Creative Kids Child Development Center 2

8VAC20-790-600-D-1

“Based record review and staff interviews, the vendor did not ensure staff who work directly with children shall have a current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care and shall include an in-person competency demonstration. Evidence: Staff #2 did not have a current CPR certification as it expired on 4-6-2024.”

8VAC20-790-600-D-2

“Based record review and staff interviews, the vendor did not ensure staff who work directly with children shall have, a current certification in First Aid appropriate to the ages of children in care. Evidence: Staff #2 did not have a current First Aid certification as it expired on 4-6-2024”

8VAC20-780-510-P

“Based on review of documentation and staff interviews, the licensee did not ensure when an authorization for medication expires, the parent shall be notified the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet. Evidence: Child #8 had a medication (Albuterol) and the medication authorization signed by the parent expired on 4-2-24. The medication had not been sent home to the parents or disposed of as required.”

8VAC20-780-550-P

“Repeat Based on center documentation review and staff interviews, the licensee did not ensure the center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence that includes all required information. Evidence: Five injury reports reviewed all were missing some information to include the future action to prevent injury, the date, time and how the parent was notified of the injury.”

8VAC20-780-570-E

“Based on observation and provider interviews, the licensee did not ensure that prepared infant formula shall be refrigerated, dated and labeled with the child's name. Evidence: One bottle was observed, and it was not dated.”

8VAC20-780-500-A

“Repeat Based on observation and staff interviews, the licensee did not ensure to follow handwashing procedures. Evidence: Staff #5 was observed feeding an infant outside on the playground and the infant did not have their hands washed with soap and running water or disposable wipes after eating..”

8VAC20-780-350-B-1

“Repeat Based on documentation review, observations and staff interviews, the licensee did not ensure to follow the required ratio of 1 staff for every 4 infants in care. Evidence: There were 17 infants and toddlers, observed on the playground with only 4 staff members supervising. Center owner, verified the 17th child, Child #1 arrived at approximately 9:48 AM and the 5th staff arrived at approximately 11:50 AM. The center did not meet the ratio of 1 staff to every 4 infants for approximately 2 hours.”

8VAC20-780-510-E

“Based on review of the medication policy and staff interviews, the center did not ensure all required information was in the policy. Evidence: The medication policy did not include the following required component's; 1.Non-prescription medication be consistent with the manufacturer's instructions for age, duration and dosage. 2 Duration of the parent's authorization for medication, provided that it shall expire or be renewed after 10 work days. Long-term prescription drug use and over-the- counter medication may be allowed with written authorization from the child's physician and parent.”

8VAC20-780-500-B

“Repeat Based on observation and staff interviews, the licensee did not ensure the required procedures were followed for diapering. Evidence: 1.Staff #7 was observed conducting a diaper change and the diaper pad was not cleaned nor sanitized as required. After the diaper change, Staff #7 sprayed the diaper pad with a sanitizing solution then immediately wiped it down. Sanitized is defined as sprayed with a disinfectant /sanitizing solution and allowed to air dry or wiped down only after two minutes. The diaper pad was not cleaned with soap and water after the diaper change. 2. During a diaper change Staff #7 did not dispose of the soiled diaper by using foot-operated trashcan or open the trashcan lid in a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Staff #7 lifted the lid of the trash can with her hand and disposed of the soiled diaper.”

8VAC20-780-350-B-1 Complaint related: No

“Based on observation, record review and staff interviews, the licensee did not ensure the staff-to-children ratio one staff for every five children for ages 16 months to 24 months was followed. Evidence: On April 23, 2024 the ratio for the Infant Two room was not met as there were 10 children with 2 staff and the youngest (Child #1) was 13 months old and the ratio of 1 to 4 was not met.”

8VAC20-780-330-B Complaint related: No

“Repeat Based on observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: On the infant playground there was a plastic playground set that only had approximately 2 feet of fall zone behind the equipment and minimum of 6 feet is required”

8VAC20-780-500-A Complaint related: No

“Based on observation and staff interviews, the licensee did not ensure staff wash their hands with soap and running water before preparing or serving food or beverages and that children wash their hands with soap and running water or disposable wipes before and after eating. Evidence: On April 23, 2024, staff was observed serving snack on the playground to preschool children and they did not follow hand washing procedures; 1.Staff #1 did not wash their hands prior to serving preschool children their afternoon snack. 2.Seven preschool children were observed being served and eating snack and they did not wash their hands with soap and running water or use disposable wipes before eating.”

