KinderCare Learning Center - Parham

8VAC20-780-260-B

“Annual approval from the health department shall be provided regarding the water supply and sewage disposal system. The center had not obtained a report of environmental sanitation from the health department as required.”

8VAC20-780-510-E

“Long-term prescription drug use may be allowed with written authorization from the child's physician and parent. The parent’s written authorization for the medication on site for Child #4 did not include the written authorization of the child’s physician.”

8VAC20-780-260-B

“Annual approval from the health department shall be provided regarding the water supply and sewage disposal system. The center had not obtained a report of environmental sanitation from the health department as required.”

8VAC20-780-510-E

“Long-term prescription drug use may be allowed with written authorization from the child's physician and parent. The parent’s written authorization for the medication on site for Child #4 did not include the written authorization of the child’s physician.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. The center did not request a search of the child abuse and neglect registry from one state for Staff #2, who has been employed for four months and was working with children at the time of the inspection.”

8VAC20-780-510-N

“The Center is required to keep a record of medication given to children which includes the staff member administering the medication. Child #6 received medication on 10/03/24 but there is no information regarding which staff member administered it.”

8VAC20-780-40-G

“The center shall meet the proof of child identity and age requirements as stated in ? 22.1-289.049 of the Code of Virginia. There was no documentation in the record of Child #2 that the center verified the child’s identity or age.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. The center did not request a search of the child abuse and neglect registry from one state for Staff #2, who has been employed for four months and was working with children at the time of the inspection.”

8VAC20-780-510-N

“The Center is required to keep a record of medication given to children which includes the staff member administering the medication. Child #6 received medication on 10/03/24 but there is no information regarding which staff member administered it.”

8VAC20-780-40-G

“The center shall meet the proof of child identity and age requirements as stated in ? 22.1-289.049 of the Code of Virginia. There was no documentation in the record of Child #2 that the center verified the child’s identity or age.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. The center did not request a search of the child abuse and neglect registry from one state for Staff #2, who has been employed for four months and was working with children at the time of the inspection.”

8VAC20-780-510-N

“The Center is required to keep a record of medication given to children which includes the staff member administering the medication. Child #6 received medication on 10/03/24 but there is no information regarding which staff member administered it.”

8VAC20-780-40-G

“The center shall meet the proof of child identity and age requirements as stated in ? 22.1-289.049 of the Code of Virginia. There was no documentation in the record of Child #2 that the center verified the child’s identity or age.”

8VAC20-780-340-A

“Based on record review and interview, the center failed to ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1) Child #1?s record contained seven incident reports dated between 4/17/24 and 7/16/24 that documented physically aggressive and disrespectful toward other children and a teacher. 2) On 4/17/24, Child #1 ?kicked another student.? 3) On 6/21/24, Child #1 started ?hitting the children? on inappropriate locations on their bodies. After Child #1 was separated from the other children he ?tried to choke? a ?non-verbal child?. 4) In the afternoon on 6/21/24, Child #1 ?got so angry? at another child that he ?slapped him in his face?. 5) On 6/27/24, Child #1 ?began to argue with? another child ?to the point of bullying him with racist language?. 6) On 7/02/24, Child #1 ?started smacking? Child #2 on an inappropriate location on their body. When Child #2 asked Child #1 ?to stop, he continued to do it?. 7) On 7/05/24, Child #1 was ?disrespectful to the teacher?. 8) On 7/15/24, Staff #1 witnessed Child #1 chasing and touching Child #3 on an inappropriate location on their body at 1:00 p.m. Staff #1 reported in an interview on 8/16/24, that Child #3 asked Child #1 to stop but the behavior continued. 9) In an interview on 8/14/24, the Program Director acknowledged Child #1?s persistent behavioral problems as outlined in seven incident reports dated between 4/17/24 and 7/16/24.”

