Connections Child Care & Learning Center

8VAC20-780-500-B

“Based on observation, the center failed to ensure that all diapering standards. Evidence: The diaper changing pad in the toddler room had several tears. The tears make the changing pad no longer nonabsorbent.”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that children washed their hands before and after eating a meal or snack. Evidence: Three groupings of children were observed eating lunch without washing hands prior to eating lunch.”

8VAC20-780-560-L

“Based on observation, the center failed to ensure that staff sat with children during meal times. Evidence: Staff did not sit with the children while eating lunch.”

8VAC20-780-550-E

“Based on record review and interviews, the center failed to ensure that all shelter in place drills were practiced a minimum of twice a year. Evidence: The center did not have documentation of two shelter in place drill for 2023.”

8VAC20-780-560-M

“Based on observation, the center failed to ensure that all children did not drink or eat while walking around. Evidence: Observed one toddler walking from lunch to the classroom drinking from the bottle.”

8VAC20-780-510-L

“Based on observation, the center failed to ensure that all medications were locked. Evidence: On the shelf in the child # 1 basket was an opened tube of prescription diaper cream that was unlocked.”

8VAC20-780-60-A

“REPEAT VIOLATION Based on record review, the center failed to ensure that the separate record for each enrolled child shall contain all the elements as required by the standards. Evidence: 1. The record for Child # 3 did not include the following information: previous childcare and schools. 2. The record for Child #5 did not include the following information: place of employment’s contact number, the , chronic physical problems, allergies and action to be taken, and previous schools attended.”

8VAC20-780-70

“Based on review of three staff records, the center failed to ensure that all records were complete per the standard. Evidence: Staff # 2 and 4 did not have at the center, about any health problems that may interfere with fulfilling the job responsibilities.”

8VAC20-780-210-A

“Based on review of staff’s records, the center failed to ensure that all program leaders had the required education and experience. Evidence: 1.Staff # 1 was hired on 11/21/22 as a program leader and did not meet one of the program leader qualifications.”

8VAC20-780-510-N

“Based on interviews, the center failed to ensure that all medications administered to children was documented on a medication log. Evidence: Staff # 1 stated that child # 5 had the prescription diaper cream administered at least twice and not documented on a medication log.”

8VAC20-780-520-A

“Based on review of nonprescription medication and topicals, the center failed to ensure that all nonprescription medication and topicals were not kept or used beyond the expiration date. Evidence: 1. There were three diaper ointments/creams and one Sunscreen in the toddler room that had expired. The Aquaphor ointment expired on 5/23, Boudreaux expired on 6/23, the Destin expired on 7/23 and the sunscreen expired on 11/22.”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that each child washed their hands after toileting. Evidence: Staff was observed changing an infant’s diaper and the infant’s hands were not washed after the diapering.”

8VAC20-780-130-A

“Based on review of five children’s records, the center failed to ensure that all children had the immunization record prior to beginning attendance. Evidence: The record for Child # 5, with documented first day of attendance of 01/12/2023, did not have the immunization prior to attending. There was no documentation on the day of the inspection of an immunization record in the child’s file.”

8VAC20-780-350-B-1

“Based on observation, the center failed to ensure that the ratio for infants was met. Evidence: Upon arrival at approximately 11:45 AM, the infant room had 9 children with two staff members. The youngest child was 4 months of age. Stated by staff # 1 the nineth child arrived at 9:45 AM. The required ratio is 4 children to 1 staff person. Three staff members were required for the room.”

8VAC20-780-510-L

“Based on observation, the center failed to ensure that all medications were locked. Evidence: On the shelf in the child # 1 basket was an opened tube of prescription diaper cream that was unlocked.”

8VAC20-780-60-A

“REPEAT VIOLATION Based on record review, the center failed to ensure that the separate record for each enrolled child shall contain all the elements as required by the standards. Evidence: 1. The record for Child # 3 did not include the following information: previous childcare and schools. 2. The record for Child #5 did not include the following information: place of employment’s contact number, the , chronic physical problems, allergies and action to be taken, and previous schools attended.”

8VAC20-780-70

“Based on review of three staff records, the center failed to ensure that all records were complete per the standard. Evidence: Staff # 2 and 4 did not have at the center, about any health problems that may interfere with fulfilling the job responsibilities.”

