Cynthia's Child Care Center

8VAC20-790-600-D-2

“(Repeat Violation) Based on review of staff records, the center failed to ensure that all staff held a current certification in First Aid. Evidence: 1. The record for staff #2 contained a First Aid certification that expired on 8/5/2023. 2. The record for staff #3 contained a First Aid certification that expired on 8/6/2023. 3. The record for staff #4 contained a First Aid certification that expired on 7/23/2023. 4. Administration verified that the First Aid certification for staff were expired.”

8VAC20-790-600-D-1

“(Repeat Violation) Based on review of staff records, the center failed to ensure that all staff had current certification in CPR. Evidence: 1. The record for staff #2 contained a CPR certification that expired on 8/5/2023. 2. The record for staff #3 contained a CPR certification that expired on 8/6/2023. 3. The record for staff #4 contained a CPR certification that expired on 7/23/2023. 4. Administration verified that the CPR certification for staff were expired.”

8VAC20-780-600-F

“Based on record review the center failed to have one staff member complete the department’s annual update health and safety course. Evidence: 1. The record for staff #1 did not have documentation that the required annual 3-hour health and safety update course was completed. Last documented course was dated 07/12/2019. 2. The record for staff #2, did not have documentation that the required annual 3-hour health and safety update course was completed. Last documented course was dated 2/28/2022. 3. The director confirmed the annual 3-hour update had not been taken.”

8VAC20-780-60-A

“Based on record review, 4 of 4 children's records did not contain all required information. Evidence: 1. Child #3 was missing a second emergency contact address. Child # 3?s date of enrollment was 6/14/2021. 2. Child #4 was missing an annual update. Child # 4?s enrollment date was 9/13/2022.”

8VAC20-780-245-A

“Based on review of staff records and interview, the center failed to ensure that all staff had completed a minimum of 16 hours of annual training appropriate to the age of children in care. Evidence: 1. The record for staff #1 (hire date 4/15/2019), contained 4 hours of annual training from 4/15/2022-4/14/2023. 2. The record for staff #2 (hire date 9/29/2017), contained 14 hours of annual training from 9/29/2022-9/28/2023. 3. The record for staff #3 (hire date 6/15/2017), contained 11 hours of annual training from 6/15/2022 ? 6/14/2023. 4. The record for staff #4 (hire date 11/15/2021), contained 5 hours of annual training from 11/15/2022 ? 11/14/2023. 5. Staff #2 verified that staff#1, staff #2, staff #3, and staff #4 did not meet the minimum requirement of 16 hours of annual training appropriate to the age of the children in care.”

8VAC20-780-270-A

“Based on observation and staff interviews, the licensee did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. In the infant room, there was chipped paint on the wall under the board accessible to children. 2. In 2 year old classroom, there was peeling and chipped paint on the wall under the board accessible to children.”

8VAC20-790-600-D-2

“Based on records review, and observation, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of current certification in First Aid. Staff #5 was observed working in the classroom with children”

8VAC20-790-600-D-1

“Based on records review, and observation, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR). Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of current certification in CPR.”

8VAC20-780-550-G

“Based on documentation review, and interview, the center failed to maintain documentation of emergency evacuation drills. Evidence: There was no drill documented for May of 2023. The Assistant Director acknowledged that the drill was not documented.”

8VAC20-780-240-B

“Based on records review, and observation, the center failed to ensure that staff complete orientation training no later than seven days of the date of assuming job responsibilities. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of completion of orientation. Staff # 5 was observed working in the classroom with children.”

8VAC20-780-450-A

“Based on observation, the center failed to ensure that cots used by children during the designated rest period shall have linens consisting of a top cover and a bottom cover. Evidence: There were 7 cots occupied by sleeping children that did not have a bottom cover.”

8VAC20-770-60-C-2

“Based on records review, the center failed to have a Central Registry finding within 30 days of employment. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain the results of a Central Registry search.”