8VAC20-780-40-E

“Based on record review and interview, the center failed to ensure that the operational responsibilities of the licensee shall include ensuring that the center's activities are maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. Evidence: 1) The Center’s ?Behavior Guidance Plan For Parents? states that ?if inappropriate behavior continues, parents will be asked to participate in an immediate parent/teacher conference.? There was no documentation of a parent/teacher conference in the record of Child #1. There were seven incident reports documenting physically aggressive and bullying behaviors toward other children and staff by Child #1 between 4/17/24 and 7/16/24. 2) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?sign in and out of classroom CSRs at the exact time they arrive or leave.? The CSR for the school age classroom dated 7/15/24 documents no staff in the classroom between 12:30 p.m. and 1:25 p.m. A Name- to-Face Check completed at 12:00 pm documents 13 school age children in the classroom. A Name- to-Face Check completed at 2:00 pm documents 15 school age children in the classroom. No transitions were documented between 12:00 and 2:00. 3) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?complete and document name-to-face checks on the CSR eight times a day? aside from transition times. The CSRs for the school age classroom dated 7/15/24 and 7/16/24 document six name-to-face checks. 4) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that ?Managers must observe at least two Name -to-Face Transitions per classroom daily and review (and sign!) every classroom’s CSR at least twice daily.? The CSR for the school age classroom dated 7/15/24 has no documentation of management observations. The CSR for the school age classroom dated 7/16/24 has documentation of one management observation. 5) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that each combined classroom or ?homeroom? at the beginning and the end of the day ?should have their own CSR?. The CSR for the school age classroom dated 7/15/24 has five Pre-K students signed in then signed out. The CSR for the school age classroom dated 7/16/24 has three Pre-K students signed in then signed out. 6) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their ?initials in the box provided for the name-to-face check?. The CSR for the school age classroom dated 7/15/24 documents a name-to-face check at 7:15. The total number of children and teachers and the teacher’s initials are not documented. 7) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their initials in the ?Teacher Initials box provided for each transition at the bottom of the CSR.? The CSR for the school age classroom dated 7/16/24 documents a transition to the playground at 9:32 a.m. The total number of children and teachers and the teacher’s initials are not documented. 8) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?Print children’s FIRST and LAST NAME as they enter the classroom? on the CSR. The CSR for the school age classroom dated 7/15/24 documents five "Pre-K" children without their last names. The CSR for the school age classroom dated 7/16/24 documents three "Pre-K" children without their last names. continued on supplemental page”

8VAC20-780-350-B-4

“Based on review of documentation, the center failed to maintain the required staff to children ratio for children three years old up to school age. Evidence: 1) The child supervision record dated 07/15/2024 documented 18 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10). 2) The child supervision record dated 07/16/2024 documented 15 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10).”

8VAC20-780-270-A

“Based on observation and interview, the center did not maintain areas of the playground in a safe condition. Evidence: The resilient surfacing on the playground was observed to be cracked and torn away in multiple places posing a tripping hazard for the children. In an interview on 8/14/24, the Program Director acknowledged that the resilient surfacing needed repair and stated that the repair had already been scheduled.”

8VAC20-780-160-C

“Based on staff record review and interview, the center did not ensure that a staff member obtained a follow up tuberculosis screening at least every two years. Evidence: The most recent tuberculosis screening for Staff #1 in the record was dated 7/22/22. In an interview on 8/14/24, the Program Director acknowledged that the TB screening for Staff #2 was overdue.”

8VAC20-780-70

“Based on record review and interview, the center did not keep staff records as required. Evidence: Staff #1?s record did not contain documentation of 16 hours of annual training between 7/2023 and 7/2024. Staff #2?s record did not contain documentation of 16 hours of annual training between 3/2023 and 3/2024. In an interview on 8/14/24, the Program Director acknowledged that documentation of 16 hours of annual training was not contained in the records of Staff #1 or Staff #2.”