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

“Based on observation and staff interviews, the licensee did not ensure that during the center's hours of operation, one adult on the premises shall be in charge of the administration of the center. Evidence: On March 21, 2024, during inspection the Licensing Inspector confirmed with all center staff there was not a designated person in charge of the center at the time inspection.”

8VAC20-780-560-M Complaint related: No

“Based on observation and staff interviews, the licensee did not ensure that no child shall be allowed to drink or eat while walking around. Evidence: On April 23, 2024 two children from the preschool classroom were observed walking around outside eating their afternoon snack of cheese sticks.”

8VAC20-780-270-A

“Based on observation and staff interviews, the licensee did not ensure areas andequipment of the center, inside and outside,shall be maintained in a clean, safe and operable condition. Evidence: Two protruding nails and a sharp metal square bar were observed on the fence that divides the toddler and preschool playground.”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the required the diaper pad/ surface was cleaned with soap and at least room temperature water and sanitized after each use. Evidence:. Infant staff were observed conducting diaper changes and they did not clean or sanitize the diaper pad in between changing two children.”

8VAC20-780-550-G

“Based on staff interviews and review of documentation, the licensee did not ensure to maintain documentation of monthly emergency evacuation drills. Evidence: Staff #2 confirmed they did not have documentation of evacuation drills conducted in December 2023.”

8VAC20-780-40-J

“Based on center documentation review and staff interview the licensee did not ensure injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services. Evidence: Center Director confirmed they did not have an annual injury prevention plan.”

8VAC20-780-80-A

“Repeat Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 17 children on the preschool playground and the roll/ attendance list only had 13 children listed. There was not a list for the 5 toddlers observed on the toddler playground.”

8VAC20-780-330-B

“Repeat Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: There following was observed on the playground and there was inadequate fall zone and resilient surfacing. 1.There was no approved resilient surfacing for the slide/ swing composite piece on the toddler playground and there was only 2 feet of fall zone in the back of the composite feet and 6 feet is required. 2. The merry- go-round bike set on the preschool playground was within 19 inches of a metal fence and minimum of 6 feet of fall zone is required.”

8VAC20-780-550-P

“Based on center documentation review and staff interviews, the licensee did not ensure the center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence that includes all required information. Evidence: Five out of five injury reports reviewed were missing information to include the date, time and how the parents were notified of the injury.”

8VAC20-780-270-A

“Based on observation and staff interviews, the licensee did not ensure areas andequipment of the center, inside and outside,shall be maintained in a clean, safe and operable condition. Evidence: Two protruding nails and a sharp metal square bar were observed on the fence that divides the toddler and preschool playground.”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the required the diaper pad/ surface was cleaned with soap and at least room temperature water and sanitized after each use. Evidence:. Infant staff were observed conducting diaper changes and they did not clean or sanitize the diaper pad in between changing two children.”

8VAC20-780-550-G

“Based on staff interviews and review of documentation, the licensee did not ensure to maintain documentation of monthly emergency evacuation drills. Evidence: Staff #2 confirmed they did not have documentation of evacuation drills conducted in December 2023.”

8VAC20-780-40-J

“Based on center documentation review and staff interview the licensee did not ensure injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services. Evidence: Center Director confirmed they did not have an annual injury prevention plan.”

8VAC20-780-80-A

“Repeat Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 17 children on the preschool playground and the roll/ attendance list only had 13 children listed. There was not a list for the 5 toddlers observed on the toddler playground.”

8VAC20-780-330-B

“Repeat Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: There following was observed on the playground and there was inadequate fall zone and resilient surfacing. 1.There was no approved resilient surfacing for the slide/ swing composite piece on the toddler playground and there was only 2 feet of fall zone in the back of the composite feet and 6 feet is required. 2. The merry- go-round bike set on the preschool playground was within 19 inches of a metal fence and minimum of 6 feet of fall zone is required.”

8VAC20-780-550-P

“Based on center documentation review and staff interviews, the licensee did not ensure the center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence that includes all required information. Evidence: Five out of five injury reports reviewed were missing information to include the date, time and how the parents were notified of the injury.”

