La Petite Academy #7140

8VAC20-780-500-B

“Based on observation, the center did not ensure that the diapering surface shall be used only for diapering or cleaning children, and it shall be cleaned with soap and at least room temperature water and sanitized after each use. Evidence: 1. Inspector observed a diapering cleaning process and the staff was observed wiping the sanitizing solution immediately after spraying it on the changing table. a. "Sanitized" means treated in such a way to remove bacteria and viruses from inanimate surfaces through using a disinfectant solution (i.e., bleach solution or commercial chemical disinfectant) or physical agent (e.g., heat). The surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions. 2. Staff #1 (Director) confirmed that the staff wiped the sanitizing solution immediately after spraying it on the changing table.”

8VAC20-780-580-B

“Based on observation, the center did not ensure that the vehicle shall meet the safety standards set by the Department of Motor Vehicles Evidence: 1. The state inspection sticker for the bus expired in November 2023. 2. Staff #1 (Director) confirmed that the bus state inspection sticker was expired.”

8VAC20-780-280-D

“Based on observation, the center did not ensure that cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single-service articles and shall be stored in areas physically separate from food. Evidence: 1. A spray bottle of cleaning solution was stored in a cabinet above a jar of apple butter. 2. Staff #1 (Director) confirmed that the bottle of cleaning solution was stored in a cabinet above a jar of apple butter.”

8VAC20-780-130-E

“REPEAT VIOLATION Based on record review, the center did not ensure that documentation of additional immunizations once every six months for children under the age of two years were in the record. Evidence: 1. The most recent immunizations on file for child #2 (age 15 months), were administered on March 16, 2023, according to documentation on file. 2. Staff #1 (Director) confirmed that immunization record has not been updated.”

8VAC20-780-350-B-1

“Based on observation, the center did not ensure that the staff to child ratio for birth to up to 16 months had a ratio of 1:4 while children were in care. Evidence: 1. The toddler room (age 16 months to two years old) had 10 children and 2 staff when reviewed by the inspector at approximately 2:50pm. The staff was using a 1:5 ratio but should have been using a 1:4 ratio because one child in care, Child #1, was 15 months. a. "Toddler" means children from 16 months up to two years. 2. Staff #1 (Director) confirmed that that child 1 was under 16 months of age and further acknowledged that a third staff was needed.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The enrollment record for child 1 lacked the work phone number and place of employment for one parent 2. The enrollment record for child 2 lacked the following: a. Work phone number for one parent; b. The name, address and phone number of a second emergency contact. 3. The enrollment record for child 3 lacked the name, address and phone number of a second emergency contact. 4. Administrative staff verified the above information was not available.”

8VAC20-780-160-C

“Based on record review and interview, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members and individuals from shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 4 was conducted on 01/18/2021. a. Administrative staff verified that an updated TB screening was not available for staff 4.”

22.1-289.011-F

“Based on observation and interview, the center failed to post on the premises the findings of the most recent inspection of the facility. Evidence: 1. The most recent inspection, conducted on 04/04/2023, was not posted. a. Administrative staff confirmed that these inspection documents were not posted.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 3, enrollment date 07/26/2023, lacked documentation of a physical exam. a. Administrative staff confirmed that a physical exam was not on file for child 3.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to ensure that staff have a central registry finding within 30 days of employment. Evidence: 1. Staff 1, hire date 05/01/2023, lacked a central registry finding. 2. Staff 2, hire date 09/04/2023, lacked a central registry finding. 3. Staff 3, hire date 08/28/2023, lacked a central registry finding. 4. Administrative staff confirmed that a central registry finding was not on file for these 3 staff.”

8VAC20-780-130-E

“Based on record review and interview, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations on file for child 1 were administered on 03/16/2023. a. Child 1 is under the age of two years and was in care during the inspection. 2. The most recent immunizations on file for child 2 were administered on 09/13/2022. a. Child 2 is under the age of two years and was in care during the inspection.”

