced a minimum of twice a year. Evidence: 1. 10 of the 10 staff interviewed stated they had not practiced shelter in place procedures since being employed at the center.”

8VAC20-790-600-D-1

“Based on review of records and interview, the center failed to ensure that all staff members had current cardiopulmonary resuscitation (CPR) certification within 90 days of hire. Evidence: 1. Staff #7?s start date was 1/31/22. There was no record of CPR certification on file. 2. Staff #6?s start date was 2/24/22. There was no record of CPR certification on file. 3. Staff #9 confirmed that neither staff member had completed CPR certification within 90 days of employment.”

8VAC20-790-600-D-2

“Based on review of records and interviews, the center failed to ensure that all staff members had current first aid certification within 90 days of hire. Evidence: 1. Staff #7?s start date was 1.31.22. There was no record of first aid certification on file. 2. Staff #6?s start date was 2/24/22. There was no record of first aid certification on file. 3. Staff #9 confirmed that neither staff member had completed first aid certification within 90 days of employment.”

8VAC20-780-240-E

“Based on review of records and interviews, the center failed to ensure that each employee had orientation training in first aid and cardiopulmonary resuscitation (CPR) within 30 days of employment. Evidence: 1. Staff #6?s first day of employment was 2/24/22. There was no record of CPR or First Aid orientation on file. 2. Staff #7?s first day of employment was 1/21/22.There was no record of CPR or First Aid orientation on file. 3. Staff #9 confirmed that neither staff member had orientation in CPR or First Aid within the first 30 days of employment.”

22.1-289.035-B-4

“The center failed to complete an out-of-state abuse and neglect registry check within 30 days of employment. Evidence: 1. Staff #1?s start date was 3/24/22. Staff #1 indicated on the sworn statement that they had resided in another state within the past 5 years. 2. Staff #9 confirmed that the out-of-state background check was sent and that it had not been sent within 30 days of employment.”

8VAC20-780-260-B

“Based on interviews, the center failed to provide annual approval from the health department. Evidence: 1. The date of the center’s last health inspection was 1/31/21. 2. Staff #9 confirmed that a health inspection had not been completed since 1/31/21.”

8VAC20-770-60-C-2

“Based on review of records and interviews, the center failed to ensure that all staff members had central registry results on file by the end of the 30th day of employment. 1. Staff #1?s first day of employment was 3/24/2022. A completed central check was not in the staff member’s file. 2. Staff #9 confirmed that the center did not have central registry results on file for Staff #1.”

8VAC20-780-530-A-2

“Based on review of records and interviews, the center failed to ensure that there was at least one staff member in each classroom that had current certification in first aid. Evidence: 1. In Classroom #1, Staff #3 and #6 were present. Neither had current first aid certification on file. Staff #9 confirmed that neither staff member had current first aid certification. 2. In Classroom #7, Staff #7 and #8 were present. Neither had current first aid certification on file. Staff #9 confirmed that neither staff member had current first aid certification.”

8VAC20-780-450-A

“Based on observation and interviews, the center failed to ensure that children had a top and bottom over on their cots. Evidence: 1. In Classroom #1, two children were observed having only a top cover on their cots. 2. Staff #4 confirmed the children did not have a bottom cover on their cot.”

8VAC20-780-530-A-1

“Based on review of records and interviews, the center failed to ensure that there was at least one staff member in each classroom that had current certification in cardiopulmonary resuscitation (CPR). Evidence: 1. In Classroom #1, Staff #3 and #6 were present. The records for these staff did not contain documentation to show that either of the staff had ever been certified in CPR. Staff # 9 confirmed that neither staff member had current CPR certification. 2. In Classroom #7, Staff #7 and #8 were present. The records for these staff did not contain documentation to show that either of the staff had ever been certified in CPR. Staff # 9 confirmed that neither staff member had current CPR certification.”

8VAC20-780-160-A

“Based on review of records and interviews, the center failed to ensure that each staff member completed a tuberculosis screening within 30 days prior to employment. Evidence: 1. Staff #3?s start date was 7/21/22. Staff #3?s TB screen was dated 4/27/22. 2. Staff #9 confirmed that Staff #3?s TB screen was completed more than 30 days prior to hire.”