8VAC20-780-350-B-4

“Based on observation and interview, the center did not maintain the required staff-to-children ratio whenever children are in care. Evidence: Following nap time, 23 children ages three to five years were observed on the playground with two staff (Staff #2 and Staff #6). Staff # 2 reported 10 children in her group. Staff #6 reported 13 children in her group. The staff-to-children ratio for children ages three to five years is one staff to ten children.”

8VAC20-780-340-A

“Based on record review and interview, the center failed to ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1) Child #1?s record contained seven incident reports dated between 4/17/24 and 7/16/24 that documented physically aggressive and disrespectful toward other children and a teacher. 2) On 4/17/24, Child #1 ?kicked another student.? 3) On 6/21/24, Child #1 started ?hitting the children? on inappropriate locations on their bodies. After Child #1 was separated from the other children he ?tried to choke? a ?non-verbal child?. 4) In the afternoon on 6/21/24, Child #1 ?got so angry? at another child that he ?slapped him in his face?. 5) On 6/27/24, Child #1 ?began to argue with? another child ?to the point of bullying him with racist language?. 6) On 7/02/24, Child #1 ?started smacking? Child #2 on an inappropriate location on their body. When Child #2 asked Child #1 ?to stop, he continued to do it?. 7) On 7/05/24, Child #1 was ?disrespectful to the teacher?. 8) On 7/15/24, Staff #1 witnessed Child #1 chasing and touching Child #3 on an inappropriate location on their body at 1:00 p.m. Staff #1 reported in an interview on 8/16/24, that Child #3 asked Child #1 to stop but the behavior continued. 9) In an interview on 8/14/24, the Program Director acknowledged Child #1?s persistent behavioral problems as outlined in seven incident reports dated between 4/17/24 and 7/16/24.”

8VAC20-780-40-E

“Based on record review and interview, the center failed to ensure that the operational responsibilities of the licensee shall include ensuring that the center's activities are maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. Evidence: 1) The Center’s ?Behavior Guidance Plan For Parents? states that ?if inappropriate behavior continues, parents will be asked to participate in an immediate parent/teacher conference.? There was no documentation of a parent/teacher conference in the record of Child #1. There were seven incident reports documenting physically aggressive and bullying behaviors toward other children and staff by Child #1 between 4/17/24 and 7/16/24. 2) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?sign in and out of classroom CSRs at the exact time they arrive or leave.? The CSR for the school age classroom dated 7/15/24 documents no staff in the classroom between 12:30 p.m. and 1:25 p.m. A Name- to-Face Check completed at 12:00 pm documents 13 school age children in the classroom. A Name- to-Face Check completed at 2:00 pm documents 15 school age children in the classroom. No transitions were documented between 12:00 and 2:00. 3) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?complete and document name-to-face checks on the CSR eight times a day? aside from transition times. The CSRs for the school age classroom dated 7/15/24 and 7/16/24 document six name-to-face checks. 4) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that ?Managers must observe at least two Name -to-Face Transitions per classroom daily and review (and sign!) every classroom’s CSR at least twice daily.? The CSR for the school age classroom dated 7/15/24 has no documentation of management observations. The CSR for the school age classroom dated 7/16/24 has documentation of one management observation. 5) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that each combined classroom or ?homeroom? at the beginning and the end of the day ?should have their own CSR?. The CSR for the school age classroom dated 7/15/24 has five Pre-K students signed in then signed out. The CSR for the school age classroom dated 7/16/24 has three Pre-K students signed in then signed out. 6) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their ?initials in the box provided for the name-to-face check?. The CSR for the school age classroom dated 7/15/24 documents a name-to-face check at 7:15. The total number of children and teachers and the teacher’s initials are not documented. 7) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their initials in the ?Teacher Initials box provided for each transition at the bottom of the CSR.? The CSR for the school age classroom dated 7/16/24 documents a transition to the playground at 9:32 a.m. The total number of children and teachers and the teacher’s initials are not documented. 8) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?Print children’s FIRST and LAST NAME as they enter the classroom? on the CSR. The CSR for the school age classroom dated 7/15/24 documents five "Pre-K" children without their last names. The CSR for the school age classroom dated 7/16/24 documents three "Pre-K" children without their last names. continued on supplemental page”

8VAC20-780-350-B-4

“Based on review of documentation, the center failed to maintain the required staff to children ratio for children three years old up to school age. Evidence: 1) The child supervision record dated 07/15/2024 documented 18 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10). 2) The child supervision record dated 07/16/2024 documented 15 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10).”