8VAC20-780-580-C

“Based on observation, the center failed to ensure that during transportation of children the number for poison control and 911 or local dial number for police, fire and emergency medical services shall be in transportation vehicles. Evidence: 1. The numbers for poison control and 911 or local dial for police, fire and emergency medical services were not in the bus or binder reviewed during the inspection. a. Administrative staff confirmed that these emergency phone numbers were not available in the bus used to transportation children to / from public school.”

8VAC20-780-550-K

“Based on interview the center failed to prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center. Evidence: 1. Administrative staff stated that the binder maintained for each bus did not have any written information regarding potential shelters, hospitals and evacuation routes that are applicable for daily pick up and drop off at local public schools. a. The binder reviewed for one bus lacked this information.”

8VAC20-780-550-D

“Based on record review and interview, the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency fire drill log for the facility indicated the most recent fire drill as being conducted on 03/20/2023. 2. Administrative staff confirmed that a fire drill had not been implemented since 03/20/2023.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each 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: 1. Staff 1, hire date 05/01/2023, lacked documentation of a TB screening. 2. Staff 2, hire date 09/04/2023, lacked documentation of a TB screening. 3. Administrative staff confirmed that a TB screening was not available for these staff.”

8VAC20-780-510-G

“Based on observation, the center failed to 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: One prescription medication for child 5 was not labeled with the child's name, the dosage amount and the time to be given.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Where steps are used for accessibility, resilient surfacing is not required. Evidence: 1. There was no resilient surfacing under the outdoor play structure on the preschool playground. a. The entire perimeter of this structure lacked any mulch and had only compacted dirt in all areas. 2. There was no resilient surfacing under the outdoor play structure on the toddler playground. a. The entire perimeter of this structure lacked any mulch and had only compacted dirt in all areas.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin. Evidence: 1. One metal stall , in the preschool classroom, had widespread areas of rust on both sides on the lower half of the stall within easy reach of children. 2. The cord from the light table, in the 2's classroom, was accessible to children as the cord was wrapped around the leg of the table with the plug in dangling to the floor within easy reach of children in care 3. The following safety hazards were observed on the preschool outdoor play area: a. Broken bricks, concrete pieces and an exposed pipe was observed on the ground beside the side walk tricycle track. This area of ground sits below the sidewalk and is littered with debris and is uneven in such a way as to create a trip hazard; b. Three exposed tree roots, measuring approximately 30 inches in length each, were observed in multiple areas around the outdoor play structure. These roots were in areas on the ground where children run and gain access to the equipment. These tree roots are protruding upward as to create a trip hazard; c. The plastic play panel has 2 cracks in the plastic which creates a pinch point for children's fingers; d. Widespread areas of peeling paint was observed on two of the metal poles for the shade structure; 4. Exposed tree roots were observed on the toddler outdoor play area. a. The exposed root by the play structure measured approximately 15 inches in length; b. The exposed root by the sidewalk measured approximately 50 inches in length. 5. The ground below ( and at the end of) the sidewalk on the toddler playground sits below the sidewalk approximately 12 inches. This drop creates a trip/fall hazard. 6. 2 of 4 toilets in the two year old classroom are not operable. a. These 2 toilets are completely covered with tape and paper to prevent use. 2. The two staff working in the two-year old classroom stated the toilets had not been operable since mid July 2023.”

8VAC20-780-260-B

“Based on interview, the center failed to provide annual approval from the health department. Evidence: Administrative staff stated that an annual inspection from the Virginia Beach health department was not available.”

8VAC20-780-260-A

“Based on record review and interview, the center failed to provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: 1. Administrative staff stated that an annual fire inspection had not been conducted.”

8VAC20-780-40-M

“Based on review and interview, the center failed to maintain a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. Evidence: 1. Child 4 has a written emergency allergy care plan for a diagnosed food allergy. This food allergy was not listed on the allergy list in any of the facility classrooms. a. Administrative staff confirmed that the allergy list had not been updated to include allergy information for child 4.”

8VAC20-780-60-A

“Based on record review and interview, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The enrollment record for child 1 lacked the work phone number and place of employment for one parent 2. The enrollment record for child 2 lacked the following: a. Work phone number for one parent; b. The name, address and phone number of a second emergency contact. 3. The enrollment record for child 3 lacked the name, address and phone number of a second emergency contact. 4. Administrative staff verified the above information was not available.”