8VAC20-780-210-A

“Based on review of staff’s records, the center failed to ensure that all program leaders had the required education and experience. Evidence: 1.Staff # 1 was hired on 11/21/22 as a program leader and did not meet one of the program leader qualifications.”

8VAC20-780-510-N

“Based on interviews, the center failed to ensure that all medications administered to children was documented on a medication log. Evidence: Staff # 1 stated that child # 5 had the prescription diaper cream administered at least twice and not documented on a medication log.”

8VAC20-780-520-A

“Based on review of nonprescription medication and topicals, the center failed to ensure that all nonprescription medication and topicals were not kept or used beyond the expiration date. Evidence: 1. There were three diaper ointments/creams and one Sunscreen in the toddler room that had expired. The Aquaphor ointment expired on 5/23, Boudreaux expired on 6/23, the Destin expired on 7/23 and the sunscreen expired on 11/22.”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that each child washed their hands after toileting. Evidence: Staff was observed changing an infant’s diaper and the infant’s hands were not washed after the diapering.”

8VAC20-780-130-A

“Based on review of five children’s records, the center failed to ensure that all children had the immunization record prior to beginning attendance. Evidence: The record for Child # 5, with documented first day of attendance of 01/12/2023, did not have the immunization prior to attending. There was no documentation on the day of the inspection of an immunization record in the child’s file.”

8VAC20-780-350-B-1

“Based on observation, the center failed to ensure that the ratio for infants was met. Evidence: Upon arrival at approximately 11:45 AM, the infant room had 9 children with two staff members. The youngest child was 4 months of age. Stated by staff # 1 the nineth child arrived at 9:45 AM. The required ratio is 4 children to 1 staff person. Three staff members were required for the room.”

8VAC20-780-60-A

“REPEAT VIOLATION Based on review of five children’s records, the center failed to ensure that all records were complete per the standard. Evidence: 1.The record for Child # 1 was missing the address for one of the two emergency contacts. The enrollment date of child # 1 was 01/03/2023. 2. The record for Child # 2 was missing documentation of allergies and action to take. The enrollment date was 10/25/2022. 3. Children # 4 did not have the DOB for the child, sex of the child, both parent’s work information, Physician’s contact information, addresses for the two required emergency contacts, chronic physical problems an allergies and action to take and previous childcare or school. The enrollment date was 01/03/2023. 4. Children # 5 did not have both parent’s work information, addresses for the two required emergency contacts, chronic physical problems an allergies and action to take and previous child care or school. The enrollment date was 12/7/2022.”

8VAC20-780-510-P

“Based on review of medications and authorizations, the center failed to ensure that all medications were returned to the parent or guardian within 14 days after the authorization expired or disposed of by the center. Evidence: Medication authorization for Child # 2 expired 14 days after 11/7/2022. As of 04/03/2023, the medication had not been returned to the parent or disposed of by the center.”

8VAC20-780-150-B

“Based on review of five children’s records, the center failed to ensure that all immunizations were signed by a physician or a physician’s designee. Evidence: Children # 2, 4 and 5 did not have a physician signature or designee on the immunization record.”

8VAC20-780-520-A

“Based on observation of the nonprescription drugs, the center failed to ensure that all nonprescription drugs are used in accordance with the manufacturer’s recommendations. Evidence: Child # 2 that was 12 months old had non-prescription Infant pain reliever at the center and was administered to the child on 11/17/2022, and 02/20/2023. The manufacturer’s recommendation is for children under the age of 2 years to consult a physician to administer.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that all chemicals were locked using a safe locking method that prevents access by children. Evidence: In a basket in the infant room, there was a container of cleaning chemical behind the diapering area. The chemicals were not in a locking mechanism that would prevent entry. There was a gate that was approximately 2 1/2 feet high around the diapering area. The chemicals were still accessible to staff and was not locked in a way that would prevent entry.”

