Clover Hill Children's Center

8VAC20-780-160-C

“Repeat Violation A tuberculosis (TB) screening is required every two years from the last screening. The initial screening for staff #5 was completed on 08/11/2022 and the follow up screening was completed on 09/11/2024.”

8VAC20-780-160-A

“Repeat Violation Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. 1. The screening for staff #1 was completed 4 days after employment. 2. The screening for staff #2 has not been completed. Staff #2 has been employed for 3 weeks. 3. The screening for staff #3 was completed 3 weeks after employment. 4. The screening for staff #4 was completed 2 days after employment.”

8VAC20-780-270-A

“The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition. There were two high chairs in the infant room that had the legs removed. The seat portion of the high chairs were bolted to a piece of wood that was attached to the wall. The high chairs were not being used in a safe or the original operable condition.”

8VAC20-780-430-L

“Infant walkers shall not be used. The infant room has an infant walker that is used.”

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. The record for child #7, enrolled for 2 months, was missing the required components. The name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached is required. The record had one designated contact listed.”

8VAC20-780-510-E

“The center is required to have written authorization from the child's physician and parent for long term prescription drugs. Child #5 requires a long term prescription medication. The medication was on site. There was not a written authorization signed by the child's physician and parent giving permission to give the medication.”

8VAC20-780-160-C

“Repeat Violation A tuberculosis (TB) screening is required every two years from the last screening. The initial screening for staff #5 was completed on 08/11/2022 and the follow up screening was completed on 09/11/2024.”

8VAC20-780-160-A

“Repeat Violation Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. 1. The screening for staff #1 was completed 4 days after employment. 2. The screening for staff #2 has not been completed. Staff #2 has been employed for 3 weeks. 3. The screening for staff #3 was completed 3 weeks after employment. 4. The screening for staff #4 was completed 2 days after employment.”

8VAC20-780-270-A

“The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition. There were two high chairs in the infant room that had the legs removed. The seat portion of the high chairs were bolted to a piece of wood that was attached to the wall. The high chairs were not being used in a safe or the original operable condition.”

8VAC20-780-430-L

“Infant walkers shall not be used. The infant room has an infant walker that is used.”

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. The record for child #7, enrolled for 2 months, was missing the required components. The name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached is required. The record had one designated contact listed.”

8VAC20-780-510-E

“The center is required to have written authorization from the child's physician and parent for long term prescription drugs. Child #5 requires a long term prescription medication. The medication was on site. There was not a written authorization signed by the child's physician and parent giving permission to give the medication.”

22.1-289.035-A

“Based on record review, and interview, the center failed to obtain a criminal background fingerprint check every five years. Evidence: The record for staff #4, date of employment 01/12/2012, contained a criminal background fingerprint check dated 06/06/2018. A criminal background fingerprint check was due on or before 06/06/2023. Administration confirmed that a criminal background fingerprint check was not conducted for staff #4 on or before 06/06/2023.”

22.1-289.035-A

“Based on record review, and interview, the center failed to obtain a criminal background fingerprint check every five years. Evidence: The record for staff #4, date of employment 01/12/2012, contained a criminal background fingerprint check dated 06/06/2018. A criminal background fingerprint check was due on or before 06/06/2023. Administration confirmed that a criminal background fingerprint check was not conducted for staff #4 on or before 06/06/2023.”

8VAC20-790-600-F

“Based on record review, the center failed to ensure that staff who work directly with children shall annually attend the department's health and safety update course. Evidence: The record for staff #5, date of employment 12/12/22, contained an annual health and safety update course dated 07/14/2022. The updated course was due on 07/14/2023.”

8VAC20-780-340-A

“Based on interviews, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, and staff #7 revealed that on November 15th child #1, age 15 months, was found alone outside of the playground gate. 2. Child # 1 was found standing by the playground gate attempting to push the gate open by staff #5 and staff #6 as they pulled into the parking lot on the school bus. 3. Staff #1, staff #2, and staff #3 were on the playground for approximately 10 minutes with 12 children ages 12 months through 24 months. Staff #1, staff #2, and staff #3 transitioned the class inside the classroom from the playground. 4. Child #1 was alone outside of the playground gate for approximately 3 minutes. 5. The center is located next to a street and shares a parking lot with other businesses.”