8VAC20-780-160-C

“Based on record review and interview, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members and individuals from shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The most recent TB screening for staff 4 was conducted on 01/18/2021. a. Administrative staff verified that an updated TB screening was not available for staff 4.”

22.1-289.011-F

“Based on observation and interview, the center failed to post on the premises the findings of the most recent inspection of the facility. Evidence: 1. The most recent inspection, conducted on 04/04/2023, was not posted. a. Administrative staff confirmed that these inspection documents were not posted.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 3, enrollment date 07/26/2023, lacked documentation of a physical exam. a. Administrative staff confirmed that a physical exam was not on file for child 3.”

8VAC20-770-60-C-2

“Based on record review and interview, the center failed to ensure that staff have a central registry finding within 30 days of employment. Evidence: 1. Staff 1, hire date 05/01/2023, lacked a central registry finding. 2. Staff 2, hire date 09/04/2023, lacked a central registry finding. 3. Staff 3, hire date 08/28/2023, lacked a central registry finding. 4. Administrative staff confirmed that a central registry finding was not on file for these 3 staff.”

8VAC20-780-130-E

“Based on record review and interview, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. The most recent immunizations on file for child 1 were administered on 03/16/2023. a. Child 1 is under the age of two years and was in care during the inspection. 2. The most recent immunizations on file for child 2 were administered on 09/13/2022. a. Child 2 is under the age of two years and was in care during the inspection.”

8VAC20-780-580-C

“Based on observation, the center failed to ensure that during transportation of children the number for poison control and 911 or local dial number for police, fire and emergency medical services shall be in transportation vehicles. Evidence: 1. The numbers for poison control and 911 or local dial for police, fire and emergency medical services were not in the bus or binder reviewed during the inspection. a. Administrative staff confirmed that these emergency phone numbers were not available in the bus used to transportation children to / from public school.”

8VAC20-780-550-K

“Based on interview the center failed to prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center. Evidence: 1. Administrative staff stated that the binder maintained for each bus did not have any written information regarding potential shelters, hospitals and evacuation routes that are applicable for daily pick up and drop off at local public schools. a. The binder reviewed for one bus lacked this information.”

8VAC20-780-550-D

“Based on record review and interview, the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency fire drill log for the facility indicated the most recent fire drill as being conducted on 03/20/2023. 2. Administrative staff confirmed that a fire drill had not been implemented since 03/20/2023.”

8VAC20-780-160-A

“Based on record review and interview, the center failed to ensure that each 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: 1. Staff 1, hire date 05/01/2023, lacked documentation of a TB screening. 2. Staff 2, hire date 09/04/2023, lacked documentation of a TB screening. 3. Administrative staff confirmed that a TB screening was not available for these staff.”

8VAC20-780-510-G

“Based on observation, the center failed to 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: One prescription medication for child 5 was not labeled with the child's name, the dosage amount and the time to be given.”

