Elzena Ross

8VAC20-800-280

“Based on observation, potentially poisonous supplies, such as disinfectants, were not stored in an area inaccessible to children. Evidence: A disinfectant spray with the words "Caution: Keep out of reach of children" was sitting on top of a storage bin approximately 3 feet in height within the programming space and was accessible to the children in care.”

8VAC20-800-180-A

“Based on record review and staff interview, the provider did not obtain for each caregiver an updated tuberculosis screening or test that was completed within the last two years. Evidence: Staff #2's most recently tuberculosis test on file was completed 8/26/2020.”

8VAC20-800-800-A

“Based on record review and staff interview, the family day home did not have a written emergency preparedness and response plan. Evidence: There was no emergency preparedness and response plan available at the time of inspection.”

8VAC20-800-920

“Based on record review and staff interview, the provider did not ensure the menu for the current one-week period was given to parents or kept on file. Evidence: The menu for the week of 9/5/2023 hadn't been developed at the time of inspection.”

8VAC20-800-940-B

“Based on observation, the provider did not have an operable thermometer available to monitor refrigerator and freezer compartment temperatures. Evidence: There was no thermometer in the refrigerator or freezer compartments that was located in the programming space and utilized for the family day home.”

8VAC20-800-100-A

“Based on record review, the provider did not obtain documentation of a physical examination prior to each child's attendance or within 30 days after the first day of attendance. Evidence: Child #3 (Start Date: 4/17/2023) did not have a physical examination on file.”

8VAC20-800-60-A

“Based on record review, the provider did not maintain an up-to-date record at the family day home for each enrolled child. Evidence: Child #1 (Start Date: 9/5/2023) was present on site and did not have a file.”

8VAC20-800-60-B

“Based on record review, the provider did not ensure that all children's records contained all required information. Evidence: 1. Child #2 (Start Date: 9/5/2023) was present at the time of inspection and did not have the following information: physician name and phone number, two emergency contacts with name, address, and phone number, medical insurance and policy number, and authorization for emergency medical care. 2. Child #3 (Start Date: 4/17/2023) was present at the time of inspection and did not have the medical insurance policy number on file. 3. Child #4 (Start Date: 5/2/2023) was present at the time of inspection and was missing one emergency contact in the file. 4. Child #5 (Start Date: 9/30/2021) was present at the time of inspection and was missing the medical insurance policy number and one emergency contact in the file.”

8VAC20-800-70-A

“Based on record review, the provider did not ensure that all parents were provided required written information prior to the child's first day of attendance. Evidence: 1. Child #2 (Start Date: 9/5/2023), Child #3 (Start Date: 4/17/2023), Child #4 (Start Date: 5/2/2023), Child #5 (Start Date: 9/30/2021), and Child #6 (Start Date: 2/10/2020) did not have documentation on file that parents were provided the provider's medication administration policy. 2. Child #2 was missing documentation on file that parents were provided the provisions of the family day home's emergency preparedness and response plan. 3. Child #2 and Child #6 did not have documentation on file that parents were informed whether or not there is liability insurance in force on the family day home operation.”

8VAC20-800-90-A

“Based on record review, the provider did not obtain documentation that all children have been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations. Evidence: Child #2 (Start Date: 9/5/2023) and Child #3 (Start Date: 4/17/2023) did not have immunizations on file.”

8VAC20-800-690-D

“Based on observation, the provider did not ensure that the diapering area had a diapering surface that was nonabsorbent. Evidence: The changing pad had a cloth cover on it making it absorbent.”

8VAC20-800-430-A

“Based on observation, children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision had access to stairs. Evidence: There was no gate at the bottom of the stairs leading from the main level of the home to the child care space in the basement. Children in care at the time of inspection ranged from 8 weeks to 4 years old.”

8VAC20-800-280

“Based on observation, potentially poisonous supplies, such as disinfectants, were not stored in an area inaccessible to children. Evidence: A disinfectant spray with the words "Caution: Keep out of reach of children" was sitting on top of a storage bin approximately 3 feet in height within the programming space and was accessible to the children in care.”