8VAC20-780-40-E

“Based on interviews, the center failed to follow the center's own policies and procedures. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, staff #7, and administration revealed that on November 15th child #1, age 15 months, was found outside of the playground gate alone. 2. Interviews with staff # 1, staff #2, and staff #3 revealed that the center playground policy was not followed when the class transitioned from the playground into the classroom. Staff #1, staff #2, and staff #3 did not conduct a headcount when they entered the classroom with the children and did not discover that child #1 was missing until staff #5 brought the child to the classroom approximately 3 minutes later. 3. The center's playground policy states "to go inside line the children up at building door, count, make sure # is correct, check off as children walk into the building. Keep the door open until all children have entered the building and all names are checked off...Never close the exit door until you have All the children!"”

8VAC20-780-160-C

“Based on record review, the center failed to ensure staff obtain and submit the results of a follow-up tuberculosis screening at least every two years from the date of the first initial screening or testing. Evidence: The record for staff #2, date of employment 09/14/2021, contained an initial tuberculosis screening dated 04/03/2021 and a follow-up tuberculosis screening dated 10/18/2023. The follow-up screening was due on or before 04/03/2023.”

8VAC20-780-160-A

“Repeat Violation Based on records review, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff #1, date of employment 03/14/2023, contained a tuberculosis screening dated 08/09/2022. The tuberculosis screening was conducted more than 30 days prior to the date of employment. 2. The record for staff #3, date of employment 01/31/2023, contained a tuberculosis screening dated 12/23/22. The tuberculosis screening was conducted more than 30 days prior to the date of employment. 3. The record for staff #5, date of employment 12/12/2022, contained a tuberculosis screening dated 06/17/2022. The tuberculosis screening was conducted more than 30 days prior to the date of employment.”

8VAC20-780-340-F

“Based on interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, and staff #7 revealed that on November 15th child #1, age 15 months, was found alone outside of the playground gate. 2. Child # 1 was found standing by the playground gate attempting to push the gate open by staff #5 and staff #6 as they pulled into the parking lot on the school bus. 3. Staff #1, staff #2, and staff #3 were on the playground for approximately 10 minutes with 12 children ages 12 months through 24 months. Staff #1, staff #2, and staff #3 transitioned the class inside the classroom from the playground. 4. Child #1 was alone outside of the playground gate for approximately 3 minutes.”

8VAC20-790-600-F

“Based on record review, the center failed to ensure that staff who work directly with children shall annually attend the department's health and safety update course. Evidence: The record for staff #5, date of employment 12/12/22, contained an annual health and safety update course dated 07/14/2022. The updated course was due on 07/14/2023.”

8VAC20-780-340-A

“Based on interviews, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, and staff #7 revealed that on November 15th child #1, age 15 months, was found alone outside of the playground gate. 2. Child # 1 was found standing by the playground gate attempting to push the gate open by staff #5 and staff #6 as they pulled into the parking lot on the school bus. 3. Staff #1, staff #2, and staff #3 were on the playground for approximately 10 minutes with 12 children ages 12 months through 24 months. Staff #1, staff #2, and staff #3 transitioned the class inside the classroom from the playground. 4. Child #1 was alone outside of the playground gate for approximately 3 minutes. 5. The center is located next to a street and shares a parking lot with other businesses.”

8VAC20-780-40-E

“Based on interviews, the center failed to follow the center's own policies and procedures. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, staff #7, and administration revealed that on November 15th child #1, age 15 months, was found outside of the playground gate alone. 2. Interviews with staff # 1, staff #2, and staff #3 revealed that the center playground policy was not followed when the class transitioned from the playground into the classroom. Staff #1, staff #2, and staff #3 did not conduct a headcount when they entered the classroom with the children and did not discover that child #1 was missing until staff #5 brought the child to the classroom approximately 3 minutes later. 3. The center's playground policy states "to go inside line the children up at building door, count, make sure # is correct, check off as children walk into the building. Keep the door open until all children have entered the building and all names are checked off...Never close the exit door until you have All the children!"”

8VAC20-780-160-C

“Based on record review, the center failed to ensure staff obtain and submit the results of a follow-up tuberculosis screening at least every two years from the date of the first initial screening or testing. Evidence: The record for staff #2, date of employment 09/14/2021, contained an initial tuberculosis screening dated 04/03/2021 and a follow-up tuberculosis screening dated 10/18/2023. The follow-up screening was due on or before 04/03/2023.”