8VAC20-780-330-B

“Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Where steps are used for accessibility, resilient surfacing is not required. Evidence: 1. There was no resilient surfacing under the outdoor play structure on the preschool playground. a. The entire perimeter of this structure lacked any mulch and had only compacted dirt in all areas. 2. There was no resilient surfacing under the outdoor play structure on the toddler playground. a. The entire perimeter of this structure lacked any mulch and had only compacted dirt in all areas.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin. Evidence: 1. One metal stall , in the preschool classroom, had widespread areas of rust on both sides on the lower half of the stall within easy reach of children. 2. The cord from the light table, in the 2's classroom, was accessible to children as the cord was wrapped around the leg of the table with the plug in dangling to the floor within easy reach of children in care 3. The following safety hazards were observed on the preschool outdoor play area: a. Broken bricks, concrete pieces and an exposed pipe was observed on the ground beside the side walk tricycle track. This area of ground sits below the sidewalk and is littered with debris and is uneven in such a way as to create a trip hazard; b. Three exposed tree roots, measuring approximately 30 inches in length each, were observed in multiple areas around the outdoor play structure. These roots were in areas on the ground where children run and gain access to the equipment. These tree roots are protruding upward as to create a trip hazard; c. The plastic play panel has 2 cracks in the plastic which creates a pinch point for children's fingers; d. Widespread areas of peeling paint was observed on two of the metal poles for the shade structure; 4. Exposed tree roots were observed on the toddler outdoor play area. a. The exposed root by the play structure measured approximately 15 inches in length; b. The exposed root by the sidewalk measured approximately 50 inches in length. 5. The ground below ( and at the end of) the sidewalk on the toddler playground sits below the sidewalk approximately 12 inches. This drop creates a trip/fall hazard. 6. 2 of 4 toilets in the two year old classroom are not operable. a. These 2 toilets are completely covered with tape and paper to prevent use. 2. The two staff working in the two-year old classroom stated the toilets had not been operable since mid July 2023.”

8VAC20-780-260-B

“Based on interview, the center failed to provide annual approval from the health department. Evidence: Administrative staff stated that an annual inspection from the Virginia Beach health department was not available.”

8VAC20-780-260-A

“Based on record review and interview, the center failed to provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction. Evidence: 1. Administrative staff stated that an annual fire inspection had not been conducted.”

8VAC20-780-40-M

“Based on review and interview, the center failed to maintain a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. Evidence: 1. Child 4 has a written emergency allergy care plan for a diagnosed food allergy. This food allergy was not listed on the allergy list in any of the facility classrooms. a. Administrative staff confirmed that the allergy list had not been updated to include allergy information for child 4.”

8VAC20-780-400-B Complaint related: Yes

“Based on interviews the center did not ensure behavioral guidance was constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. It was reported, Staff 1 used verbal commands, described as "harsh, loud and shouting" instead of guiding children to the appropriate behavior. 2. Several staff reported Staff 1 does not get up from the chair to redirect children, rather she shouts verbal commands. 3. Staff #1 had a written disciplinary action for not using positive guidance or redirection on 03/22/2023. 4. Staff #1 confirmed she gets loud with the children when she becomes stressed.”

8VAC20-790-600-D-1

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in CPR. 2. Staff 2, hire date 09/19/2022, lacks certification in CPR. 3. The CPR certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current CPR certification.”

8VAC20-790-600-D-2

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid appropriate to the ages of children in care. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in first aid. 2. Staff 2, hire date 09/19/2022, lacks certification in first aid. 3. The first aid certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current first aid certification.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 1, enrollment date 11/07/2022, lacked documentation of a physical exam. 2. Administrative staff confirmed that a written physical exam was not on file for child 1.”

8VAC20-780-580-C

“Based on observation, the center failed to ensure that during transportation of children the number for poison control shall be in transportation vehicles. Evidence: 1. The number for poison control was not posted in the center bus nor was this number listed in the bus binder.”

8VAC20-780-550-G

“Based on record review and interview, the center failed to ensure that documentation shall be maintained of emergency shelter-in-place practice drills. Evidence: 1. The emergency log for the facility did not indicate if any shelter-in-place practice drills had been conducted in 2022. 2. Administrative staff verified that the 2022 emergency log did not indicate any shelter-in-place practice drills for 2022.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that outside areas of the center shall be maintained in a safe condition. Evidence: 1. A dangling cable type cord was observed on the side of the building within easy reach of children on the toddler/ two's outdoor play area.”

8VAC20-780-550-K

“Based on interview, the center failed to prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center. Evidence: 1. Administrative staff stated that the binder maintained for each bus did not have any written information regarding potential shelters, hospitals and evacuation routes that are applicable for daily pick up and drop off at local public schools.”

8VAC20-790-600-D-1

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in CPR. 2. Staff 2, hire date 09/19/2022, lacks certification in CPR. 3. The CPR certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current CPR certification.”