8VAC20-800-180-A

“Based on record review and staff interview, the provider did not obtain for each caregiver an updated tuberculosis screening or test that was completed within the last two years. Evidence: Staff #2's most recently tuberculosis test on file was completed 8/26/2020.”

8VAC20-800-800-A

“Based on record review and staff interview, the family day home did not have a written emergency preparedness and response plan. Evidence: There was no emergency preparedness and response plan available at the time of inspection.”

8VAC20-800-920

“Based on record review and staff interview, the provider did not ensure the menu for the current one-week period was given to parents or kept on file. Evidence: The menu for the week of 9/5/2023 hadn't been developed at the time of inspection.”

8VAC20-800-940-B

“Based on observation, the provider did not have an operable thermometer available to monitor refrigerator and freezer compartment temperatures. Evidence: There was no thermometer in the refrigerator or freezer compartments that was located in the programming space and utilized for the family day home.”

8VAC20-800-100-A

“Based on record review, the provider did not obtain documentation of a physical examination prior to each child's attendance or within 30 days after the first day of attendance. Evidence: Child #3 (Start Date: 4/17/2023) did not have a physical examination on file.”

8VAC20-800-60-A

“Based on record review, the provider did not maintain an up-to-date record at the family day home for each enrolled child. Evidence: Child #1 (Start Date: 9/5/2023) was present on site and did not have a file.”

8VAC20-800-60-B

“Based on record review, the provider did not ensure that all children's records contained all required information. Evidence: 1. Child #2 (Start Date: 9/5/2023) was present at the time of inspection and did not have the following information: physician name and phone number, two emergency contacts with name, address, and phone number, medical insurance and policy number, and authorization for emergency medical care. 2. Child #3 (Start Date: 4/17/2023) was present at the time of inspection and did not have the medical insurance policy number on file. 3. Child #4 (Start Date: 5/2/2023) was present at the time of inspection and was missing one emergency contact in the file. 4. Child #5 (Start Date: 9/30/2021) was present at the time of inspection and was missing the medical insurance policy number and one emergency contact in the file.”

8VAC20-800-70-A

“Based on record review, the provider did not ensure that all parents were provided required written information prior to the child's first day of attendance. Evidence: 1. Child #2 (Start Date: 9/5/2023), Child #3 (Start Date: 4/17/2023), Child #4 (Start Date: 5/2/2023), Child #5 (Start Date: 9/30/2021), and Child #6 (Start Date: 2/10/2020) did not have documentation on file that parents were provided the provider's medication administration policy. 2. Child #2 was missing documentation on file that parents were provided the provisions of the family day home's emergency preparedness and response plan. 3. Child #2 and Child #6 did not have documentation on file that parents were informed whether or not there is liability insurance in force on the family day home operation.”

8VAC20-800-90-A

“Based on record review, the provider did not obtain documentation that all children have been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations. Evidence: Child #2 (Start Date: 9/5/2023) and Child #3 (Start Date: 4/17/2023) did not have immunizations on file.”

8VAC20-800-690-D

“Based on observation, the provider did not ensure that the diapering area had a diapering surface that was nonabsorbent. Evidence: The changing pad had a cloth cover on it making it absorbent.”

8VAC20-800-430-A

“Based on observation, children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision had access to stairs. Evidence: There was no gate at the bottom of the stairs leading from the main level of the home to the child care space in the basement. Children in care at the time of inspection ranged from 8 weeks to 4 years old.”

8VAC20-800-570-A

“Based on observation and interview, it was determined that a caregiver exceeded 16 points. Evidence: The Licensing Inspector observed staff A alone with 17 children ( 3 of the children are residential children) between the ages of 2 years to 9 years for a total of 28 points. Each caregiver shall not exceed 16 points.”

8VAC20-800-30-A

“Based on observation and interview, it was determined that the provider did not ensure compliance with these standards and the terms of the current license issued by the department . Evidence: Upon arrival, the Licensing Inspector observed 17 children with one caregiver. Interview revealed that 3 of the 17 children resides in the home, therefore the remaining 14 children were enrolled in the family day home. The family day home has a licensed capacity of 12 children.”