8VAC20-780-160-A

“Based on records review, and observation, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record for staff #4, date of employment 05/26/20, did not contain documentation of a negative tuberculosis screening. Staff #4 was observed working in the classroom with children.”

8VAC20-780-70

“Based on records review, and observation, the center failed to document that two or more references as to character and reputation as well as competency were checked before employment. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of references. Staff #5 was observed working in the classroom with children.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #4, date of employment 05/26/20, and the record for staff #5, date of employment 08/21/2022, did not contain documentation of the VDOE orientation course being completed.”

8VAC20-790-600-D-2

“Based on records review, and observation, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of current certification in First Aid. Staff #5 was observed working in the classroom with children”

8VAC20-790-600-D-1

“Based on records review, and observation, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR). Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of current certification in CPR.”

8VAC20-780-550-G

“Based on documentation review, and interview, the center failed to maintain documentation of emergency evacuation drills. Evidence: There was no drill documented for May of 2023. The Assistant Director acknowledged that the drill was not documented.”

8VAC20-780-240-B

“Based on records review, and observation, the center failed to ensure that staff complete orientation training no later than seven days of the date of assuming job responsibilities. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of completion of orientation. Staff # 5 was observed working in the classroom with children.”

8VAC20-780-450-A

“Based on observation, the center failed to ensure that cots used by children during the designated rest period shall have linens consisting of a top cover and a bottom cover. Evidence: There were 7 cots occupied by sleeping children that did not have a bottom cover.”

8VAC20-770-60-C-2

“Based on records review, the center failed to have a Central Registry finding within 30 days of employment. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain the results of a Central Registry search.”

8VAC20-780-160-A

“Based on records review, and observation, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record for staff #4, date of employment 05/26/20, did not contain documentation of a negative tuberculosis screening. Staff #4 was observed working in the classroom with children.”

8VAC20-780-70

“Based on records review, and observation, the center failed to document that two or more references as to character and reputation as well as competency were checked before employment. Evidence: The record for staff #5, date of employment 08/21/2022, did not contain documentation of references. Staff #5 was observed working in the classroom with children.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #4, date of employment 05/26/20, and the record for staff #5, date of employment 08/21/2022, did not contain documentation of the VDOE orientation course being completed.”

8VAC20-790-600-F

“Based on records review, the center failed to ensure that all staff who work directly with children shall annually attend the departments health and safety update course. Evidence: 1) The record for staff #3, date of employment 11/15/21, contained documentation of the annual health and safety course dated 11/21/21. 2) The record for staff #4, date of employment 06/15/17, contained documentation of the annual health and safety course dated 05/26/20.”

8VAC20-790-600-D-2

“Based on records review, the center failed to ensure that all staff who work directly with children have current certification in first aid. Evidence: The record for staff # 5, date of employment 05/26/20, contained documentation of first aid certification dated 03/22/19.”

8VAC20-790-600-D-1

“Based on records review, the center failed to ensure that all staff who work directly with children have current certification in cardiopulmonary resuscitation (CPR). Evidence: The record for staff # 5, date of employment 05/26/20, contained documentation of CPR certification dated 03/22/19.”

8VAC20-780-550-D

“Based on interview, the center failed to ensure that they implement a monthly practice evacuation drill with all of the children in the center. Evidence: When interviewed, the Director stated that they do not take the infants out with them when they have practice evacuation drills.”

8VAC20-780-70

“Based on records review, and observation, the center failed to document that two or more references as to character and reputation as well as competency were checked before employment. Evidence: The record for staff #1, date of employment 03/06/23, and the record for staff #5, date of employment 05/26/20, did not contain documentation of references. Staff #1 and staff #5 were observed working in the classroom with children.”

8VAC20-780-160-A

“Based on records review, and observation, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record for staff #5, date of employment 05/26/20, did not contain documentation of a negative tuberculosis screening. Staff #5 was observed working in the classroom with children.”

8VAC20-780-550-G

“Based on documentation review, and interview, the center failed to maintain documentation of emergency evacuation drills. Evidence: There were no drills documented for January or February of 2023. The Director acknowledged that the drills were not documented.”