8VAC20-780-60-A

“REPEAT VIOLATION Based on review of five children’s records, the center failed to ensure that all records were complete per the standard. Evidence: 1.The record for Child # 1 was missing the address for one of the two emergency contacts. The enrollment date of child # 1 was 01/03/2023. 2. The record for Child # 2 was missing documentation of allergies and action to take. The enrollment date was 10/25/2022. 3. Children # 4 did not have the DOB for the child, sex of the child, both parent’s work information, Physician’s contact information, addresses for the two required emergency contacts, chronic physical problems an allergies and action to take and previous childcare or school. The enrollment date was 01/03/2023. 4. Children # 5 did not have both parent’s work information, addresses for the two required emergency contacts, chronic physical problems an allergies and action to take and previous child care or school. The enrollment date was 12/7/2022.”

8VAC20-780-510-P

“Based on review of medications and authorizations, the center failed to ensure that all medications were returned to the parent or guardian within 14 days after the authorization expired or disposed of by the center. Evidence: Medication authorization for Child # 2 expired 14 days after 11/7/2022. As of 04/03/2023, the medication had not been returned to the parent or disposed of by the center.”

8VAC20-780-150-B

“Based on review of five children’s records, the center failed to ensure that all immunizations were signed by a physician or a physician’s designee. Evidence: Children # 2, 4 and 5 did not have a physician signature or designee on the immunization record.”

8VAC20-780-520-A

“Based on observation of the nonprescription drugs, the center failed to ensure that all nonprescription drugs are used in accordance with the manufacturer’s recommendations. Evidence: Child # 2 that was 12 months old had non-prescription Infant pain reliever at the center and was administered to the child on 11/17/2022, and 02/20/2023. The manufacturer’s recommendation is for children under the age of 2 years to consult a physician to administer.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that all chemicals were locked using a safe locking method that prevents access by children. Evidence: In a basket in the infant room, there was a container of cleaning chemical behind the diapering area. The chemicals were not in a locking mechanism that would prevent entry. There was a gate that was approximately 2 1/2 feet high around the diapering area. The chemicals were still accessible to staff and was not locked in a way that would prevent entry.”

8VAC20-780-570-E

“Based on observation of the infant room, the center failed to ensure that all bottles were dated. Evidence: There were three bottles two sitting on the counter and one in the refrigerator that were not dated with today’s date.”

8VAC20-780-570-H

“Based on observation of the refrigerator the center failed to prepared baby food no consumed during that feeding by an infant may be used by that same infant later in the same day; provided that the food is not served out of the baby jar and is dated and stored in the refrigerator. Evidence: 1. There was a baby food jar of Harvest Turkey Dinner in the refrigerator with no name and no date. The jar was previously opened and partly consumed. 2. Staff was not able to confirm the owner of the baby food jar.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that the separate record for each enrolled child shall contain all the elements as required by the standards. Evidence: 1. The record for Child # 1 did not include the following information: the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached (Only one person was documented in the record and did not provide an address). Previous Childcare and other programs attending and chronic physical problems and allergies were not documented. 2. The record for Child #2 did not include the following information: address, work information for both parents, the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached (there was not an address or phone number provided for both designated people). Previous Childcare and other programs attending, Chronic physical problems and allergies were not documented.”

8VAC20-780-570-E

“Based on observation of the infant room, the center failed to ensure that all bottles were dated. Evidence: There were three bottles two sitting on the counter and one in the refrigerator that were not dated with today’s date.”

8VAC20-780-570-H

“Based on observation of the refrigerator the center failed to prepared baby food no consumed during that feeding by an infant may be used by that same infant later in the same day; provided that the food is not served out of the baby jar and is dated and stored in the refrigerator. Evidence: 1. There was a baby food jar of Harvest Turkey Dinner in the refrigerator with no name and no date. The jar was previously opened and partly consumed. 2. Staff was not able to confirm the owner of the baby food jar.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that the separate record for each enrolled child shall contain all the elements as required by the standards. Evidence: 1. The record for Child # 1 did not include the following information: the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached (Only one person was documented in the record and did not provide an address). Previous Childcare and other programs attending and chronic physical problems and allergies were not documented. 2. The record for Child #2 did not include the following information: address, work information for both parents, the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached (there was not an address or phone number provided for both designated people). Previous Childcare and other programs attending, Chronic physical problems and allergies were not documented.”