La Petite Academy #7143

8VAC20-780-410-1

“Based on interviews and a review of video footage, it was determined that the center failed to ensure actions that are considered forbidden do not occur. Evidence: 1. On 8/14/23, the center director self-reported that a staff member witnessed staff 1 ?grabbing a child by his cheeks? on 8/10/23 in the two-year-old classroom. The center director also reported that upon review of the video footage for the two’s classroom on 8/10/23, additional incidents were observed of staff 1 and staff 2 roughly handling multiple children. 2. On 8/29/23, the licensing inspector, along with the district manager, viewed video footage from 8/10/23 of the two-year-old classroom, at which time staff 1 and staff 2 were responsible for the children in care. The video is of an approximate 20-minute time period. The video showed the following incidents of forbidden actions by staff 1 and staff 2: a. Staff 1 is sweeping the floor and picks up child 1 (age 2 years) by his upper left arm, lifts him off his feet into the air, and sets him back on the floor to move him out of her way. Staff 1 continues to sweep the floor and then takes child 2 (age 2 years) by her left arm and pulls her by the arm to move her out of the way. b. Child 3 (age 2 years) is standing by a shelf and takes his shoe off. Staff 1 walks over to child 1, takes him by his upper right arm and pulls him down to a sitting position on the floor to put his shoe back on his foot. c. Child 1 is sitting on the floor when staff 1 bends down to talk to him. Staff 1 then stands up and grabs child 1 with her hand by both sides of his mouth. d. Child 4 (age 2 years) is running in the classroom when staff 1 takes him by his upper right arm and pulls him down to a sitting position against the wall. e. Staff 2 takes child 3 by his left forearm and pulls him up to a standing position and pulls him across the carpet. Child 3 can be seen moving his arms and legs trying to get loose from staff 2. Child 3 then falls to the floor and staff 2 hits him on his back. Staff 2 then picks child 3 up, pulls him over to the window and sits him down on the floor. 3. Staff 3 stated that on 8/10/23 she was on the playground with her class and was standing by the window of the two-year-old classroom. Staff 3 stated she was looking through the window and witnessed staff 1 ?grab? child 1 by the face on both sides of his mouth. 4. Center management confirmed that staff 1 and staff 2 engaged in multiple forbidden actions of roughly handling children and striking a child in the two-year-old classroom on 8/10/23.”

8VAC20-780-40-E

“Based on interviews, video footage and a review of the center’s policies, the center failed to ensure that the center’s services are maintained in compliance with the center’s own policies and procedures that are required by these standards. Evidence: The center failed to follow their written procedures for inappropriate redirection as demonstrated by the following incident: 1. The center’s written procedure regarding inappropriate redirection states ?The use of physical, mental, or emotional punishment on or demeaning behavior toward any child is prohibited. No staff member is permitted to utilize the following means of punishment or redirection on any child, including his/her own or a relative’s child, while on company property: Hitting, shaking, biting, pinching, pulling, pushing, physical force or inflicting any other form of corporal punishment to hurt a child?restricting a child’s movement by binding, tying or any other type of physical restrain or timeout, including lifting or carrying a child.? a. On 8/10/23, staff 1 pulled multiple children by their arm and sat them down on the floor, lifted a child up in the air by his arm to move him and grabbed a child on both sides of his mouth with her hand. On that same date, staff 2 pulled a child by his arm, hit him on his back after he fell to the floor and then pulled him by his arm again to sit him down on the floor. 2. Center management confirmed that staff 1 and staff 2 did not follow the center’s written procedures regarding inappropriate redirection.”