8VAC20-780-270-A

“Based on observation and interview, the center did not maintain areas of the playground in a safe condition. Evidence: The resilient surfacing on the playground was observed to be cracked and torn away in multiple places posing a tripping hazard for the children. In an interview on 8/14/24, the Program Director acknowledged that the resilient surfacing needed repair and stated that the repair had already been scheduled.”

8VAC20-780-160-C

“Based on staff record review and interview, the center did not ensure that a staff member obtained a follow up tuberculosis screening at least every two years. Evidence: The most recent tuberculosis screening for Staff #1 in the record was dated 7/22/22. In an interview on 8/14/24, the Program Director acknowledged that the TB screening for Staff #2 was overdue.”

8VAC20-780-70

“Based on record review and interview, the center did not keep staff records as required. Evidence: Staff #1?s record did not contain documentation of 16 hours of annual training between 7/2023 and 7/2024. Staff #2?s record did not contain documentation of 16 hours of annual training between 3/2023 and 3/2024. In an interview on 8/14/24, the Program Director acknowledged that documentation of 16 hours of annual training was not contained in the records of Staff #1 or Staff #2.”

8VAC20-780-350-B-4

“Based on observation and interview, the center did not maintain the required staff-to-children ratio whenever children are in care. Evidence: Following nap time, 23 children ages three to five years were observed on the playground with two staff (Staff #2 and Staff #6). Staff # 2 reported 10 children in her group. Staff #6 reported 13 children in her group. The staff-to-children ratio for children ages three to five years is one staff to ten children.”

8VAC20-780-340-A

“Based on record review and interview, the center failed to ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1) Child #1?s record contained seven incident reports dated between 4/17/24 and 7/16/24 that documented physically aggressive and disrespectful toward other children and a teacher. 2) On 4/17/24, Child #1 ?kicked another student.? 3) On 6/21/24, Child #1 started ?hitting the children? on inappropriate locations on their bodies. After Child #1 was separated from the other children he ?tried to choke? a ?non-verbal child?. 4) In the afternoon on 6/21/24, Child #1 ?got so angry? at another child that he ?slapped him in his face?. 5) On 6/27/24, Child #1 ?began to argue with? another child ?to the point of bullying him with racist language?. 6) On 7/02/24, Child #1 ?started smacking? Child #2 on an inappropriate location on their body. When Child #2 asked Child #1 ?to stop, he continued to do it?. 7) On 7/05/24, Child #1 was ?disrespectful to the teacher?. 8) On 7/15/24, Staff #1 witnessed Child #1 chasing and touching Child #3 on an inappropriate location on their body at 1:00 p.m. Staff #1 reported in an interview on 8/16/24, that Child #3 asked Child #1 to stop but the behavior continued. 9) In an interview on 8/14/24, the Program Director acknowledged Child #1?s persistent behavioral problems as outlined in seven incident reports dated between 4/17/24 and 7/16/24.”