8VAC20-800-60-B

“Based on a review of four children's files and an interview with the provider, it was determined that 3 children's files did not contain all of the required components. Evidence: Child A, B and C's files did not contain their insurance policy numbers nor their date of enrollment.”

22.1-289.036-A

“Based on interview and a review of record keeping, it was determined that two caregivers/household members did not have the repeat central registry finding background checks every five years as required. Evidence: Person A's central registry finding is dated 11/15/16 and Person B's central registry finding is dated 11/19/16, neither have obtain repeat background checks every five years thereafter.”

8VAC20-770-40-D-5-a

“Based on interview it was determined that a household member between 14 to 18 years of age did not have a central registry finding on file within 30 days of becoming a household member. Evidence: Person C is 16 years of age and became a household member in 7/22 and the provider has not obtained a central registry background check as required.”

8VAC20-800-50-A

“Based on interview and a review of the attendance log, it was determined that the provider is not maintaining a written record of children in attendance each day. Evidence: There was no written record showing that 8 day care children were in attendance.”

8VAC20-800-70-A

“Based on interview and a review of 4 children's files, it was determined that parents were not provided in writing information on the homes check in and out procedures and/or termination procedures. Evidence: The family day home's check in and out procedures were not provided in writing to the parents of child B and C. Termination procedures were not provided in writing to the parents of child C. Child C enrolled on 7/10/20.”

8VAC20-800-510-A

“Based on observation and interview, it was determined that children were not provided a cot, mat or bed for resting. Evidence: The Licensing Inspector observed 4 of the 7 preschoolers sleeping on a sleep sack napper and not a cot, mat or bed as required.”

8VAC20-800-60-B

“Based on a review of four children's files and an interview with the provider, it was determined that 3 children's files did not contain all of the required components. Evidence: Child A, B and C's files did not contain their insurance policy numbers nor their date of enrollment.”

22.1-289.036-A

“Based on interview and a review of record keeping, it was determined that two caregivers/household members did not have the repeat central registry finding background checks every five years as required. Evidence: Person A's central registry finding is dated 11/15/16 and Person B's central registry finding is dated 11/19/16, neither have obtain repeat background checks every five years thereafter.”

8VAC20-770-40-D-5-a

“Based on interview it was determined that a household member between 14 to 18 years of age did not have a central registry finding on file within 30 days of becoming a household member. Evidence: Person C is 16 years of age and became a household member in 7/22 and the provider has not obtained a central registry background check as required.”

8VAC20-800-50-A

“Based on interview and a review of the attendance log, it was determined that the provider is not maintaining a written record of children in attendance each day. Evidence: There was no written record showing that 8 day care children were in attendance.”

8VAC20-800-70-A

“Based on interview and a review of 4 children's files, it was determined that parents were not provided in writing information on the homes check in and out procedures and/or termination procedures. Evidence: The family day home's check in and out procedures were not provided in writing to the parents of child B and C. Termination procedures were not provided in writing to the parents of child C. Child C enrolled on 7/10/20.”

8VAC20-800-510-A

“Based on observation and interview, it was determined that children were not provided a cot, mat or bed for resting. Evidence: The Licensing Inspector observed 4 of the 7 preschoolers sleeping on a sleep sack napper and not a cot, mat or bed as required.”

8VAC20-800-70-A

“Based on a review of seven children's files and an interview with the provider, it was determined that before the children's first day of attendance, parents were no provided in writing policies and procedures outlined under this standard. Evidence: 1. There was no check in an out procedures in the file for child A, B, C and D. 2. There was no discipline policy to include if the provider uses time out or not for child A and B.”

8VAC20-820-120-E-2

“Based on observation and interview, it was determined that the findings of the most recent inspection of the family day home was not posted,”

22.1-289.058

“Based on observation and interview, it was determined that there was no carbon monoxide detectors in the family day home.”

8VAC20-800-60-B

“Based on a review of seven children's records and an interview with the provider, it was determined that there were missing components in children's files. Evidence: 1. There was no insurance policy numbers on file for child A, B, C, and E. 2. There was no enrollment date on file for child B, C and D 3. Child A enrolled on 6/21/22, child E enrolled on 2/10/20.”