8VAC20-780-40-J

“Based on interviews and review of records, the center failed to ensure that the injury prevention plan was updated at least annually. Evidence: 1. The date of the last update of the injury prevention plan was 7/21/21. 2. Staff #9 confirmed that the injury prevention plan had not been updated since 7/21/21”

8VAC20-780-240-A

“Based on review of records and interviews, the center failed to ensure that each staff member completed the Virginia Department of Education sponsored orientation with 90 calendar days of employment. Evidence: 1. Staff #5?s start date was 2/22/22. There was no documentation that the staff member had completed the Virginia Department of Education sponsored orientation. 2. Staff #9 confirmed that the staff member had not completed the Virginia Department of Education sponsored orientation within 90 days of employment.”

8VAC20-790-600-D-1

“Based on review of records and interview, the center failed to ensure that all staff members had current cardiopulmonary resuscitation (CPR) certification within 90 days of hire. Evidence: 1. Staff #7?s start date was 1/31/22. There was no record of CPR certification on file. 2. Staff #6?s start date was 2/24/22. There was no record of CPR certification on file. 3. Staff #9 confirmed that neither staff member had completed CPR certification within 90 days of employment.”

8VAC20-790-600-D-2

“Based on review of records and interviews, the center failed to ensure that all staff members had current first aid certification within 90 days of hire. Evidence: 1. Staff #7?s start date was 1.31.22. There was no record of first aid certification on file. 2. Staff #6?s start date was 2/24/22. There was no record of first aid certification on file. 3. Staff #9 confirmed that neither staff member had completed first aid certification within 90 days of employment.”

8VAC20-780-240-E

“Based on review of records and interviews, the center failed to ensure that each employee had orientation training in first aid and cardiopulmonary resuscitation (CPR) within 30 days of employment. Evidence: 1. Staff #6?s first day of employment was 2/24/22. There was no record of CPR or First Aid orientation on file. 2. Staff #7?s first day of employment was 1/21/22.There was no record of CPR or First Aid orientation on file. 3. Staff #9 confirmed that neither staff member had orientation in CPR or First Aid within the first 30 days of employment.”

22.1-289.035-B-4

“The center failed to complete an out-of-state abuse and neglect registry check within 30 days of employment. Evidence: 1. Staff #1?s start date was 3/24/22. Staff #1 indicated on the sworn statement that they had resided in another state within the past 5 years. 2. Staff #9 confirmed that the out-of-state background check was sent and that it had not been sent within 30 days of employment.”

8VAC20-780-260-B

“Based on interviews, the center failed to provide annual approval from the health department. Evidence: 1. The date of the center’s last health inspection was 1/31/21. 2. Staff #9 confirmed that a health inspection had not been completed since 1/31/21.”

8VAC20-770-60-C-2

“Based on review of records and interviews, the center failed to ensure that all staff members had central registry results on file by the end of the 30th day of employment. 1. Staff #1?s first day of employment was 3/24/2022. A completed central check was not in the staff member’s file. 2. Staff #9 confirmed that the center did not have central registry results on file for Staff #1.”

8VAC20-780-530-A-2

“Based on review of records and interviews, the center failed to ensure that there was at least one staff member in each classroom that had current certification in first aid. Evidence: 1. In Classroom #1, Staff #3 and #6 were present. Neither had current first aid certification on file. Staff #9 confirmed that neither staff member had current first aid certification. 2. In Classroom #7, Staff #7 and #8 were present. Neither had current first aid certification on file. Staff #9 confirmed that neither staff member had current first aid certification.”

8VAC20-780-450-A

“Based on observation and interviews, the center failed to ensure that children had a top and bottom over on their cots. Evidence: 1. In Classroom #1, two children were observed having only a top cover on their cots. 2. Staff #4 confirmed the children did not have a bottom cover on their cot.”