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

“Based on interviews with staff and other parties involved, center documentation and a review of text messages, the licensee did not ensure the center shall notify the parent by the end of the day of any known minor injuries. Evidence: On May 31, 2023, Child #1, age 1 was in the infant room and at approximately 12:15 PM another infant threw a small toy and it Child #1 in the forehead. Text messages on May 31, 2023 between Staff #1 and Staff #2 confirm that an injury report was completed on the day of the injury, however the parent of Child #1 had not been notified of the injury on May 31, 2023. On June 3, 2023, the parent of Child #1 contacted Staff #1 about a bruise they noticed on the forehead of Child #1. Staff #1 at that time notified the parent of the injury that occurred on May 31, 2023.”

8VAC20-780-350-B-1 Complaint related: No

“Based on staff interviews, center documentation and review of video footage, the licensee did not ensure the staff-to-children ratio one staff or every four infant children was followed. Evidence: On May 1, 2023 between approximately 12:00 PM and 1:00 PM there were 12 children in the infant classroom with only two staff (Staff #1 and Staff #2). The age range of children in the infant room was 4 months (Child #3) and to age 4 (Child #2).”

8VAC20-780-80-A Complaint related: No

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: On May 1st in the infant room, during the centers designated nap time there were 12 children in the infant room and the attendance list for the infant room only listed 10 children. Staff#1 confirmed Child #1 and Child #2 were in the infant room, however they were not listed on the daily attendance for that group of children.”

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

“Based on interviews with staff and other parties involved, center documentation and a review of text messages, the licensee did not ensure the center shall notify the parent by the end of the day of any known minor injuries. Evidence: On May 4, 2023, Child #1, age 3 was picked up from the center at approximately 4:05 and when the child’s parent was putting Child #1 in their car seat, they noticed an abrasion on the child’s chin and a scratch mark on their cheek. The parent and Child#1 walked back into the center and the parent spoke to Staff #3. Staff #3 did verify with the parent that Child #1 had had told them earlier in the day ?I fell?. Then Child #1 told Staff #3 and their parent they were running and then they pointed to the door frame of the hallway bathroom and they said ?I fell?. Text messages between Child 1#?s parent and Staff #1 confirm that two center staff had observed on May 4, 2023 the marks on Child #1?s cheek but not on their chin. The center did not notify Child #1?s parent of the injury.”

8VAC20-780-160-A

“Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment, prior to coming into contact with children and the documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department. Evidence: Center Director confirmed the following staff did not obtain TB screenings within the required timeframe. 1.Staff #1 date of hire was 5-17-23 and TB screening date was 5-22-23 2.Staff #2 date of hire was 5-22-23 and TB screening date was 5-23-23 3.Staff #3 date of hire was 5-17-23 and TB screening was 5-23-23 4.Staff #4 date of hire was 3-13-23 and TB screening was 1-30-23 5.Staff #5 date of hire was 5-16-23 and TB screening was 5-19-23”

8VAC20-780-245-J-3

“Based on documentation review and staff interviews, the licensee did not ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements for medication administration training. Evidence: Child #6, has an emergency medication at the center. Child #6 arrived at the center on 6-7-2023 at 7:34 AM and there was not a staff member at the center who had obtained the required medication administration training until 8:49 AM when Staff #1 arrived. .”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: Staff #4 (hire date 3-13-23) did not have documentation they had obtained orientation training to include prevention of abusive head trauma.”

8VAC20-780-80-A

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 6 children in the 3?s classroom observed outside on the playground and the center staff confirmed they did not have an attendance sheet for the 6 children they were supervising.”

8VAC20-780-60-A

“Based on record review and staff interviews, the licensee did not ensure to maintain and keep at the center a separate record for each child enrolled which contained the required information. Evidence: The record for child #5 did not include the appropriate legal paperwork on file when the custodial parent requests the center not to release the child to the other parent.”

8VAC20-780-330-B

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: There following was observed on the playground and there was inadequate fall zone and resilient surfacing. 1.The plastic composite piece with a blue slide had inadequate fall zone as there was a yellow and red covered metal structure that was within 4 feet of the slide chute and minimum of 6 feet is of fall zone is required for the blue plastic slide. 2.The plastic composite piece had inadequate resilient surfacing for the slide chutes that require a minimum of 6 inches of resilient surfacing. The blue slide had only 2 to 3 inches of resilient surfacing and the yellow slide had only 3 to 4 inches of resilient surfacing at the bases of the slide chute and around the fall zone areas.”

8VAC20-780-350-B-1 Complaint related: No

“Based on staff interviews, center documentation and review of video footage, the licensee did not ensure the staff-to-children ratio one staff or every four infant children was followed. Evidence: On May 1, 2023 between approximately 12:00 PM and 1:00 PM there were 12 children in the infant classroom with only two staff (Staff #1 and Staff #2). The age range of children in the infant room was 4 months (Child #3) and to age 4 (Child #2).”