8VAC20-800-830-D

“Based on observation and interview, it was determined that the provider was unable to locate their record of emergency evacuation and shelter in place drills for one year.”

8VAC20-800-70-A

“Based on a review of seven children's files and an interview with the provider, it was determined that before the children's first day of attendance, parents were no provided in writing policies and procedures outlined under this standard. Evidence: 1. There was no check in an out procedures in the file for child A, B, C and D. 2. There was no discipline policy to include if the provider uses time out or not for child A and B.”

8VAC20-820-120-E-2

“Based on observation and interview, it was determined that the findings of the most recent inspection of the family day home was not posted,”

22.1-289.058

“Based on observation and interview, it was determined that there was no carbon monoxide detectors in the family day home.”

8VAC20-800-60-B

“Based on a review of seven children's records and an interview with the provider, it was determined that there were missing components in children's files. Evidence: 1. There was no insurance policy numbers on file for child A, B, C, and E. 2. There was no enrollment date on file for child B, C and D 3. Child A enrolled on 6/21/22, child E enrolled on 2/10/20.”

8VAC20-800-830-D

“Based on observation and interview, it was determined that the provider was unable to locate their record of emergency evacuation and shelter in place drills for one year.”

8VAC20-800-70-A

“Based on a review of two children's files, it was determined that parents were not provided in writing the information required under this standard. Evidence: Child A's file did not contain information on the policies for administration of medications, or notification of liability insurance.”

8VAC20-800-100-A

“Based on a review of children's records, it was determined that one child did not have a physical on file within 30 days of enrollment. Evidence: Child A enrolled in January 2022 and as of May 12, 2022 there was no physical on file.”

8VAC20-800-60-B

“Based on a review of two children's files, it was determined that for one child's record did not contain all of the required information upon enrollment. Evidence: Child A started in January 2022 and the file does not contain the medical insurance policy or written authorization for emergency medical care”

8VAC20-800-50-A

“Based on observation and a review of the attendance log, it was determined that a written record of children in attendance each day was not maintained. Evidence: There were 5 daycare children present however only three were listed on the attendance log.”

8VAC20-800-90-A

“Based on a review of children's files, it was determined that a child was allowed to attend the family day home before obtaining their immunization record. Evidence: There was no immunization record on file for child A who enrolled in January 2022.”

8VAC20-800-680-B

“Based on observation, it was determined that the caregivers did not ensure that the 10 children's hands were washed after coming in from playing outside as their hands were dirty nor after eating their lunch.”

8VAC20-800-630-A

“Based on observation, it was determined that a caregiver failed to use methods of discipline that was constructive , nor did she model and redirect the children to acceptable behavior Evidence: On one occasion the LI observed caregiver B leaning over the chair and the child with her body as the child sat in the chair trying to get the child to comply, caregiver B's behavior was determined to be intimidating.”

8VAC20-800-900-B

“Based on observation, it was determined that at least three children were observed walking and playing outside while eating their peanut butter and jelly sandwiches.”

8VAC20-800-560-A

“Based on observation and interview, it was determined that the one of the two caregivers were not providing direct care and supervision to the children while outside. The caregiver that was present with the children in the backyard thought she was caring for 9 children, when in fact she had 10 children in care. Evidence: The Licensing Inspector (LI) observed 10 preschoolers ( ages 22 months to 5 years of age) outside in the backyard playing and eating with caregiver A supervising. The LI asked caregiver A how many children were in care and was told 9 children were in care today. The LI repeated the question 20 minutes later and again was told 9 children were present. The LI pointed out there were in fact 10 children present, then caregiver A acknowledged that there were 10 children present and not the 9. The LI asked caregiver A if there was any other caregivers as she was alone with the 10 preschoolers, which totaled 21 points. Caregiver A reported that caregiver B was inside the house. Caregiver A asked caregiver B to join her outside with the children, caregiver B came outside for a few minutes and then returned inside, leaving caregiver A alone again with 10 preschoolers. Several minutes later, caregiver A decided to send 3 to 4 children inside with caregiver B. Caregiver B, while inside, was not providing direct care supervision of the children consequently leaving caregiver A alone with 10 children, which totaled 21 points. One caregiver should not exceed 16 points.”