8VAC20-780-160-A

“Repeat Violation Based on records review, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff #1, date of employment 03/14/2023, contained a tuberculosis screening dated 08/09/2022. The tuberculosis screening was conducted more than 30 days prior to the date of employment. 2. The record for staff #3, date of employment 01/31/2023, contained a tuberculosis screening dated 12/23/22. The tuberculosis screening was conducted more than 30 days prior to the date of employment. 3. The record for staff #5, date of employment 12/12/2022, contained a tuberculosis screening dated 06/17/2022. The tuberculosis screening was conducted more than 30 days prior to the date of employment.”

8VAC20-780-340-F

“Based on interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. Interviews with staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, and staff #7 revealed that on November 15th child #1, age 15 months, was found alone outside of the playground gate. 2. Child # 1 was found standing by the playground gate attempting to push the gate open by staff #5 and staff #6 as they pulled into the parking lot on the school bus. 3. Staff #1, staff #2, and staff #3 were on the playground for approximately 10 minutes with 12 children ages 12 months through 24 months. Staff #1, staff #2, and staff #3 transitioned the class inside the classroom from the playground. 4. Child #1 was alone outside of the playground gate for approximately 3 minutes.”

8VAC20-770-60-C-2

“Based on record review, the center failed to ensure that the results of a central registry finding are received within 30 days of employment. Evidence: The record for staff #1, date of employment 07/25/2023, did not contain the results of a central registry finding. Staff #1 was observed working at the center.”

22.1-289.035-A

“Based on record review, the center failed to ensure that each staff shall undergo a criminal background check every five years. Evidence: The record for staff #6, date of employment 11/28/05, contained a criminal background check dated 06/18/18. A repeat criminal background check was due on or before 06/18/2023.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member shall submit documentation of negative tuberculosis screening at the time of employment and no more than 30 days prior to the time of employment. Evidence: 1. The record for staff #1, date of employment 07/25/2023, contained documentation of a tuberculosis screening dated 01/05/2023. 2. The record for staff #2, date of employment, 05/03/2023, contained documentation of a tuberculosis screening dated 05/08/2023.”

8VAC20-770-60-C-2

“Based on record review, the center failed to ensure that the results of a central registry finding are received within 30 days of employment. Evidence: The record for staff #1, date of employment 07/25/2023, did not contain the results of a central registry finding. Staff #1 was observed working at the center.”

22.1-289.035-A

“Based on record review, the center failed to ensure that each staff shall undergo a criminal background check every five years. Evidence: The record for staff #6, date of employment 11/28/05, contained a criminal background check dated 06/18/18. A repeat criminal background check was due on or before 06/18/2023.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member shall submit documentation of negative tuberculosis screening at the time of employment and no more than 30 days prior to the time of employment. Evidence: 1. The record for staff #1, date of employment 07/25/2023, contained documentation of a tuberculosis screening dated 01/05/2023. 2. The record for staff #2, date of employment, 05/03/2023, contained documentation of a tuberculosis screening dated 05/08/2023.”

8VAC20-770-60-C-2

“Based on record review, the center failed to ensure that the results of a central registry finding are received within 30 days of employment. Evidence: The record for staff #1, date of employment 07/25/2023, did not contain the results of a central registry finding. Staff #1 was observed working at the center.”

22.1-289.035-A

“Based on record review, the center failed to ensure that each staff shall undergo a criminal background check every five years. Evidence: The record for staff #6, date of employment 11/28/05, contained a criminal background check dated 06/18/18. A repeat criminal background check was due on or before 06/18/2023.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member shall submit documentation of negative tuberculosis screening at the time of employment and no more than 30 days prior to the time of employment. Evidence: 1. The record for staff #1, date of employment 07/25/2023, contained documentation of a tuberculosis screening dated 01/05/2023. 2. The record for staff #2, date of employment, 05/03/2023, contained documentation of a tuberculosis screening dated 05/08/2023.”