8VAC20-780-140-A

“Based on records review, the center failed to ensure that each child has a physical examination within 30 days after the first day of attendance. Evidence: The record for child #1, date of enrollment 06/14/21, the record for child #2, date of enrollment 12/1/20, and the record for child #3, date of enrollment, 11/30/20, did not contain documentation of a physical examination.”

8VAC20-770-60-C-2

“Based on a review of records, and interview, the center did not ensure that all employees have a CPS background check that is repeated every 5 years. Evidence: The record for staff #2, date of employment 09/29/17, and the record for staff #4, date of employment 06/15/17, had original CPS background checks that expired in May 2022. There was no evidence that a new CPS background check had been mailed. When asked, the Director stated that the background checks had not been repeated.”

8VAC20-770-60-B

“Based on records review, the center failed to obtain a repeat Sworn Statement 5 years from the original Sworn Statement. Evidence: The record for staff #2, date of employment 09/29/17, had a Sworn Statement dated 08/03/17, and the record for staff #4, date of employment 06/15/17, had a Sworn Statement dated 08/03/17.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #5, date of employment, 05/26/20, did not contain documentation of the VDOE orientation course being completed.”

8VAC20-790-600-F

“Based on records review, the center failed to ensure that all staff who work directly with children shall annually attend the departments health and safety update course. Evidence: 1) The record for staff #3, date of employment 11/15/21, contained documentation of the annual health and safety course dated 11/21/21. 2) The record for staff #4, date of employment 06/15/17, contained documentation of the annual health and safety course dated 05/26/20.”

8VAC20-790-600-D-2

“Based on records review, the center failed to ensure that all staff who work directly with children have current certification in first aid. Evidence: The record for staff # 5, date of employment 05/26/20, contained documentation of first aid certification dated 03/22/19.”

8VAC20-790-600-D-1

“Based on records review, the center failed to ensure that all staff who work directly with children have current certification in cardiopulmonary resuscitation (CPR). Evidence: The record for staff # 5, date of employment 05/26/20, contained documentation of CPR certification dated 03/22/19.”

8VAC20-780-550-D

“Based on interview, the center failed to ensure that they implement a monthly practice evacuation drill with all of the children in the center. Evidence: When interviewed, the Director stated that they do not take the infants out with them when they have practice evacuation drills.”

8VAC20-780-70

“Based on records review, and observation, the center failed to document that two or more references as to character and reputation as well as competency were checked before employment. Evidence: The record for staff #1, date of employment 03/06/23, and the record for staff #5, date of employment 05/26/20, did not contain documentation of references. Staff #1 and staff #5 were observed working in the classroom with children.”

8VAC20-780-160-A

“Based on records review, and observation, the center failed to ensure that staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record for staff #5, date of employment 05/26/20, did not contain documentation of a negative tuberculosis screening. Staff #5 was observed working in the classroom with children.”

8VAC20-780-550-G

“Based on documentation review, and interview, the center failed to maintain documentation of emergency evacuation drills. Evidence: There were no drills documented for January or February of 2023. The Director acknowledged that the drills were not documented.”

8VAC20-780-140-A

“Based on records review, the center failed to ensure that each child has a physical examination within 30 days after the first day of attendance. Evidence: The record for child #1, date of enrollment 06/14/21, the record for child #2, date of enrollment 12/1/20, and the record for child #3, date of enrollment, 11/30/20, did not contain documentation of a physical examination.”

8VAC20-770-60-C-2

“Based on a review of records, and interview, the center did not ensure that all employees have a CPS background check that is repeated every 5 years. Evidence: The record for staff #2, date of employment 09/29/17, and the record for staff #4, date of employment 06/15/17, had original CPS background checks that expired in May 2022. There was no evidence that a new CPS background check had been mailed. When asked, the Director stated that the background checks had not been repeated.”