8VAC20-780-530-A-1

“Based on review of records and interviews, the center failed to ensure that there was at least one staff member in each classroom that had current certification in cardiopulmonary resuscitation (CPR). Evidence: 1. In Classroom #1, Staff #3 and #6 were present. The records for these staff did not contain documentation to show that either of the staff had ever been certified in CPR. Staff # 9 confirmed that neither staff member had current CPR certification. 2. In Classroom #7, Staff #7 and #8 were present. The records for these staff did not contain documentation to show that either of the staff had ever been certified in CPR. Staff # 9 confirmed that neither staff member had current CPR certification.”

8VAC20-780-160-A

“Based on review of records and interviews, the center failed to ensure that each staff member completed a tuberculosis screening within 30 days prior to employment. Evidence: 1. Staff #3?s start date was 7/21/22. Staff #3?s TB screen was dated 4/27/22. 2. Staff #9 confirmed that Staff #3?s TB screen was completed more than 30 days prior to hire.”

8VAC20-780-40-J

“Based on interviews and review of records, the center failed to ensure that the injury prevention plan was updated at least annually. Evidence: 1. The date of the last update of the injury prevention plan was 7/21/21. 2. Staff #9 confirmed that the injury prevention plan had not been updated since 7/21/21”

8VAC20-780-240-A

“Based on review of records and interviews, the center failed to ensure that each staff member completed the Virginia Department of Education sponsored orientation with 90 calendar days of employment. Evidence: 1. Staff #5?s start date was 2/22/22. There was no documentation that the staff member had completed the Virginia Department of Education sponsored orientation. 2. Staff #9 confirmed that the staff member had not completed the Virginia Department of Education sponsored orientation within 90 days of employment.”

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

“Based on observation, the center failed to ensure that all personal items were individually labeled with the child's name. Evidence: 1. In classroom #3, there was one cup in the refrigerator not labeled with the child's name. 2. In classroom #4, there were eight cups in the refrigerator not labeled with the children's names. 3. Staff verified that the cups were not label with the children's names.”

8VAC20-780-450-A Complaint related: Yes

“Based on observations, the center failed to ensure all children had a top and bottom cover on their cots. Evidence: 1. In Classroom #1, there was one child who did not have a bottom cover. 2. In Classroom #2, 4 children did not have a bottom cover. 3. Staff verified that the children only had one covering and there were no extra linens available.”

8VAC20-780-570-E Complaint related: No

“Based on observation, the center failed to ensure infant formula was dated and label with the child's name. Evidence: 1. In classroom #3, there was 1 bottle not dated and one bottle not dated or label with the child's name. 2. Staff confirmed that the bottles were not dated or labeled with the child's name.”

8VAC20-780-260-B

“Based record review and discussion with the director, the center did not obtain an updated health inspection within a year of the most recent one. Evidence: 1. The most recent health inspection was dated 01/13/2021. 2. The director confirmed the last health inspection was completed on 01/13/2021.”

8VAC20-780-140-A

“Based on review of three children's records and verification from the director, the center did not obtain the results of a physical examination for one child within one month of enrollment. Evidence: 1. The record for Child #2 contained the results of a physical examination dated 02/24/2022. Date of enrollment for Child #2 was 08/30/2021. 2, The director confirmed that a physical exam report was not obtained within a month of enrollment.”

8VAC20-780-260-B

“Based record review and discussion with the director, the center did not obtain an updated health inspection within a year of the most recent one. Evidence: 1. The most recent health inspection was dated 01/13/2021. 2. The director confirmed the last health inspection was completed on 01/13/2021.”

8VAC20-780-140-A

“Based on review of three children's records and verification from the director, the center did not obtain the results of a physical examination for one child within one month of enrollment. Evidence: 1. The record for Child #2 contained the results of a physical examination dated 02/24/2022. Date of enrollment for Child #2 was 08/30/2021. 2, The director confirmed that a physical exam report was not obtained within a month of enrollment.”

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

“Based on observation and confirmation with staff, in one classroom a staff member was supervising children by herself and she did not meet the qualifications to be a program leader. Evidence: 1. Staff #5 was supervising four children in Classroom A all by herself and she did not meet the qualifications to be a program lead. 2. Staff #2 confirmed that the job title for Staff #5 was an assistant and that she did not meet program lead qualifications.”