8VAC20-780-40-E

“Based on record review and interview, the center failed to ensure that the operational responsibilities of the licensee shall include ensuring that the center's activities are maintained in compliance with these standards and the center's own policies and procedures that are required by these standards. Evidence: 1) The Center’s ?Behavior Guidance Plan For Parents? states that ?if inappropriate behavior continues, parents will be asked to participate in an immediate parent/teacher conference.? There was no documentation of a parent/teacher conference in the record of Child #1. There were seven incident reports documenting physically aggressive and bullying behaviors toward other children and staff by Child #1 between 4/17/24 and 7/16/24. 2) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?sign in and out of classroom CSRs at the exact time they arrive or leave.? The CSR for the school age classroom dated 7/15/24 documents no staff in the classroom between 12:30 p.m. and 1:25 p.m. A Name- to-Face Check completed at 12:00 pm documents 13 school age children in the classroom. A Name- to-Face Check completed at 2:00 pm documents 15 school age children in the classroom. No transitions were documented between 12:00 and 2:00. 3) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?complete and document name-to-face checks on the CSR eight times a day? aside from transition times. The CSRs for the school age classroom dated 7/15/24 and 7/16/24 document six name-to-face checks. 4) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that ?Managers must observe at least two Name -to-Face Transitions per classroom daily and review (and sign!) every classroom’s CSR at least twice daily.? The CSR for the school age classroom dated 7/15/24 has no documentation of management observations. The CSR for the school age classroom dated 7/16/24 has documentation of one management observation. 5) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires that each combined classroom or ?homeroom? at the beginning and the end of the day ?should have their own CSR?. The CSR for the school age classroom dated 7/15/24 has five Pre-K students signed in then signed out. The CSR for the school age classroom dated 7/16/24 has three Pre-K students signed in then signed out. 6) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their ?initials in the box provided for the name-to-face check?. The CSR for the school age classroom dated 7/15/24 documents a name-to-face check at 7:15. The total number of children and teachers and the teacher’s initials are not documented. 7) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?write the total number of children and teachers at the bottom of the CSR? and to add their initials in the ?Teacher Initials box provided for each transition at the bottom of the CSR.? The CSR for the school age classroom dated 7/16/24 documents a transition to the playground at 9:32 a.m. The total number of children and teachers and the teacher’s initials are not documented. 8) The center’s ?Child Supervision Records (CSR) Standard Operating Procedure (SOP)? requires teachers to ?Print children’s FIRST and LAST NAME as they enter the classroom? on the CSR. The CSR for the school age classroom dated 7/15/24 documents five "Pre-K" children without their last names. The CSR for the school age classroom dated 7/16/24 documents three "Pre-K" children without their last names. continued on supplemental page”

8VAC20-780-350-B-4

“Based on review of documentation, the center failed to maintain the required staff to children ratio for children three years old up to school age. Evidence: 1) The child supervision record dated 07/15/2024 documented 18 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10). 2) The child supervision record dated 07/16/2024 documented 15 children in a group between three years-eight years of age with Staff #3. The required ratio for three-year-old children to school age is 1 staff to ten children (1:10).”

8VAC20-780-270-A

“Based on observation and interview, the center did not maintain areas of the playground in a safe condition. Evidence: The resilient surfacing on the playground was observed to be cracked and torn away in multiple places posing a tripping hazard for the children. In an interview on 8/14/24, the Program Director acknowledged that the resilient surfacing needed repair and stated that the repair had already been scheduled.”

8VAC20-780-160-C

“Based on staff record review and interview, the center did not ensure that a staff member obtained a follow up tuberculosis screening at least every two years. Evidence: The most recent tuberculosis screening for Staff #1 in the record was dated 7/22/22. In an interview on 8/14/24, the Program Director acknowledged that the TB screening for Staff #2 was overdue.”

8VAC20-780-70

“Based on record review and interview, the center did not keep staff records as required. Evidence: Staff #1?s record did not contain documentation of 16 hours of annual training between 7/2023 and 7/2024. Staff #2?s record did not contain documentation of 16 hours of annual training between 3/2023 and 3/2024. In an interview on 8/14/24, the Program Director acknowledged that documentation of 16 hours of annual training was not contained in the records of Staff #1 or Staff #2.”

8VAC20-780-350-B-4

“Based on observation and interview, the center did not maintain the required staff-to-children ratio whenever children are in care. Evidence: Following nap time, 23 children ages three to five years were observed on the playground with two staff (Staff #2 and Staff #6). Staff # 2 reported 10 children in her group. Staff #6 reported 13 children in her group. The staff-to-children ratio for children ages three to five years is one staff to ten children.”

