Karter School of Cascades

8VAC20-780-60-A

“Based on record review and interview, the center did not obtain all the required information for each child's record. Evidence: Child #5 is missing proof of identity and two emergency contacts.”

8VAC20-780-60-A-8

“Based on record review and interview, the center did not obtain a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: Child #16's written care plan did not include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.”

8VAC20-780-130-A

“Based on record review and interview, the center did not obtain documentation of the required immunization record. Evidence: 1. Child #2 did not have documentation of an immunization record that is required by the State Board of Health before their first day of attendance. 2. Child #2 start date is 11/02/2022.”

8VAC20-780-280-B

“Based on observation and interview, hazardous substances such as cleaning materials, insecticides, and pesticides were not kept in a locked place using a safe locking method that prevents access by children. Evidence: Five spray bottles of sanitizer were found in an unlocked cabinet over a counter in the Florence classroom.”

8VAC20-780-140-A

“Based on record review and interview, the center did not obtain documentation of a physical for each child within 30 days of enrollment. Evidence: 1. Child #2 did not have documentation of a physical examination. 2. Child #2 start date is 11/02/2022”

8VAC20-780-60-A-8

“Based on record review and interview, the center did not obtain a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: Child #16's written care plan did not include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.”

8VAC20-780-130-A

“Based on record review and interview, the center did not obtain documentation of the required immunization record. Evidence: 1. Child #2 did not have documentation of an immunization record that is required by the State Board of Health before their first day of attendance. 2. Child #2 start date is 11/02/2022.”

8VAC20-780-280-B

“Based on observation and interview, hazardous substances such as cleaning materials, insecticides, and pesticides were not kept in a locked place using a safe locking method that prevents access by children. Evidence: Five spray bottles of sanitizer were found in an unlocked cabinet over a counter in the Florence classroom.”

8VAC20-780-140-A

“Based on record review and interview, the center did not obtain documentation of a physical for each child within 30 days of enrollment. Evidence: 1. Child #2 did not have documentation of a physical examination. 2. Child #2 start date is 11/02/2022”

8VAC20-780-280-B Complaint related: No

“Based on observation and interview, hazardous substances such as cleaning materials were not kept in a locked place using a safe locking method that prevents access by children. Evidence: A bottle of disinfectant spray and all-purpose cleaner was found in the Venice classroom's bathroom, on a shelf above the diaper changing table, not locked.”

8VAC20-780-510-G Complaint related: No

“Based on observation and interview, the center failed to ensure that medication was labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: In the Cairo classroom, an inhaler was not labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given.”

8VAC20-780-280-B Complaint related: No

“Based on observation and interview, hazardous substances such as cleaning materials were not kept in a locked place using a safe locking method that prevents access by children. Evidence: A bottle of disinfectant spray and all-purpose cleaner was found in the Venice classroom's bathroom, on a shelf above the diaper changing table, not locked.”

8VAC20-780-510-G Complaint related: No

“Based on observation and interview, the center failed to ensure that medication was labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: In the Cairo classroom, an inhaler was not labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given.”

8VAC20-780-40-E

“Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance. Evidence: 1. On October 17, 2022, video footage shows Staff #1 taking a stuffed toy from Child #1 after a child claims Child #1 hit them. Staff #1 told Child #1 to apologize and then pushed Child #1's head twice. 2. On October 18, 2022, video footage shows several children on the playground holding and straddling Staff #1's legs and feet. After a while, Staff #1 appeared frustrated and pushed Child #3 on the head and Child #4 on the shoulder to prevent them from straddling their leg again. 3. Staff #1 failed to adhere to the center’s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?”