8VAC20-790-600-D-2

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid appropriate to the ages of children in care. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in first aid. 2. Staff 2, hire date 09/19/2022, lacks certification in first aid. 3. The first aid certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current first aid certification.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 1, enrollment date 11/07/2022, lacked documentation of a physical exam. 2. Administrative staff confirmed that a written physical exam was not on file for child 1.”

8VAC20-780-580-C

“Based on observation, the center failed to ensure that during transportation of children the number for poison control shall be in transportation vehicles. Evidence: 1. The number for poison control was not posted in the center bus nor was this number listed in the bus binder.”

8VAC20-780-550-G

“Based on record review and interview, the center failed to ensure that documentation shall be maintained of emergency shelter-in-place practice drills. Evidence: 1. The emergency log for the facility did not indicate if any shelter-in-place practice drills had been conducted in 2022. 2. Administrative staff verified that the 2022 emergency log did not indicate any shelter-in-place practice drills for 2022.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that outside areas of the center shall be maintained in a safe condition. Evidence: 1. A dangling cable type cord was observed on the side of the building within easy reach of children on the toddler/ two's outdoor play area.”

8VAC20-780-550-K

“Based on interview, the center failed to prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center. Evidence: 1. Administrative staff stated that the binder maintained for each bus did not have any written information regarding potential shelters, hospitals and evacuation routes that are applicable for daily pick up and drop off at local public schools.”

8VAC20-790-600-D-1

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in CPR. 2. Staff 2, hire date 09/19/2022, lacks certification in CPR. 3. The CPR certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current CPR certification.”

8VAC20-790-600-D-2

“Based on record review and interview, the vendor failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid appropriate to the ages of children in care. Evidence: 1. Staff 1 , hire date 09/01/2022, lacks certification in first aid. 2. Staff 2, hire date 09/19/2022, lacks certification in first aid. 3. The first aid certification for staff 3 expired on 11/21/2022. 4. Administrative staff verified that these staff did not have current first aid certification.”

8VAC20-780-140-A

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 1, enrollment date 11/07/2022, lacked documentation of a physical exam. 2. Administrative staff confirmed that a written physical exam was not on file for child 1.”

8VAC20-780-580-C

“Based on observation, the center failed to ensure that during transportation of children the number for poison control shall be in transportation vehicles. Evidence: 1. The number for poison control was not posted in the center bus nor was this number listed in the bus binder.”

8VAC20-780-550-G

“Based on record review and interview, the center failed to ensure that documentation shall be maintained of emergency shelter-in-place practice drills. Evidence: 1. The emergency log for the facility did not indicate if any shelter-in-place practice drills had been conducted in 2022. 2. Administrative staff verified that the 2022 emergency log did not indicate any shelter-in-place practice drills for 2022.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that outside areas of the center shall be maintained in a safe condition. Evidence: 1. A dangling cable type cord was observed on the side of the building within easy reach of children on the toddler/ two's outdoor play area.”

8VAC20-780-550-K

“Based on interview, the center failed to prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center. Evidence: 1. Administrative staff stated that the binder maintained for each bus did not have any written information regarding potential shelters, hospitals and evacuation routes that are applicable for daily pick up and drop off at local public schools.”

8VAC20-780-400-B

“Based on staff interviews and a review of center video, the center failed to ensure that behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior. Evidence: 1. Staff 1 failed to provide positive redirection or constructive guidance to child 1, age 18 months, who had pulled a chair up to the hand washing sink and wasplaying in the water. 2. Staff 2 stated it was normal for child 1 to pull a chair up to the hand washing sink and play in the water. Staff 2 additionally stated that child 1 did not generally respond to verbal redirection. a. Staff 2 stated that child 1 had been playing in the hand washing sink at 11:00 am that morning. b. Center video showed child 1 playing in the hand washing sink at approximately 12:04 pm as the class prepared for nap. 3. On both occasions, staff 1 grabbed child 1 by the arm in order to move him away from the sink. a. Center video shows staff 1 taking child 1 by the arm and quickly moving him across the room and dropping him on his cot at 12:04 pm. Staff 1 then walks away without offering any quite activity, comfort or nap assistance. b. Staff 2 reported that staff 1 grabbed child 1 by the arm to remove him from the sink at 11:00am. According to staff 2, staff 1, "appeared frustrated" as she moved child 1 by the arm across the room, and dropped him on the carpeted area. Staff 2 indicated that staff 1 walked away leaving child 1 crying on the carpeted area of the classroom.”