8VAC20-800-240-A

“Based on observation, it was determined that the area inside and outside was not maintianed in a safe and operable condtion. Evidence: 1. The banister on the stairs leading to the basement was detaching from the wall and provided very little hand support. 2. In the backyard play area, the children were running around, playing and using tricycles/scooters near the the top of the stairs that lead to the basement. There was no protective barrier to prevent access to the stairs and the fall from the top to the bottom would have been approximately 7 feet.”

8VAC20-800-90-A

“Based on a review of children's files and interviews with the caregivers, it was determined that there were no immunization records on file before attendance for child B and C.”

8VAC20-800-70-A

“Based on a review of seven children's files and interview with the caregivers, it was determined that there were no information provided in writing to parents to include check in and out procedures identified, operational information, schedule and fee information on file for child C, D. E, F and G.”

8VAC20-800-60-B

“Based on a review of 7 children's records and interviews with three caregivers, it was determined that children's records did not contain all of the required information outlined under this standard. Evidence: 1. There were no dates of enrollment listed for children A through G. 2. There were no insurance information on file for child F, G and B. 3. There were no physician information on file for child C and D. All information above is required at the time of enrollment.”

8VAC20-800-60-A

“Based on observation and interview, it was determined that there was no file available for review for child A. Interviews revealed that child A enrolled approximately 2 week prior.”

22.1-289.036-A

“Based on interview, it was determined that one caregiver/household member did not have a repeat background check every five years. Evidence: Caregiver B's central registry finding is dated 11/15/16.”

8VAC20-800-730-D

“Based on observation, it was determined that medication was not kept locked and was accessible to the children. Evidence: The Licensing Inspector observed a full bottle of Ibuprofen sitting on the kitchen counter. The medication was accessible to all of the children in care as the children were in and out of the kitchen area throughout the inspection.”

8VAC20-800-50-A

“Based on observation and interview, there was no written record of children in attendance.”

8VAC20-800-100-A

“Based on a review of children's files and interviews with the caregivers, it was determined that there were no physicals on file within 30 days of attendance for child B and C.”

8VAC20-800-920

“Based on observation and interview, it was determined that there was no menu given to parents or posted/placed in a area accessible to parents for the current one-week period.”

8VAC20-800-880

“Based on observation and interview, it was determined that the provider was not following the most recent nutritional requirements of a recognized authority such as the child and adult care program by the USDA. Evidence; The LI observed the children being served only peanut butter and jelly sandwiches for lunch.”

8VAC20-800-580-A

“Based on observation, it was determined that caregiver B did not promote the children's emotional and social well being and growth by providing needed help, comfort, and support. Evidence: Five preschoolers were not napping and were told to watch tv by caregiver B. The Licensing Inspector observed/overheard caregiver B repeatedly tell the 5 children to sit and watch tv. Caregiver B repeatedly told the children to "be quiet", "sit down" "get back over there" "great, now turn around" all was done with a harsh and demeaning voice tone. One child said they couldn't hear the tv, caregiver B said to the child, "say it again and you wont hear nothing"”

8VAC20-800-680-B

“Based on observation, it was determined that the caregivers did not ensure that the 10 children's hands were washed after coming in from playing outside as their hands were dirty nor after eating their lunch.”

8VAC20-800-630-A

“Based on observation, it was determined that a caregiver failed to use methods of discipline that was constructive , nor did she model and redirect the children to acceptable behavior Evidence: On one occasion the LI observed caregiver B leaning over the chair and the child with her body as the child sat in the chair trying to get the child to comply, caregiver B's behavior was determined to be intimidating.”

8VAC20-800-900-B

“Based on observation, it was determined that at least three children were observed walking and playing outside while eating their peanut butter and jelly sandwiches.”