8VAC20-780-410-1

“Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment. Evidence: 1. On October 17, 2022, at approximately 9:37 a.m., video footage shows Staff #1 talking to Child #1 about hitting. Staff #1 then takes a stuffed toy from Child #1. The child reaches up to get their stuffed toy back. Staff #1 then grabs and moves Child #1's arm away while holding the stuffed toy above their head. Staff #1 pushes Child #1 on the back of the head. Child #1 takes the stuffed toy back, and as the child walks away, Staff #1 can be seen pushing Child #1's head from the side. 2. On October 17, 2022, at approximately 4:26 pm, video footage shows Child #2 running up to Staff #1, who is sitting in a chair. Child #2 gives Staff #1 a hug and starts to play with the toys on the table while Staff #1 sits next to them. After a while, Staff #1 is seen touching Child #2's hair and then pulling it twice. Child #2 appears upset and walks away from Staff #1. 3. On October 18, 2022, at approximately 4:50 p.m., video footage shows several children on the playground holding and straddling Staff #1's legs and feet. After a while, Staff #1 appears to become frustrated and begins to withdraw their feet from the children. As Staff #1 walks away, a few students follow and begin to wrap themselves around the staff member's legs and feet approximately 2-3 more times. Staff #1 can be heard saying, "Stop, go play on the slide," before pulling their foot away from the children and walking towards the front of the playground near the slide. The video then shows four children running behind Staff #1, attempting to cling and straddle the staff's legs and feet again. Staff #1 can be heard saying "Stop," and then seen pushing Child #3 on the head and Child #4 on the shoulder.”

8VAC20-780-400-B

“Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, constructive in nature and intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. On October 17, 2022, video footage shows Staff #1 taking a stuffed toy from Child #1 after a child claims Child #1 hit them. Staff #1 told Child #1 to apologize and then pushed Child #1's head twice. 2. On October 18, 2022, video footage shows several children on the playground holding and straddling Staff #1's legs and feet. After a while, Staff #1 appeared frustrated and pushed Child #3 on the head and Child #4 on the shoulder to prevent them from straddling their leg again. 3. Staff #1?s method of behavior guidance with Child#1, Child #3, and Child #4 was not age and stage-appropriate and constructive in nature.”

8VAC20-780-40-E Complaint related: No

“Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance. Evidence: 1. On October 18, 2022, Staff #1 is seen rough handling Child #1 (4-year-old) onto their nap mat after asking the child to lie on their nap mat during nap time. 2. Staff #1 failed to adhere to the center’s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?”

8VAC20-780-400-B Complaint related: No

“Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, constructive in nature and intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. On October 18, 2022, Staff #1 is seen throwing, grabbing, and flipping Child #1 (4-year-old) on their nap mat after asking the child to lie on their nap mat during nap time. 2. Staff #1?s method of behavior guidance with Child#1 was not age and stage-appropriate, and constructive in nature.”

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

“Based on video observation, the center failed to ensure care, protection, and guidance. Evidence: Staff #1 failed to ensure care, protection, and guidance when attempting to place Child #1 on their nap mat. Instead, Staff #1 used rough handling as a method to put the child down for nap.”

63.2-1509-A Complaint related: No

“Based on interviews, the center failed to contact the local department or the department's toll-free child abuse and neglect hotline to report an allegation of suspected child abuse or neglect. Evidence: On October 27, 2022, the center received notification from the local authorities about a recording of Staff #1 rough handling Child #1, which occurred at the center on October 18, 2022. The facility did not contact the local department or the department's toll-free child abuse and neglect hotline to report the allegation as mandated.”

8VAC20-780-410-1 Complaint related: No

“Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment. 1. Evidence: On October 18, 2022, Staff #1 is seen on video rough handling Child #1 (4-year-old), during naptime. 2. On video, Staff #1 is heard repeatedly asking Child #1 to "lay down" before picking up, swinging, and throwing the child onto their nap mat. Afterward, Staff #1 grabbed Child #1's right arm and leg and flipped the child over approximately four times to place them on their nap mat. Once the child was lying down on the nap mat, Staff #1 wrapped a blanket around the child’s entire body from head to toe and started to pat the child to sleep.”

8VAC20-780-40-E

“Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance. Evidence: 1. On October 21, 2022, Staff #1 is seen on video pushing Child #1 (4-year-old), which causes the child to fall and hit the back of their head on a wooden chair after the child is seen pushing into them. 2. Staff #1 failed to adhere to the center’s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?”