8VAC20-770-60-B

“Based on records review, the center failed to obtain a repeat Sworn Statement 5 years from the original Sworn Statement. Evidence: The record for staff #2, date of employment 09/29/17, had a Sworn Statement dated 08/03/17, and the record for staff #4, date of employment 06/15/17, had a Sworn Statement dated 08/03/17.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #5, date of employment, 05/26/20, did not contain documentation of the VDOE orientation course being completed.”

8VAC20-780-570-E

“Based on observation and interview, the center did not ensure that prepared infant formula was refrigerated, dated, and labeled with the child’s name. Evidence: There were 8 bottles lined up on the counter. The bottles were not refrigerated and did not contain a date or a name. When asked, the staff member stated that they do not refrigerate the bottles.”

8VAC20-780-570-B

“Based on observation, the center did not ensure that a bottle was not used while the child is in their designated sleeping location. Evidence: Two (2) infants were given a bottle while laying down in their crib.”

8VAC20-780-500-B

“Based on observation and interview, the center did not ensure that a nonabsorbent surface for diapering or changing was used and that it was cleaned with soap and water and sanitized after each use. Evidence: The infant room had a diaper pad that had a cloth cover on it. When asked, the teacher stated that the cloth cover on the diaper pad is washed daily and that they do not clean and sanitize the pad in between each diaper change.”

8VAC20-780-560-G

“Based on observation, the center did not ensure that when food is brought from home the food container is clearly dated and labeled in a way that identifies the owner. Evidence: 1) Class # 2 had food containers lined up on the counter. None of the food containers were labeled. 2) Class #3 had lunchboxes and water bottles lined up on the counter that were not dated or labeled.”

8VAC20-770-60-C-2

“Based on a review of records, and interview, the center did not ensure that all employees have a CPS background check mailed within 7 days of employment and that it is repeated every 5 years. Evidence: 1) Staff #3, DOH 11/21/21; and Staff #4 DOH 5/19/22 did not have evidence that the CPS background check was mailed. When asked, the Director stated that she had mailed the requests and that the checks were cashed but she never received the results. 2) Staff #1 and staff #2 had original CPS background checks that expired in May 2022. There was no evidence that a new CPS background check had been mailed. When asked, the Director stated that she was unaware that it had to be repeated every five years.”

8VAC20-780-245-L

“Based on records review, and interview, the center did not ensure to always have at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: 5 out of 5 records reviewed did not have evidence of daily health observation training. When asked, the Director stated that she was unaware of this requirement.”

8VAC20-780-260-B

“Based on a review of records and interview, the center did not ensure to obtain annual approval from the health department. Evidence: The most recent health inspection was on 10/16/20. When asked, the Director stated that she has tried calling several times to schedule the inspection but no one has come out.”

8VAC20-780-350-B-1

“Based on observation and interview, the center did not ensure that the staff to children ratios were followed at all times. Evidence: At approximately 10:25 am the infant teacher was seen down the hall coming out of the preschool classroom. There were 8 infants left in the classroom with 1 staff member. When asked, the teacher stated that she does this regularly when she needs something from the other classroom, but she always makes sure the infants are put in their cribs before she leaves.”

8VAC20-780-440-L

“Based on observation, the center did not ensure that pillows and filled comforters were not used by children under two years of age. Evidence: A stuffed dinosaur pillow was in a crib with a toddler during the designated sleep time.”

8VAC20-780-560-M

“Based on observation, the center did not ensure that no child shall be allowed to drink or eat while walking around. Evidence: Classroom #2 allowed 2 children to walk around while drinking out of bottles/sippy cups.”

8VAC20-780-570-E

“Based on observation and interview, the center did not ensure that prepared infant formula was refrigerated, dated, and labeled with the child’s name. Evidence: There were 8 bottles lined up on the counter. The bottles were not refrigerated and did not contain a date or a name. When asked, the staff member stated that they do not refrigerate the bottles.”