8VAC20-780-340-F

“Based on documentation review and interviews the facility failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: According to reports and interviews, child, C1, age 3, was left alone on the playground on 11/14/2023 for approximately 4 minutes. The classroom teacher, S1 did not know the child walked behind her after she called his name during the transition from the playground to the to the classroom. C1 was left alone on the playground from approximately 11:30 a.m. to 11:34 a.m. At approximately 11:34 a.m.,the director observed the child on the playground from her office window. The incident report prepared by the center documented that C1 walked inside when his name was called but then turned around and walked behind S1 and walked back outside.”

8VAC20-780-340-F

“Based on documentation review and interviews the facility failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: According to reports and interviews, child, C1, age 3, was left alone on the playground on 11/14/2023 for approximately 4 minutes. The classroom teacher, S1 did not know the child walked behind her after she called his name during the transition from the playground to the to the classroom. C1 was left alone on the playground from approximately 11:30 a.m. to 11:34 a.m. At approximately 11:34 a.m.,the director observed the child on the playground from her office window. The incident report prepared by the center documented that C1 walked inside when his name was called but then turned around and walked behind S1 and walked back outside.”

8VAC20-780-160-C

“Based on records review, and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at least every two years from the date of the initial screening or testing. Evidence: The record for staff #1, date of employment 01/01/01, contained a tuberculosis screening dated 01/20/21. A repeat screening was due on 01/20/23.”

8VAC20-780-510-P

“Based on documentation review, and observation, the center failed to obtain an updated medication authorization when the medication authorization expires. Evidence: Documentation review revealed that the medication authorization for child #5, date of enrollment 11/07/22, expired 04/2023. When an authorization for medication expires, the parent shall be notified that 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. The medication was observed in the medication lock box.”

8VAC20-780-160-C

“Based on records review, and interview, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at least every two years from the date of the initial screening or testing. Evidence: The record for staff #1, date of employment 01/01/01, contained a tuberculosis screening dated 01/20/21. A repeat screening was due on 01/20/23.”

8VAC20-780-510-P

“Based on documentation review, and observation, the center failed to obtain an updated medication authorization when the medication authorization expires. Evidence: Documentation review revealed that the medication authorization for child #5, date of enrollment 11/07/22, expired 04/2023. When an authorization for medication expires, the parent shall be notified that 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. The medication was observed in the medication lock box.”

8VAC20-780-340-F

“Based on interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: Interviews with staff #1, staff #2, and staff #3, revealed that child #1, age 21 months, was left in the building unsupervised for approximately 10 minutes while the class was outside on the playground. Child #1 was found in the staff lounge alone by staff #4.”

8VAC20-780-340-A

“Based on interviews, and documentation review, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: Interviews revealed that on June 8th, staff #1, and staff #2, did not conduct a name-to-face check when the class transitioned outside. Child #1, age 21 months, was left alone in the center for approximately 10 minutes. Child #1 was found in the staff lounge by staff #4. Staff #1 and staff #2 did not discover that child #1 was missing until approximately 30 minutes after the class transitioned outside. Documentation review revealed that the class transitioned outside at 10:45 am.”