8VAC20-780-410-1

“Based on staff interviews and a review of video, the center failed to ensure that roughly handling a child is forbidden. Evidence: 1. Child 1 received a bruise to his left forearm when staff 1 inappropriately picked him up on two instances on 08/18/2022. 2. Staff 2 who was in the classroom with staff 1, stated she observed staff 1 grapping child 1 by the arm at approximately 11:00 am. a. Staff 2 stated that child 1 was standing on a chair at the hand washing sink when staff 1 grabbed child 1 by the arm and pulled him off of the chair. b. Staff 2 stated that staff 1 pulled child 1 over to the carpeted area of the classroom, by his arm, and dropped him onto the carpet. c. Staff 2 stated that child 1 cried when his arm was grabbed by staff 1. 2. At 12:04 pm center video shows staff 1 picking child 1 up by the arm and pulling him off of a chair. a. Staff 1 is then observed holding child 1's hand and walking at a faster pace than the child is able which causes him to trip over a cot. b. Staff 1 picks child 1 up by the arm, pulls him the rest of the way to his cot and then drops him onto his cot and walks away. 3. The parent of child 1 reported that her child had a finger shaped bruise on his left arm which was noted the evening of 08/18/2022 during bath time. a. The parent stated she had observed the live feed of the center video on 08/18/2022 and noted that staff 1 had grabbed her child by the arm in a way that appeared aggressive. 4. Staff 2 and staff 3 confirmed they saw the bruise on child 1's forearm on 08/19/2022. a. Staff 2 described the bruise as purple in appearance and in the shape of a fingerprint. b. Staff 3 described the bruise as purple in appearance and in the shape of a thumbprint.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The enrollment record for child 1 lacked an address for the two designated emergency contacts.”

8VAC20-780-560-N

“Based on observation, the center failed to ensure that food shall be stored in a clean and sanitary manner. Evidence: 1. Two bottles of prepared infant formula were observed heating up inside of water coolers placed inside of the sink attached to the diaper changing table. a. Both staff working in the infant room stated it was the usual practice to heat infant bottles up in water coolers that were placed inside of the diaper changing table sink.”

8VAC20-780-510-P

“Based on medication review, the center failed to ensure that 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. Evidence: 1. Two medications, for child 2, with an authorization that expired on 12/11/2021 were observed stored in the center medication box. 2. Two medications for child 3, with an authorization that expired on 12/03/2021 and 10/13/2021, were observed stored in the center medication box.”

8VAC20-780-550-D

“Based on record review and interview, the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency log for the facility indicated that fire drills had not been conducted in August, October, November and December of 2021. a. Administrative staff stated that a fire drill had been conducted in December of 2021 however, she was unsure if fire drills had been conducted in August, October and November of 2021. 2. The emergency log for the facility indicated that no fire drills had been implemented in January, February or March of 2022. a. Administrative staff verified that no fire drills had been conducted in 2022.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. An area of missing cement, measuring approximately 14 inches, was observed on the basketball court. This is a trip hazard. 2. The cloth shade panels were loose and coming apart from the shade structure on the preschool outdoor play area.”

8VAC20-780-60-A

“Based on record review, the center failed to ensure that children's records contain all of the required elements. Evidence: 1. The enrollment record for child 1 lacked an address for the two designated emergency contacts.”

8VAC20-780-560-N

“Based on observation, the center failed to ensure that food shall be stored in a clean and sanitary manner. Evidence: 1. Two bottles of prepared infant formula were observed heating up inside of water coolers placed inside of the sink attached to the diaper changing table. a. Both staff working in the infant room stated it was the usual practice to heat infant bottles up in water coolers that were placed inside of the diaper changing table sink.”