8VAC20-780-400-A

“Based on interview, and review of video footage, the center failed to ensure that in order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort, and support. Evidence: 1. Interviews and video footage revealed that staff #1, date of employment 2/11/22, yelled at child #1, age 4 years, to get off of the cot after nap time was over. Staff #1 was observed to pick child #1 up off of the cot under the arms and place child #1 on the floor causing child #1 to start crying. Staff #1 did not try to comfort the child or redirect the child.”

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

“Based on record review, and interview, the center failed to ensure that staff complete a Sworn Statement on or before the first day of employment. Evidence: 1) The record for staff #1, date of employment 11/28/22, did not contain a Sworn Statement. 2) The Assistant Director acknowledged that the record for staff #1 did not contain a Sworn Statement.”

8VAC20-780-560-P Complaint related: Yes

“Based on observation, interview and review of video footage, the center failed to ensure that a child with a diagnosed food allergy shall not be served any food identified in the written care plan. Evidence: 1) Child #1 is on the center's list of children's allergies, sensitivities, and dietary restrictions as allergic to milk. 2) Review of video footage confirmed that child #1, age 3 years, was served and consumed ice cream on 06/16/2023. 3) The Assistant Director confirmed that Child #1 was served and consumed ice cream on 06/16/2023.”

8VAC20-780-60-A-8 Complaint related: Yes

“Based on record review, and interviews, the center failed to have a written care plan for each child, with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 1) The record for child #1, age 3 years, did not contain a written allergy care plan. 2) Interview with the Assistant Director confirmed that the record for child #1 did not contain a written allergy care plan.”

8VAC20-780-40-M Complaint related: Yes

“Based on documentation review, and interview, the center failed to maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions that is dated and kept confidential. Evidence: When asked to view the allergy list that was posted in the classroom, the date was confirmed as 10/13/22. Child #1, age 3 years, was listed as assigned to a different classroom then the child is currently assigned in.”

8VAC20-780-400-A

“Based on interview, and review of video footage, the center failed to ensure that in order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort, and support. Evidence: 1. Interviews and video footage revealed that staff #1, date of employment 2/11/22, yelled at child #1, age 4 years, to get off of the cot after nap time was over. Staff #1 was observed to pick child #1 up off of the cot under the arms and place child #1 on the floor causing child #1 to start crying. Staff #1 did not try to comfort the child or redirect the child.”

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

“Based on record review, and interview, the center failed to ensure that staff complete a Sworn Statement on or before the first day of employment. Evidence: 1) The record for staff #1, date of employment 11/28/22, did not contain a Sworn Statement. 2) The Assistant Director acknowledged that the record for staff #1 did not contain a Sworn Statement.”

8VAC20-780-560-P Complaint related: Yes

“Based on observation, interview and review of video footage, the center failed to ensure that a child with a diagnosed food allergy shall not be served any food identified in the written care plan. Evidence: 1) Child #1 is on the center's list of children's allergies, sensitivities, and dietary restrictions as allergic to milk. 2) Review of video footage confirmed that child #1, age 3 years, was served and consumed ice cream on 06/16/2023. 3) The Assistant Director confirmed that Child #1 was served and consumed ice cream on 06/16/2023.”

8VAC20-780-60-A-8 Complaint related: Yes

“Based on record review, and interviews, the center failed to have a written care plan for each child, with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 1) The record for child #1, age 3 years, did not contain a written allergy care plan. 2) Interview with the Assistant Director confirmed that the record for child #1 did not contain a written allergy care plan.”

8VAC20-780-40-M Complaint related: Yes

“Based on documentation review, and interview, the center failed to maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions that is dated and kept confidential. Evidence: When asked to view the allergy list that was posted in the classroom, the date was confirmed as 10/13/22. Child #1, age 3 years, was listed as assigned to a different classroom then the child is currently assigned in.”

8VAC20-780-400-A

“Based on interview, and review of video footage, the center failed to ensure that in order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort, and support. Evidence: 1. Interviews and video footage revealed that staff #1, date of employment 2/11/22, yelled at child #1, age 4 years, to get off of the cot after nap time was over. Staff #1 was observed to pick child #1 up off of the cot under the arms and place child #1 on the floor causing child #1 to start crying. Staff #1 did not try to comfort the child or redirect the child.”