8VAC20-780-80-A Complaint related: No

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: On May 1st in the infant room, during the centers designated nap time there were 12 children in the infant room and the attendance list for the infant room only listed 10 children. Staff#1 confirmed Child #1 and Child #2 were in the infant room, however they were not listed on the daily attendance for that group of children.”

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

“Based on interviews with staff and other parties involved, center documentation and a review of text messages, the licensee did not ensure the center shall notify the parent by the end of the day of any known minor injuries. Evidence: On May 4, 2023, Child #1, age 3 was picked up from the center at approximately 4:05 and when the child’s parent was putting Child #1 in their car seat, they noticed an abrasion on the child’s chin and a scratch mark on their cheek. The parent and Child#1 walked back into the center and the parent spoke to Staff #3. Staff #3 did verify with the parent that Child #1 had had told them earlier in the day ?I fell?. Then Child #1 told Staff #3 and their parent they were running and then they pointed to the door frame of the hallway bathroom and they said ?I fell?. Text messages between Child 1#?s parent and Staff #1 confirm that two center staff had observed on May 4, 2023 the marks on Child #1?s cheek but not on their chin. The center did not notify Child #1?s parent of the injury.”

8VAC20-780-160-A

“Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment, prior to coming into contact with children and the documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department. Evidence: Center Director confirmed the following staff did not obtain TB screenings within the required timeframe. 1.Staff #1 date of hire was 5-17-23 and TB screening date was 5-22-23 2.Staff #2 date of hire was 5-22-23 and TB screening date was 5-23-23 3.Staff #3 date of hire was 5-17-23 and TB screening was 5-23-23 4.Staff #4 date of hire was 3-13-23 and TB screening was 1-30-23 5.Staff #5 date of hire was 5-16-23 and TB screening was 5-19-23”

8VAC20-780-245-J-3

“Based on documentation review and staff interviews, the licensee did not ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements for medication administration training. Evidence: Child #6, has an emergency medication at the center. Child #6 arrived at the center on 6-7-2023 at 7:34 AM and there was not a staff member at the center who had obtained the required medication administration training until 8:49 AM when Staff #1 arrived. .”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: Staff #4 (hire date 3-13-23) did not have documentation they had obtained orientation training to include prevention of abusive head trauma.”

8VAC20-780-80-A

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 6 children in the 3?s classroom observed outside on the playground and the center staff confirmed they did not have an attendance sheet for the 6 children they were supervising.”

8VAC20-780-60-A

“Based on record review and staff interviews, the licensee did not ensure to maintain and keep at the center a separate record for each child enrolled which contained the required information. Evidence: The record for child #5 did not include the appropriate legal paperwork on file when the custodial parent requests the center not to release the child to the other parent.”

8VAC20-780-330-B

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: There following was observed on the playground and there was inadequate fall zone and resilient surfacing. 1.The plastic composite piece with a blue slide had inadequate fall zone as there was a yellow and red covered metal structure that was within 4 feet of the slide chute and minimum of 6 feet is of fall zone is required for the blue plastic slide. 2.The plastic composite piece had inadequate resilient surfacing for the slide chutes that require a minimum of 6 inches of resilient surfacing. The blue slide had only 2 to 3 inches of resilient surfacing and the yellow slide had only 3 to 4 inches of resilient surfacing at the bases of the slide chute and around the fall zone areas.”

8VAC20-780-350-B-1 Complaint related: No

“Based on staff interviews, center documentation and review of video footage, the licensee did not ensure the staff-to-children ratio one staff or every four infant children was followed. Evidence: On May 1, 2023 between approximately 12:00 PM and 1:00 PM there were 12 children in the infant classroom with only two staff (Staff #1 and Staff #2). The age range of children in the infant room was 4 months (Child #3) and to age 4 (Child #2).”

8VAC20-780-80-A Complaint related: No

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: On May 1st in the infant room, during the centers designated nap time there were 12 children in the infant room and the attendance list for the infant room only listed 10 children. Staff#1 confirmed Child #1 and Child #2 were in the infant room, however they were not listed on the daily attendance for that group of children.”