8VAC20-780-510-P

“Based on medication review, the center failed to ensure that 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. Evidence: 1. Two medications, for child 2, with an authorization that expired on 12/11/2021 were observed stored in the center medication box. 2. Two medications for child 3, with an authorization that expired on 12/03/2021 and 10/13/2021, were observed stored in the center medication box.”

8VAC20-780-550-D

“Based on record review and interview, the center failed to implement a monthly practice evacuation drill. Evidence: 1. The emergency log for the facility indicated that fire drills had not been conducted in August, October, November and December of 2021. a. Administrative staff stated that a fire drill had been conducted in December of 2021 however, she was unsure if fire drills had been conducted in August, October and November of 2021. 2. The emergency log for the facility indicated that no fire drills had been implemented in January, February or March of 2022. a. Administrative staff verified that no fire drills had been conducted in 2022.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. An area of missing cement, measuring approximately 14 inches, was observed on the basketball court. This is a trip hazard. 2. The cloth shade panels were loose and coming apart from the shade structure on the preschool outdoor play area.”

8VAC20-780-130-E Complaint related: No

“Based on record review and interview, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. Child 1, age 14 months, lacks documentation of current immunizations. a. The most recent immunization record on file indicates the most recent immunizations were administered on 01/12/2021. 2. Administrative staff confirmed that an updated immunization had not been obtained for child 1.”

8VAC20-780-140-A Complaint related: No

“Based on record review and interview, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before enrollment or within one month after attendance. Evidence: 1. Child 1, enrollment date 02/01/2021, lacks documentation of a physical exam. 2. Administrative staff confirmed that a written physical exam was not on file for child 1.”

22VAC40-185-400-B

“Based on interviews and a review of center video, the center failed to ensure that behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. A review of center video shows two children on the carpeted area of the classroom at approximately 3:45 pm on 10/05/2021. Staff 1 is observed walking over to the children and lifting child 1 up by the wrist. Child 1 is then dragged across the carpet, his feet briefly leaving the floor, while staff 1 continues to hold on to his wrist. 2. Staff 1 stated that child 1 and another child were "rolling around on the carpet while I was doing circle time." a. Staff 1 stated she provided several verbal prompts which did not bring child 1 back to circle time. b. Staff 1 stated she then went over and removed child 1 by picking him up under his arms and bringing him back to circle time nevertheless, child 1 left circle time and resumed rolling around on the floor with another child. c. Staff 1 stated she attempted an additional verbal prompte however, this failed to bring child 1 back to circle time. d. Staff 1 stated she then went over to child 1 and "took his hand and picked him up off the floor." "I picked him up and stood him up....I sat him down next to me." e. Shortly thereafter, child 1 began crying and stating that his arm hurt according to staff 1. 3. The facility positive guidance and redirection policy states, "No staff member is permitted to use physical punishment on any child." Pulling is listed as a prohibited form of punishment. a. Administrative staff stated that staff 1 did not properly redirect child 1 when she lifted him up by his arm and pulled him across the carpet.”

22VAC40-185-410-1

“Based on review of center video and interviews, the center failed to ensure that the following actions are forbidden: Roughly handling of children. Evidence: 1. Video footage on 10/05/2021 at approximately 3:45 pm shows staff 1 lifting child 1, age 3 years, by the wrist and dragging child 1 across the carpeted area. For a brief moment, child 1's feet leave the floor as he is being picked up and dragged. 2. Staff 1 stated she went over to child 1 and "took his hand and picked him up off the floor." "I picked him up and stood him up....I sat him down next to me." 3. Staff 1 stated that approximately one minute later, child 1 was crying and stated that his arm hurt. a. Staff 1 administered first aid in the form of an ice pack and took child 1 to the office. 4. Staff 2 stated that child 1 was brought to the office at approximately 4:20 pm. a. Child 1 was holding his arm and cried when any attempt was made to move the arm according to staff 2. 5. Child 1 was taken for medical treatment on 10/05/2021 where he was diagnosed with nursemaid's elbow. a. The parent of child 1 stated that the physician stated the ligament had been pulled out of place when someone had pulled child 1 up by the arm.”