8VAC20-780-40-E

“Based on interviews, and documentation review, the center failed to follow it's own policies and procedures. Evidence: Interviews with staff #1, staff #2, and staff #3 revealed that on June 8th child #1, age 21 months, was found inside the building while the rest of the class and teachers were outside. Staff #1 and staff #2 revealed that the "name to face attendance check" was not completed upon the transition outside to the playground and they did not conduct a name to face check until approximately 30 minutes after they arrived outside, when they discovered that child #1 was missing. Documentation review revealed that staff #2 did not sign out of the CSR when she left the classroom to take the trash out. The policy titled "Child Supervision Record (CSR)" states "perform name-to-face checks as children cross the threshold from the space they're in to the new location. For example, when leaving the classroom to go to the playground, complete name-to-face before crossing the threshold out of the classroom and again after crossing the threshold into the playground. Make sure you actually look at each child's face and verify they're with you instead of just counting children." Under Teacher/Staff Attendance the policy states "when teachers leave the classroom for breaks, lunch, or at the end of their shift, they must sign out on the CSR by recording the time in the "out" column in the teacher/staff attendance section."”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that each staff member shall 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 #1, date of employment 05/10/2023, contained a tuberculosis screening dated 06/20/2023.”

8VAC20-780-350-B-2

“Repeat Violation-Based on interviews, and documentation review, the center failed to ensure that the staff-to-children ratios are followed whenever children are in care. Evidence: Interviews with staff #1, and staff #2, revealed that staff #2 left the classroom for approximately 5 minutes to take the trash to the dumpster located on the outside of the building. Staff #1 was left alone in classroom #1 with a group of 10 children age 16 months to 24 months. The ratio for this age is 1 staff to every 5 children.”

22.1-289.035-B-2

“Based on records review, and interview, the center failed to ensure that the results of a criminal history records check are received prior to the first day of employment. Evidence: The record for staff #2, date of employment 05/08/2023, contained the results of a criminal history records check dated 05/16/23. Interview with the Director confirmed the date of the criminal history record check.”

8VAC20-780-340-F

“Based on interviews, the center failed to ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: Interviews with staff #1, staff #2, and staff #3, revealed that child #1, age 21 months, was left in the building unsupervised for approximately 10 minutes while the class was outside on the playground. Child #1 was found in the staff lounge alone by staff #4.”

8VAC20-780-340-A

“Based on interviews, and documentation review, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: Interviews revealed that on June 8th, staff #1, and staff #2, did not conduct a name-to-face check when the class transitioned outside. Child #1, age 21 months, was left alone in the center for approximately 10 minutes. Child #1 was found in the staff lounge by staff #4. Staff #1 and staff #2 did not discover that child #1 was missing until approximately 30 minutes after the class transitioned outside. Documentation review revealed that the class transitioned outside at 10:45 am.”

8VAC20-780-40-E

“Based on interviews, and documentation review, the center failed to follow it's own policies and procedures. Evidence: Interviews with staff #1, staff #2, and staff #3 revealed that on June 8th child #1, age 21 months, was found inside the building while the rest of the class and teachers were outside. Staff #1 and staff #2 revealed that the "name to face attendance check" was not completed upon the transition outside to the playground and they did not conduct a name to face check until approximately 30 minutes after they arrived outside, when they discovered that child #1 was missing. Documentation review revealed that staff #2 did not sign out of the CSR when she left the classroom to take the trash out. The policy titled "Child Supervision Record (CSR)" states "perform name-to-face checks as children cross the threshold from the space they're in to the new location. For example, when leaving the classroom to go to the playground, complete name-to-face before crossing the threshold out of the classroom and again after crossing the threshold into the playground. Make sure you actually look at each child's face and verify they're with you instead of just counting children." Under Teacher/Staff Attendance the policy states "when teachers leave the classroom for breaks, lunch, or at the end of their shift, they must sign out on the CSR by recording the time in the "out" column in the teacher/staff attendance section."”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that each staff member shall 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 #1, date of employment 05/10/2023, contained a tuberculosis screening dated 06/20/2023.”

8VAC20-780-350-B-2

“Repeat Violation-Based on interviews, and documentation review, the center failed to ensure that the staff-to-children ratios are followed whenever children are in care. Evidence: Interviews with staff #1, and staff #2, revealed that staff #2 left the classroom for approximately 5 minutes to take the trash to the dumpster located on the outside of the building. Staff #1 was left alone in classroom #1 with a group of 10 children age 16 months to 24 months. The ratio for this age is 1 staff to every 5 children.”