8VAC20-780-40-K

“Based on staff interviews, the center failed to develop written procedures for the prevention of shaken baby syndrome or abusive head trauma. Evidence: 1. There was no documentation of written procedures for the prevention of shaken baby syndrome and abusive head trauma. 2. Staff #2 confirmed the center did not have written procedures for the prevention of shaken baby syndrome and abusive head trauma.”

8VAC20-780-410-1

“Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment. Evidence: On October 21, 2022, Staff #1 is seen on video pushing Child #1 (4-year-old), which causes the child to fall and hit the back of their head on a wooden chair. After pushing Child #1, Staff #1 is heard on video saying, ?Don?t push me, that's what you get." Staff #1 walked away and rendered no aid to the child.”

8VAC20-780-550-P

“Based on record review, the center failed to maintain compliance relating to injury reporting. Evidence: 1. The injury report stated that Child # 1 hit their head on a wooden chair; however, the report provided no documentation as to how or why Child #1 hit their head. 2. The injury report stated the parent of child #1 was notified at 1:00 pm. However, according to documents provided during the investigation, the parent was called at 1:20 pm.”

8VAC20-780-400-B

“Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, and constructive in nature. Evidence: 1. On October 21, 2022, Child #1 (4-year-old) is seen running towards Staff #1 and pushing into them. Staff #1 pushed Child #1, which resulted in Child #1 falling and hitting their head on a wooden chair. Staff #1 stated "Don?t push me, that’s what you get,? walked away, and did not render aid to Child #1. 2. Staff #1?s method of behavior guidance with Child#1 was not age and stage-appropriate, and constructive in nature.”

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

“Based on staff interviews, it was determined the center failed to comply with its own policies and procedures as it relates to reporting incidents. Evidence: 1. On 10/12/2022, child #1 informed multiple staff members that child #2 had grabbed and hit them several times in the private area. Staff members did not notify a leadership member within 30 minutes of the incident, and the parents of children #1 and #2 were not notified within 1 hour of the incident or immediately, as required by center policy. Incident reports were completed for both children after the parent of child #1 reported the incident to a leadership member. 2. The staff failed to adhere to the center’s policy, which states: ?When accidents or behavioral incidents occur, it is important to complete the appropriate form and notify a leadership member within 30 minutes of the occurrence. The parent must be notified within the hour of the incident and if the incident is severe the parent must be notified immediately. Report all incidents or accidents, no matter how minor they may seem, to leadership so that they can help assess the situation."”

8VAC20-780-270-A

“Based on observation, the areas and equipment of the center were not maintained in a safe condition. Evidence: In the Athens classroom, a small laminator was located on a table, plugged in, and accessible to children.”

8VAC20-780-160-A

“Based on record review and staff interview, the center did not ensure that a tuberculosis screening was completed within the last 30 calendar days of the date of employment . Evidence: 1. Date of employment for Staff # 2 was 5/23/22 and the tuberculosis screening on file was dated 06/07/2022. 2. Date of employment for Staff #3 was 8/22/22 and the tuberculosis screening on file was dated 12/2/2021.”

8VAC20-780-270-A

“Based on observation, the areas and equipment of the center were not maintained in a safe condition. Evidence: In the Athens classroom, a small laminator was located on a table, plugged in, and accessible to children.”

8VAC20-780-160-A

“Based on record review and staff interview, the center did not ensure that a tuberculosis screening was completed within the last 30 calendar days of the date of employment . Evidence: 1. Date of employment for Staff # 2 was 5/23/22 and the tuberculosis screening on file was dated 06/07/2022. 2. Date of employment for Staff #3 was 8/22/22 and the tuberculosis screening on file was dated 12/2/2021.”

8VAC20-780-260-A

“Based on the review of the inspection report from the local fire marshal , the center failed to get an annual fire inspection done. Evidence: The last fire inspection was conducted on 2/10 2021.”

8VAC20-780-260-A

“Based on the review of the inspection report from the local fire marshal , the center failed to get an annual fire inspection done. Evidence: The last fire inspection was conducted on 2/10 2021.”