8VAC20-780-570-B

“Based on observation, the center did not ensure that a bottle was not used while the child is in their designated sleeping location. Evidence: Two (2) infants were given a bottle while laying down in their crib.”

8VAC20-780-500-B

“Based on observation and interview, the center did not ensure that a nonabsorbent surface for diapering or changing was used and that it was cleaned with soap and water and sanitized after each use. Evidence: The infant room had a diaper pad that had a cloth cover on it. When asked, the teacher stated that the cloth cover on the diaper pad is washed daily and that they do not clean and sanitize the pad in between each diaper change.”

8VAC20-780-560-G

“Based on observation, the center did not ensure that when food is brought from home the food container is clearly dated and labeled in a way that identifies the owner. Evidence: 1) Class # 2 had food containers lined up on the counter. None of the food containers were labeled. 2) Class #3 had lunchboxes and water bottles lined up on the counter that were not dated or labeled.”

8VAC20-770-60-C-2

“Based on a review of records, and interview, the center did not ensure that all employees have a CPS background check mailed within 7 days of employment and that it is repeated every 5 years. Evidence: 1) Staff #3, DOH 11/21/21; and Staff #4 DOH 5/19/22 did not have evidence that the CPS background check was mailed. When asked, the Director stated that she had mailed the requests and that the checks were cashed but she never received the results. 2) Staff #1 and staff #2 had original CPS background checks that expired in May 2022. There was no evidence that a new CPS background check had been mailed. When asked, the Director stated that she was unaware that it had to be repeated every five years.”

8VAC20-780-245-L

“Based on records review, and interview, the center did not ensure to always have at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: 5 out of 5 records reviewed did not have evidence of daily health observation training. When asked, the Director stated that she was unaware of this requirement.”

8VAC20-780-260-B

“Based on a review of records and interview, the center did not ensure to obtain annual approval from the health department. Evidence: The most recent health inspection was on 10/16/20. When asked, the Director stated that she has tried calling several times to schedule the inspection but no one has come out.”

8VAC20-780-350-B-1

“Based on observation and interview, the center did not ensure that the staff to children ratios were followed at all times. Evidence: At approximately 10:25 am the infant teacher was seen down the hall coming out of the preschool classroom. There were 8 infants left in the classroom with 1 staff member. When asked, the teacher stated that she does this regularly when she needs something from the other classroom, but she always makes sure the infants are put in their cribs before she leaves.”

8VAC20-780-440-L

“Based on observation, the center did not ensure that pillows and filled comforters were not used by children under two years of age. Evidence: A stuffed dinosaur pillow was in a crib with a toddler during the designated sleep time.”

8VAC20-780-560-M

“Based on observation, the center did not ensure that no child shall be allowed to drink or eat while walking around. Evidence: Classroom #2 allowed 2 children to walk around while drinking out of bottles/sippy cups.”

8VAC20-770-60-C-2

“Based on a review of staff records and interview, on February 25, 2022, the center did not ensure that each staff record reviewed contained a central registry finding within 30 days of employment. Evidence: The record of staff #1, hired on 11/15/21, did not contain documentation of results of a central registry check. Administration acknowledged the application was returned to the center due to an error and needs to be mailed again.”

8VAC20-780-130-E

“Based on record review, the center did not ensure to obtain documentation of immunizations once every six months for children under the age of two years. Evidence: The record of child #2 (DOB 2/26/21) contained documentation of immunizations dated 7/13/21.”

8VAC20-780-160-A

“Based on a review of staff records, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #1, hired on 11/15/21, contained documentation of a tuberculosis screening dated 2/23/22.”

8VAC20-780-260-B

“Based on a review of records and interview, the center did not ensure annual approval from the health department shall be provided, or approvals of a plan of correction, for meeting requirements for water supply, sewage disposal system, and food service, if applicable. Evidence: The most recent health inspection report is dated 10/16/20. Administration acknowledged the inspection is overdue.”