8VAC20-780-580-C Complaint related: Yes

“Based on staff interviews and a review of center documents, it was determined that the center did not ensure that Virginia state statutes about safety belts are followed as required by ?46.2-1095 through ?46.2-1100 of the Code of Virginia and that stated maximum number of passengers in a vehicle is not exceeded during transportation of children. Evidence: 1. Two staff members stated that on 7/14/23, they took 17 school-aged children on one of the centers? two vehicles for a field trip. The staff members stated that the center vehicles only have enough seats and seat belts for a maximum of 14 children. 2. Staff stated that because there were not enough seats for the number of children on the field trip, they had to sit several of the children three to a seat and some children did not have seat belts to wear. One staff member stated that she had to sit on the floor of the vehicle due to there being no seat for her to sit in. 3. The licensing inspector observed a total of 14 seat belts available on the center vehicle used to transport children. 4. There are 17 children listed on the field trip Face-to-Name sheet for 7/14/23. The staff supervising the field trip that day confirmed that the face-to-name sheet was correct and that the 17 children listed were transported on the center vehicle to and from the field trip. 5. The center director confirmed that the center vehicle used to transport children holds two children per seat for a maximum of 14 children.”

8VAC20-780-400-B

“Based on observations and interactions the facility 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 ? While on the playground with the toddler/two-year-old class, Staff #2 verbally stated to a child in care ?She's just mean?she's mean.? loud enough for all the children to hear. 2 ? Staff #2 could be heard yelling at a child in care ?Get Down! No! Get Down! No! No! (Child’s name) Get Down!?. Staff #6 was passing through the two-year-old room as she returned to the playground with her class, the toddler group. 3 ? Staff #6 could be heard yelling ?Get off of each other NOW!? a. The staff’s raised voice startled adults seated at the opposite end of the child care center. Adults hearing this stopped typing, writing and reviewing records to turn in the direction of the raised voice.”

8VAC20-780-340-F

“Based on observation and interview the center failed to ensure that children under 10 years of age are always within actual sight and sound supervision of staff. Evidence: 1 - Video footage viewed and staff interview confirm that on May 12, 2023, two-year old, Child # 1, while in the care of Staff #2 and #3, was left unattended in the two-year-old classroom for approximately 2 - 4 minutes. 2 - Staff #4 found the child in the two-year-old classroom while walking through the center carrying out lunch related duties. a. Staff #4 stated that the child was not crying "but he looked confused, like where is everybody." 3 - An incident report generated by the facility documents that Child #1 was left unattended by Staff #2 and #3 on May 12, 2023 at approximately 11:00am.”

8VAC20-780-40-E

“Based on interviews, the center failed to demonstrate operational responsibilities ensuring that the center's activities, services, and facilities are maintained in compliance with the center's own policies and procedures. Evidence: 1 - The center's policy states ?face to name transition sheet must be used to document staff to child ratios at the following times throughout the day: hourly, children arriving and leaving the classroom, transitioning children from one location to another, combining and or blending classrooms, teachers changes and breaks in the classroom.? However, on May 12, 2023, the policy was not followed leading to a Child #1 being left alone and unattended in the two-year-old classroom by Staff #2 and #3. a. Staff #2 stated that she did not complete the required head count using the face-to-name sheet; she thought Staff #3 had completed the head count using the face-to-name sheet because Staff #3 was the last staff to leave the classroom. b. Staff #3 stated that she was not regularly assigned to the two-year-old classroom, and she was not the lead teacher, therefore she did not fill out the face-to-name sheet. c. Staff #3 stated that she did not follow the center procedure of using the face-to-name sheet until returning to classroom and preparing to go outside. d. Staff #2 stated that she understood it was the responsibility of both staff to ensure that the policy of head counts with the face-to-name sheet was completed, and that both she and Staff #3 confirmed that it was both of their responsibility to ensure that the face-to-face sheet was completed. 2 ? The center’s procedure for a child being separated from their group states when ??a child is unintentionally separated from their group, not within sight or sound of a staff member, for any period of time call for help while ensuring the supervision of other children.? However, on May 12, 2023, Staff #2 stated that it was approximately 15 ? 30 minutes before she called for help after it was known to her that Child #1 was not present in the group of children she was responsible for. a. Staff #1, #4 and #5 stated that they were never notified by Staff #2 that Child #1 was no longer within her sight/sound supervision. b. b. Staff #3 who was present in the two’s classroom stated that at no time did either herself or Staff #2 inform management that Child #1 was no longer in their sight sound supervision. 3 - The center’s procedure for managing challenging behaviors states: ?No staff member is permitted to utilize the following means of punishment or redirection on any child - Subjecting a child to harsh, abusive, or profane language.? On May 16, 2023, Staff #2 and #6 were observed subjecting children to harsh language in three separate incidents: a. Staff #6 was heard using a raised angry voice while speaking to children in her care. She stated, ?GET OFF EACH OTHER NOW!?. Staff #5 was located at the back of the building, and she was heard clearly by people sitting near the front door of the building. b. Staff #2 was heard saying ?She’s mean! She’s just mean!? Staff #6 was referring to a toddler in care. The statement was made while the toddler class, consisting of 10 children and two staff, was outside on the playground and could be heard by everyone within hearing proximity. c. Staff #2 was heard using a raised angry voice as she passed through the two-year old room. Staff #6 stated GET DOWN! NO! GET DOWN! NO! NO! [Child #2] GET DOWN! 4 ? Staff #1 confirmed that Staff #2 and #6 did not follow center policy regarding managing challenging behaviors.”