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

“Based on record review, and interview, the center failed to ensure that staff complete a Sworn Statement on or before the first day of employment. Evidence: 1) The record for staff #1, date of employment 11/28/22, did not contain a Sworn Statement. 2) The Assistant Director acknowledged that the record for staff #1 did not contain a Sworn Statement.”

8VAC20-780-560-P Complaint related: Yes

“Based on observation, interview and review of video footage, the center failed to ensure that a child with a diagnosed food allergy shall not be served any food identified in the written care plan. Evidence: 1) Child #1 is on the center's list of children's allergies, sensitivities, and dietary restrictions as allergic to milk. 2) Review of video footage confirmed that child #1, age 3 years, was served and consumed ice cream on 06/16/2023. 3) The Assistant Director confirmed that Child #1 was served and consumed ice cream on 06/16/2023.”

8VAC20-780-60-A-8 Complaint related: Yes

“Based on record review, and interviews, the center failed to have a written care plan for each child, with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 1) The record for child #1, age 3 years, did not contain a written allergy care plan. 2) Interview with the Assistant Director confirmed that the record for child #1 did not contain a written allergy care plan.”

8VAC20-780-40-M Complaint related: Yes

“Based on documentation review, and interview, the center failed to maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions that is dated and kept confidential. Evidence: When asked to view the allergy list that was posted in the classroom, the date was confirmed as 10/13/22. Child #1, age 3 years, was listed as assigned to a different classroom then the child is currently assigned in.”

8VAC20-780-330-A

“Based on observation, the center did not ensure that the playground was located and designed to protect children from hazards. Evidence: The playground contains a 3 ft x 3 ft x 3 ft box labeled ?Caution. Keep off. Keep out!? There is not a fence surrounding the box and the children have direct access to it.”

8VAC20-780-330-B

“Based on observation, the center did not ensure to comply with minimum safety standards for resilient surfacing underneath and surrounding equipment. Evidence: There was less than ? an inch of pea gravel in some areas and no pea gravel in other areas directly underneath and surrounding the climbing structures on the playground.”

8VAC20-780-330-A

“Based on observation, the center did not ensure that the playground was located and designed to protect children from hazards. Evidence: The playground contains a 3 ft x 3 ft x 3 ft box labeled ?Caution. Keep off. Keep out!? There is not a fence surrounding the box and the children have direct access to it.”

8VAC20-780-330-B

“Based on observation, the center did not ensure to comply with minimum safety standards for resilient surfacing underneath and surrounding equipment. Evidence: There was less than ? an inch of pea gravel in some areas and no pea gravel in other areas directly underneath and surrounding the climbing structures on the playground.”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment or 30 days prior to employment and prior to coming into contact with children. Evidence: 1) The record for staff #1, date of employment 7/13/22, contained documentation of tuberculosis screening dated 6/1/22; the record for staff #5, date of employment 8/22/22, contained documentation of tuberculosis screening dated 9/29/21; the record for staff # 6, date of employment 10/04/22, contained documentation of tuberculosis screening dated, 05/29/22; 2) The record for staff #2, date of employment 7/18/22, contained documentation of tuberculosis screening dated 8/11/22; the record for staff #4, date of employment 7/8/22, contained documentation of tuberculosis screening dated 7/14/22; the record for staff #7, date of employment 8/23/22, contained documentation of tuberculosis screening dated 8/26/22.”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment or 30 days prior to employment and prior to coming into contact with children. Evidence: 1) The record for staff #1, date of employment 7/13/22, contained documentation of tuberculosis screening dated 6/1/22; the record for staff #5, date of employment 8/22/22, contained documentation of tuberculosis screening dated 9/29/21; the record for staff # 6, date of employment 10/04/22, contained documentation of tuberculosis screening dated, 05/29/22; 2) The record for staff #2, date of employment 7/18/22, contained documentation of tuberculosis screening dated 8/11/22; the record for staff #4, date of employment 7/8/22, contained documentation of tuberculosis screening dated 7/14/22; the record for staff #7, date of employment 8/23/22, contained documentation of tuberculosis screening dated 8/26/22.”

8VAC20-770-60-C-2

“Based on a review of staff records and interview on April 6, 2022, the center did not ensure that each staff record reviewed contained a central registry finding within 30 days of employment. Evidence: 1. The record of staff #4 (hired 2/17/22) did not contain documentation of a central registry check. 2. Administration acknowledged the result was not complete.”