8VAC20-780-500-A

“Based on observation and interview on February 25, 2022, the center did not ensure that staff and children's hands shall be washed with soap and running water after a diaper change. Evidence: After diapering, Staff #1 was observed to not wash their hands and a child's hands with soap and running water. Staff #1 acknowledged hand washing was not completed after diapering.”

8VAC20-780-500-B

“Based on observation and interview on February 25, 2022, the center did not ensure a nonabsorbent surface for diapering or changing is used. Evidence: In the diaper changing area there were three changing pads observed to have several tears and holes which exposed the inner foam of the pad, which no longer makes the surface nonporous.”

8VAC20-780-550-D

“Based on a review of records and interview on February 24, 2022, the center did not ensure to implement a monthly practice evacuation drill. Evidence: There was no documentation of a fire drill being practiced in January 2022. Administration confirmed the drill was not conducted.”

8VAC20-780-560-J

“Based on observation and interview on February 25, 2022, the center did not ensure tables and high chairs are sanitized using a spray disinfectant solution before and after each use for feeding. Evidence: After lunch, a volunteer was observed using disinfectant wipes to sanitize high chair trays. Administration acknowledged the wipes were being used.”

8VAC20-780-150-B

“Based on a review of records on February 25, 2022, the center did not ensure that physical examinations and dates immunizations received shall be signed by a physician, his designee, or an official of the local health department. Evidence: The record of child #2 contained documentation of a physical and immunizations that were not signed by a physician, his designee, or an official of a local health department.”

8VAC20-770-60-C-2

“Based on a review of staff records and interview, on February 25, 2022, the center did not ensure that each staff record reviewed contained a central registry finding within 30 days of employment. Evidence: The record of staff #1, hired on 11/15/21, did not contain documentation of results of a central registry check. Administration acknowledged the application was returned to the center due to an error and needs to be mailed again.”

8VAC20-780-130-E

“Based on record review, the center did not ensure to obtain documentation of immunizations once every six months for children under the age of two years. Evidence: The record of child #2 (DOB 2/26/21) contained documentation of immunizations dated 7/13/21.”

8VAC20-780-160-A

“Based on a review of staff records, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #1, hired on 11/15/21, contained documentation of a tuberculosis screening dated 2/23/22.”

8VAC20-780-260-B

“Based on a review of records and interview, the center did not ensure annual approval from the health department shall be provided, or approvals of a plan of correction, for meeting requirements for water supply, sewage disposal system, and food service, if applicable. Evidence: The most recent health inspection report is dated 10/16/20. Administration acknowledged the inspection is overdue.”

8VAC20-780-500-A

“Based on observation and interview on February 25, 2022, the center did not ensure that staff and children's hands shall be washed with soap and running water after a diaper change. Evidence: After diapering, Staff #1 was observed to not wash their hands and a child's hands with soap and running water. Staff #1 acknowledged hand washing was not completed after diapering.”

8VAC20-780-500-B

“Based on observation and interview on February 25, 2022, the center did not ensure a nonabsorbent surface for diapering or changing is used. Evidence: In the diaper changing area there were three changing pads observed to have several tears and holes which exposed the inner foam of the pad, which no longer makes the surface nonporous.”

8VAC20-780-550-D

“Based on a review of records and interview on February 24, 2022, the center did not ensure to implement a monthly practice evacuation drill. Evidence: There was no documentation of a fire drill being practiced in January 2022. Administration confirmed the drill was not conducted.”

8VAC20-780-560-J

“Based on observation and interview on February 25, 2022, the center did not ensure tables and high chairs are sanitized using a spray disinfectant solution before and after each use for feeding. Evidence: After lunch, a volunteer was observed using disinfectant wipes to sanitize high chair trays. Administration acknowledged the wipes were being used.”

8VAC20-780-150-B

“Based on a review of records on February 25, 2022, the center did not ensure that physical examinations and dates immunizations received shall be signed by a physician, his designee, or an official of the local health department. Evidence: The record of child #2 contained documentation of a physical and immunizations that were not signed by a physician, his designee, or an official of a local health department.”