22.1-289.035-B-2

“Based on records review, and interview, the center failed to ensure that the results of a criminal history records check are received prior to the first day of employment. Evidence: The record for staff #2, date of employment 05/08/2023, contained the results of a criminal history records check dated 05/16/23. Interview with the Director confirmed the date of the criminal history record check.”

8VAC20-780-510-G

“Based on observation, the center did not ensure that medication shall be labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: Child #6 with prescribed Auvi-Q medication had the Auvi-Q container that did not contain the original prescription label.”

8VAC20-780-350-B-3

“Based on observation and interview, the center did not ensure that staff to children ratios are followed whenever children are in care. Evidence: Classroom #2 was outside with two teachers and 14 children aged two years. Staff #3 took one child inside to the restroom leaving one teacher outside alone with 13 children. The ratio for this age group is 1:8. When interviewed, Staff #3 stated that she ?was not thinking when she did that.?”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: Classroom #6 and #4 both had closets that were unlocked and propped open which contained several cleaning agents labeled ?Keep out of reach of children? and ?Hazardous?”

8VAC20-780-270-A

“Based on observation, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition bending, or warping. Evidence: 1) Several broken buckets on playground with sharp edges. 2) Several bikes with missing pedals 3) The poured-in-place material on playground was cracked and open.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that children and staff wash their hands at all required times. Evidence:1) A child received a diaper change and was allowed to immediately play with other children and toys without washing hands 2) Staff #3 was observed changing a diaper. Staff did not wash hands before or after changing the diaper.”

8VAC20-780-510-G

“Based on observation, the center did not ensure that medication shall be labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: Child #6 with prescribed Auvi-Q medication had the Auvi-Q container that did not contain the original prescription label.”

8VAC20-780-350-B-3

“Based on observation and interview, the center did not ensure that staff to children ratios are followed whenever children are in care. Evidence: Classroom #2 was outside with two teachers and 14 children aged two years. Staff #3 took one child inside to the restroom leaving one teacher outside alone with 13 children. The ratio for this age group is 1:8. When interviewed, Staff #3 stated that she ?was not thinking when she did that.?”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: Classroom #6 and #4 both had closets that were unlocked and propped open which contained several cleaning agents labeled ?Keep out of reach of children? and ?Hazardous?”

8VAC20-780-270-A

“Based on observation, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition bending, or warping. Evidence: 1) Several broken buckets on playground with sharp edges. 2) Several bikes with missing pedals 3) The poured-in-place material on playground was cracked and open.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that children and staff wash their hands at all required times. Evidence:1) A child received a diaper change and was allowed to immediately play with other children and toys without washing hands 2) Staff #3 was observed changing a diaper. Staff did not wash hands before or after changing the diaper.”

8VAC20-780-510-G

“Based on observation, the center did not ensure that medication shall be labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: Child #6 with prescribed Auvi-Q medication had the Auvi-Q container that did not contain the original prescription label.”

8VAC20-780-350-B-3

“Based on observation and interview, the center did not ensure that staff to children ratios are followed whenever children are in care. Evidence: Classroom #2 was outside with two teachers and 14 children aged two years. Staff #3 took one child inside to the restroom leaving one teacher outside alone with 13 children. The ratio for this age group is 1:8. When interviewed, Staff #3 stated that she ?was not thinking when she did that.?”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: Classroom #6 and #4 both had closets that were unlocked and propped open which contained several cleaning agents labeled ?Keep out of reach of children? and ?Hazardous?”

8VAC20-780-270-A

“Based on observation, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition bending, or warping. Evidence: 1) Several broken buckets on playground with sharp edges. 2) Several bikes with missing pedals 3) The poured-in-place material on playground was cracked and open.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that children and staff wash their hands at all required times. Evidence:1) A child received a diaper change and was allowed to immediately play with other children and toys without washing hands 2) Staff #3 was observed changing a diaper. Staff did not wash hands before or after changing the diaper.”