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

“Based on interviews with staff and other parties involved, center documentation and a review of text messages, the licensee did not ensure the center shall notify the parent by the end of the day of any known minor injuries. Evidence: On May 4, 2023, Child #1, age 3 was picked up from the center at approximately 4:05 and when the child’s parent was putting Child #1 in their car seat, they noticed an abrasion on the child’s chin and a scratch mark on their cheek. The parent and Child#1 walked back into the center and the parent spoke to Staff #3. Staff #3 did verify with the parent that Child #1 had had told them earlier in the day ?I fell?. Then Child #1 told Staff #3 and their parent they were running and then they pointed to the door frame of the hallway bathroom and they said ?I fell?. Text messages between Child 1#?s parent and Staff #1 confirm that two center staff had observed on May 4, 2023 the marks on Child #1?s cheek but not on their chin. The center did not notify Child #1?s parent of the injury.”

8VAC20-780-160-A

“Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment, prior to coming into contact with children and the documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department. Evidence: Center Director confirmed the following staff did not obtain TB screenings within the required timeframe. 1.Staff #1 date of hire was 5-17-23 and TB screening date was 5-22-23 2.Staff #2 date of hire was 5-22-23 and TB screening date was 5-23-23 3.Staff #3 date of hire was 5-17-23 and TB screening was 5-23-23 4.Staff #4 date of hire was 3-13-23 and TB screening was 1-30-23 5.Staff #5 date of hire was 5-16-23 and TB screening was 5-19-23”

8VAC20-780-245-J-3

“Based on documentation review and staff interviews, the licensee did not ensure that for any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements for medication administration training. Evidence: Child #6, has an emergency medication at the center. Child #6 arrived at the center on 6-7-2023 at 7:34 AM and there was not a staff member at the center who had obtained the required medication administration training until 8:49 AM when Staff #1 arrived. .”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: Staff #4 (hire date 3-13-23) did not have documentation they had obtained orientation training to include prevention of abusive head trauma.”

8VAC20-780-80-A

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 6 children in the 3?s classroom observed outside on the playground and the center staff confirmed they did not have an attendance sheet for the 6 children they were supervising.”

8VAC20-780-60-A

“Based on record review and staff interviews, the licensee did not ensure to maintain and keep at the center a separate record for each child enrolled which contained the required information. Evidence: The record for child #5 did not include the appropriate legal paperwork on file when the custodial parent requests the center not to release the child to the other parent.”

8VAC20-780-330-B

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: There following was observed on the playground and there was inadequate fall zone and resilient surfacing. 1.The plastic composite piece with a blue slide had inadequate fall zone as there was a yellow and red covered metal structure that was within 4 feet of the slide chute and minimum of 6 feet is of fall zone is required for the blue plastic slide. 2.The plastic composite piece had inadequate resilient surfacing for the slide chutes that require a minimum of 6 inches of resilient surfacing. The blue slide had only 2 to 3 inches of resilient surfacing and the yellow slide had only 3 to 4 inches of resilient surfacing at the bases of the slide chute and around the fall zone areas.”

8VAC20-780-40-K

“Based on review of center documentation and staff interviews, the licensee did not ensure the center shall develop written procedures for abusive head trauma. Evidence: Center Owner confirmed there was not a policy available for review related to head trauma.”

8VAC20-780-550-P

“Based on review of center documentation and staff interviews, the licensee did not ensure the center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence that includes all required information. Evidence: Center Owner, after a review of 4 injury reports, confirmed that 2 did not have documentation on how parent was notified, and the date and time the parent was notified and 1 did not have any future action to prevent recurrence of the injury.”

8VAC20-780-40-I

“Based on review of center documentation and staff interviews, the licensee did not ensure the center shall develop written procedures for injury prevention. Evidence: Center Owner confirmed there was not a policy available for review related injury prevention.”

22.1-289.058

“Based on observation and staff interviews, the licensee did not ensure that each building that was built before 2015 and that house a child day program that is licensed and serves preschool-age children shall be equipped with at least one carbon monoxide detector. Evidence: The center director confirmed they do not have a carbon monoxide detector.”

8VAC20-780-70

“Based on a review of 5 staff records and staff interviews, the licensee did not ensure that all required items were in a staff record. Evidence: The following records did not have documentation to demonstrate the individual possesses the education and certification, required by the job position. 1.The record for staff #4, the designated program lead for the toddler room did not have documentation to demonstrate the individual possesses the education and certification, required for Program Lead. 2.The record for staff #1, the designated Program Director did not include documentation to demonstrate the individual possesses the education and certification, required for Program Director.”