8VAC20-800-560-A

“Based on observation and interview, it was determined that the one of the two caregivers were not providing direct care and supervision to the children while outside. The caregiver that was present with the children in the backyard thought she was caring for 9 children, when in fact she had 10 children in care. Evidence: The Licensing Inspector (LI) observed 10 preschoolers ( ages 22 months to 5 years of age) outside in the backyard playing and eating with caregiver A supervising. The LI asked caregiver A how many children were in care and was told 9 children were in care today. The LI repeated the question 20 minutes later and again was told 9 children were present. The LI pointed out there were in fact 10 children present, then caregiver A acknowledged that there were 10 children present and not the 9. The LI asked caregiver A if there was any other caregivers as she was alone with the 10 preschoolers, which totaled 21 points. Caregiver A reported that caregiver B was inside the house. Caregiver A asked caregiver B to join her outside with the children, caregiver B came outside for a few minutes and then returned inside, leaving caregiver A alone again with 10 preschoolers. Several minutes later, caregiver A decided to send 3 to 4 children inside with caregiver B. Caregiver B, while inside, was not providing direct care supervision of the children consequently leaving caregiver A alone with 10 children, which totaled 21 points. One caregiver should not exceed 16 points.”

8VAC20-800-240-A

“Based on observation, it was determined that the area inside and outside was not maintianed in a safe and operable condtion. Evidence: 1. The banister on the stairs leading to the basement was detaching from the wall and provided very little hand support. 2. In the backyard play area, the children were running around, playing and using tricycles/scooters near the the top of the stairs that lead to the basement. There was no protective barrier to prevent access to the stairs and the fall from the top to the bottom would have been approximately 7 feet.”

8VAC20-800-90-A

“Based on a review of children's files and interviews with the caregivers, it was determined that there were no immunization records on file before attendance for child B and C.”

8VAC20-800-70-A

“Based on a review of seven children's files and interview with the caregivers, it was determined that there were no information provided in writing to parents to include check in and out procedures identified, operational information, schedule and fee information on file for child C, D. E, F and G.”

8VAC20-800-60-B

“Based on a review of 7 children's records and interviews with three caregivers, it was determined that children's records did not contain all of the required information outlined under this standard. Evidence: 1. There were no dates of enrollment listed for children A through G. 2. There were no insurance information on file for child F, G and B. 3. There were no physician information on file for child C and D. All information above is required at the time of enrollment.”

8VAC20-800-60-A

“Based on observation and interview, it was determined that there was no file available for review for child A. Interviews revealed that child A enrolled approximately 2 week prior.”

22.1-289.036-A

“Based on interview, it was determined that one caregiver/household member did not have a repeat background check every five years. Evidence: Caregiver B's central registry finding is dated 11/15/16.”

8VAC20-800-730-D

“Based on observation, it was determined that medication was not kept locked and was accessible to the children. Evidence: The Licensing Inspector observed a full bottle of Ibuprofen sitting on the kitchen counter. The medication was accessible to all of the children in care as the children were in and out of the kitchen area throughout the inspection.”

8VAC20-800-50-A

“Based on observation and interview, there was no written record of children in attendance.”

8VAC20-800-100-A

“Based on a review of children's files and interviews with the caregivers, it was determined that there were no physicals on file within 30 days of attendance for child B and C.”

8VAC20-800-920

“Based on observation and interview, it was determined that there was no menu given to parents or posted/placed in a area accessible to parents for the current one-week period.”

8VAC20-800-880

“Based on observation and interview, it was determined that the provider was not following the most recent nutritional requirements of a recognized authority such as the child and adult care program by the USDA. Evidence; The LI observed the children being served only peanut butter and jelly sandwiches for lunch.”

8VAC20-800-580-A

“Based on observation, it was determined that caregiver B did not promote the children's emotional and social well being and growth by providing needed help, comfort, and support. Evidence: Five preschoolers were not napping and were told to watch tv by caregiver B. The Licensing Inspector observed/overheard caregiver B repeatedly tell the 5 children to sit and watch tv. Caregiver B repeatedly told the children to "be quiet", "sit down" "get back over there" "great, now turn around" all was done with a harsh and demeaning voice tone. One child said they couldn't hear the tv, caregiver B said to the child, "say it again and you wont hear nothing"”