22.1-289.035-B-2

“Based on a review of records and interview on April 6, 2022, the center did not ensure to obtain a fingerprint based national criminal record check prior to the first day of employment for each staff. Evidence: 1. The record of staff #4 (hired 2/17/22) contained documentation of fingerprints dated 2/18/22. 2. The record of staff #5 (hired 12/6/21) contained documentation of fingerprints dated 12/7/21. 3. Administration acknowledged the fingerprints were late.”

8VAC20-780-340-D

“Based on a review of staff records and interview on April 6, 2022, the center failed to ensure that there is a qualified program leader regularly present in each grouping of children. Evidence: Staff #4 was identified by administration as the program leader for the 4 year old classroom. Administration reported staff #4 works as the only teacher in the room Monday-Friday from 3-6pm. Administration reported that staff #4 does not have 6 months programmatic experience. The record of staff #4 did not contain documentation to demonstrate that the individual possesses the education, certification, and experience required by the job position. Staff #4 does not meet the qualifications for the position.”

8VAC20-780-260-A

“Based on a review of records and interview, the center did not ensure to obtain an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: The record of the annual fire inspection is dated 1/19/21. Administration acknowledged they did not contact the local fire official until 3/31/22.”

22.1-289.035-B-4

“Based on a review of staff records and interview on April 6, 2022, the center did not obtain results of a check of the out-of-state criminal history record check and out-of-state sex offender registry prior to employment for each employee and did not request an out-of-state search of the child abuse and neglect registry or equivalent by the end of the 30th day of employment for each employee who has resided in any other state in the preceding five years. Evidence: 1. The record of staff #1 (hired 3/9/22) did not contain documentation of an out-of-state criminal history check, sex offender registry check, and central registry check. Staff #1 indicated living in two other states in the previous five years on the staff's sworn disclosure statement. 2. The record of staff #2 (hired 1/25/22) did not contain documentation of an out-of-state criminal history check for two states, a sex offender check and central registry check for two states. Staff #2 indicated living in three other states in the previous five years on the staff's sworn disclosure statement. 3. Administration confirmed the out-of-state background checks were not completed.”

8VAC20-780-70

“Based on a review of staff records and interview on April 6, 2022, the center did not ensure that each staff record contains all required information. Evidence: 1. The record of staff #4 (hired 2/17/22) contained documentation of references that were checked after employment dated 2/21/22. Administration acknowledged they were late. 2. The record of staff #3 (hired 2/11/22) did not contain documentation of 24 hours of program leader training. Administration reported that staff #3 is a program leader and they have not documented the required training in the staff's record.”

8VAC20-780-140-A

“Based on a review of children's records on April 6, 2022, the center did not ensure to obtain documentation of a physical examination by or under the direction of a physician for each child before the child's attendance or within one month after attendance. Evidence: The record of child #3 (enrolled 11/15/21) contained documentation of a physical dated 4/5/22. Administration confirmed it was late.”

8VAC20-770-60-C-2

“Based on a review of staff records and interview on April 6, 2022, the center did not ensure that each staff record reviewed contained a central registry finding within 30 days of employment. Evidence: 1. The record of staff #4 (hired 2/17/22) did not contain documentation of a central registry check. 2. Administration acknowledged the result was not complete.”

22.1-289.035-B-2

“Based on a review of records and interview on April 6, 2022, the center did not ensure to obtain a fingerprint based national criminal record check prior to the first day of employment for each staff. Evidence: 1. The record of staff #4 (hired 2/17/22) contained documentation of fingerprints dated 2/18/22. 2. The record of staff #5 (hired 12/6/21) contained documentation of fingerprints dated 12/7/21. 3. Administration acknowledged the fingerprints were late.”

8VAC20-780-340-D

“Based on a review of staff records and interview on April 6, 2022, the center failed to ensure that there is a qualified program leader regularly present in each grouping of children. Evidence: Staff #4 was identified by administration as the program leader for the 4 year old classroom. Administration reported staff #4 works as the only teacher in the room Monday-Friday from 3-6pm. Administration reported that staff #4 does not have 6 months programmatic experience. The record of staff #4 did not contain documentation to demonstrate that the individual possesses the education, certification, and experience required by the job position. Staff #4 does not meet the qualifications for the position.”