8VAC20-780-160-A

“Risk rating B2 Based on record review and interview the center failed to ensure that each staff member obtained documentation of a negative tuberculosis screening within the required time frames. Evidence.: 1 - The record for Staff #7 does not contain any documentation that a Tuberculosis screening was completed. a. The documented date of hire for Staff #7 is February 13, 2023. 2 - The record for Staff #8 contained documentation of a tuberculosis screening; however, the results do not contain the date the results were determined. a. The documented date of hire for Staff #8 is April 10, 2023. 3 - Staff #1 confirmed that there was not a tuberculosis screening on file for Staff #7. Additionally, Staff #1 confirmed that the documentation in the record of Staff #8 for was not dated.”

8VAC20-780-140-A

“Based on record review and interview the facility failed to ensure that each child has documentation of a physical examination on file within the required time frame. Evidence: 1 - The records for children #3 and #4 did not contain documentation of any physical examination. a. Child #3 has a documented first date of attendance as April 10, 2023. b. Child #4 has a documented first date of attendance as April 3, 2023. 2 - Staff #1 confirmed that there was not any documentation of physical examinations in the records of Child #3 or #4.”

8VAC20-780-340-A

“Based on interviews, the center failed to demonstrate that when staff are supervising children, they shall always ensure their care and protection. 1 ? Staff #2 and #3 took their group of children from the two-year-old classroom to retrieve materials from the preschool classroom. Upon returning to the two-year-old classroom Staff #2 stated to Staff #3 that Child #1 was not present in the classroom. However, neither Staff #2 or #3 took action to determine if Child #1 was anywhere in the building or to locate Child #1 once it was determined that the child was not present in their care. a. Staff #3 stated that Child #1 was missing from their classroom for approximately 30 minutes to an hour, until Staff #1 returned the child to their care. 2 ? Child #1 had been found alone and unsupervised in the two-year-old classroom by Staff #4. Staff #4 stated that while Child #1 ?was not crying he appeared confused, like where is everybody.? a. Staff #4 stated that she brought Child #1 to the office where she stayed with him and fed him lunch. 3 ? Staff #1 and #4 stated that there were general radio calls throughout the center asking staff to complete head counts/face to name sheets and report back. However, a response from Staff #2 or #3 was never received. a. Staff #1 stated that he was waiting to see how long it took Staff #2 and #3 to report that they did not have possession of Child #1. b. After approximately 30 minutes to an hour Staff #1 returned Child #1 to the two-year-old classroom. c. Staff #1 stated that Staff #2 nor #3 ever acknowledged that Child #1 was not within their supervision.”