8VAC20-780-260-A

“Based on a review of records and interview, the center did not ensure to obtain an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: The record of the annual fire inspection is dated 1/19/21. Administration acknowledged they did not contact the local fire official until 3/31/22.”

22.1-289.035-B-4

“Based on a review of staff records and interview on April 6, 2022, the center did not obtain results of a check of the out-of-state criminal history record check and out-of-state sex offender registry prior to employment for each employee and did not request an out-of-state search of the child abuse and neglect registry or equivalent by the end of the 30th day of employment for each employee who has resided in any other state in the preceding five years. Evidence: 1. The record of staff #1 (hired 3/9/22) did not contain documentation of an out-of-state criminal history check, sex offender registry check, and central registry check. Staff #1 indicated living in two other states in the previous five years on the staff's sworn disclosure statement. 2. The record of staff #2 (hired 1/25/22) did not contain documentation of an out-of-state criminal history check for two states, a sex offender check and central registry check for two states. Staff #2 indicated living in three other states in the previous five years on the staff's sworn disclosure statement. 3. Administration confirmed the out-of-state background checks were not completed.”

8VAC20-780-70

“Based on a review of staff records and interview on April 6, 2022, the center did not ensure that each staff record contains all required information. Evidence: 1. The record of staff #4 (hired 2/17/22) contained documentation of references that were checked after employment dated 2/21/22. Administration acknowledged they were late. 2. The record of staff #3 (hired 2/11/22) did not contain documentation of 24 hours of program leader training. Administration reported that staff #3 is a program leader and they have not documented the required training in the staff's record.”

8VAC20-780-140-A

“Based on a review of children's records on April 6, 2022, the center did not ensure to obtain documentation of a physical examination by or under the direction of a physician for each child before the child's attendance or within one month after attendance. Evidence: The record of child #3 (enrolled 11/15/21) contained documentation of a physical dated 4/5/22. Administration confirmed it was late.”

22VAC40-665-540-A

“Based on a review of staff records, the vendor did not ensure that each staff submitted documentation of a tuberculosis screening at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days Evidence: The record of Staff #5 (DOH 9/14/21) contained documentation of a tuberculosis screening dated 4/3/21.”

22VAC40-185-70-A

“Based on a review of staff records, the center did not ensure that each staff record contains all required documentation. Evidence: 1. The record of Staff #5 contains a telephone reference check that is not signed. 2. The record of Staff #2 (DOH 9/14/21) contains documentation of a tuberculosis (tb) screening dated 6/23/20. Staff hired prior to October 13, 2021, shall have had a tb screening completed within 12 months prior to employment. 3. Administration acknowledged the reference wasn't signed and the tb was late.”

22VAC40-185-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. The infant room had an unlocked cabinet containing cleaning materials with labels stated "keep out of the reach of children" and "warning." 2. Administration acknowledged the cabinet was not locked.”

22VAC40-185-560-F

“Based on a review of records and interview, the center did not ensure to follow the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: 1. Documentation of the center's menu contains one component of the USDA's two component requirement. 2. Administration acknowledged there was only one approved component being served.”

22VAC40-665-540-A

“Based on a review of staff records, the vendor did not ensure that each staff submitted documentation of a tuberculosis screening at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days Evidence: The record of Staff #5 (DOH 9/14/21) contained documentation of a tuberculosis screening dated 4/3/21.”

22VAC40-185-70-A

“Based on a review of staff records, the center did not ensure that each staff record contains all required documentation. Evidence: 1. The record of Staff #5 contains a telephone reference check that is not signed. 2. The record of Staff #2 (DOH 9/14/21) contains documentation of a tuberculosis (tb) screening dated 6/23/20. Staff hired prior to October 13, 2021, shall have had a tb screening completed within 12 months prior to employment. 3. Administration acknowledged the reference wasn't signed and the tb was late.”

22VAC40-185-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. The infant room had an unlocked cabinet containing cleaning materials with labels stated "keep out of the reach of children" and "warning." 2. Administration acknowledged the cabinet was not locked.”

22VAC40-185-560-F

“Based on a review of records and interview, the center did not ensure to follow the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: 1. Documentation of the center's menu contains one component of the USDA's two component requirement. 2. Administration acknowledged there was only one approved component being served.”