8VAC20-780-60-A Complaint related: No

“Based on record review and interview, the center did not ensure that children's records contain all the required items. Evidence: 1. The record for child 1 (date of enrollment: 11/21/22) contains only one name, address and phone number of a designated person to call in an emergency if a parent cannot be reached, where two are required. 2. The center director confirmed that the record for child 1 is lacking one of the required two emergency contacts.”

8VAC20-780-500-A Complaint related: No

“Based on a review of video footage and interview, the center did not ensure that children's hands shall be washed with soap and running water after toileting and that staff shall wash their hands with soap and running water before and after a diaper change. Evidence: 1. The licensing inspector reviewed video footage from 1/25/23 of the 2-year old classroom. Staff 1 was observed changing 2 children's diapers. Staff 1 did not wash his hands before or after changing each child's diaper and did not ensure that either child washed their hands after having their diaper changed. a. Both children were observed to be playing and touching toys and furniture in the classroom directly after having their diaper changed and without washing their hands. 2. Staff 1 confirmed that he did not wash his hands before or after diaper changes and that the children did not wash their hands after having their diaper changed.”

8VAC20-780-350-B-3 Complaint related: Yes

“Based on a review of video footage and interview, the center did not ensure that the staff-to-children ratio of 1:8 for 2 year old's is maintained. Evidence: 1. On 1/25/23, staff 1 was caring for 10 2-year old children alone from 3:30pm until 4:45pm. The number and ages of the children required 2 staff to be present. that the 2-year old classroom was out of ratio for approximately 45 minutes on 1/25/23.”

8VAC20-780-340-A Complaint related: Yes

“Based on a review of video footage and interview, the center did not ensure that when staff are supervision children, they shall always ensure their care and protection. Evidence: 1. The licensing inspector viewed video footage of the two's classroom from 1/25/23 between the hours of 4:00pm and 5:00pm. Staff 1 was alone in the classroom supervising 10 children. During the course of that hour, multiple children were observed climbing onto chairs, tables and bookshelves by the window and two other children were observed playing in water at the sinks in the classroom and dumping the water onto the floor. 2. It took several minutes before staff 1 redirected the children who were climbing on the furniture to safer activities as he was changing other children's diapers during that same time. 3. Staff 1 did not intervene with the children playing in the water at the sink until a parent arrived in the classroom to pick up their child, who then alerted him to the situation. Staff 1 could then be seen going over to the children and cleaning the water up off the floor with paper towels. 4. Staff 1 was unable to immediately ensure the children's safety in the above incidents due to being the only staff person in the classroom.”

8VAC20-780-400-B

“Based on interviews and a review of video footage, the center did not 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. The center self-reported that a parent reported they witnessed staff 1 inappropriately handle child 2 (age 1 year) on 12/8/22 through the center’s live camera system. 2. The licensing inspector viewed video footage from 12/8/22 provided by the center of the toddler classroom. The video is of an approximate 15-minute time period. Staff 1 was alone supervising 4 children, ages 1 year, while attempting to clean up the childcare area after lunch. There were no planned activities provided during this time. As a result, the techniques used to manage the children’s behavior were not age and stage appropriate. The video showed the following incidents of inappropriate behavioral guidance: a. Child 1 (age 1 year) is standing by a table and staff 1 takes him by his upper left arm and pulls him over to the area rug. Staff 1 sits child 1 down on the area rug and takes away a toy that child 1 was holding. b. Child 2 (age 1 year) is walking around the classroom when staff 1 takes her by her upper arm and walks her over to the area rug and sits her down. c. Child 1 is standing by the diaper changing table when staff 1 takes him by his upper arm and sits him down on the area rug. Child 1 begins to cry. d. Child 2 is walking around the classroom holding a soft foam rocker chair when she slips on a piece of food that is on the floor next to the table staff 1 is cleaning. Child 2 falls to the floor and staff 1 takes her by her upper right arm, lifts her off her feet into the air and pulls child 2 onto the area rug. Staff 1 then picks up the foam rocker chair and throws it overhead onto the area rug where the children are all standing. e. Child 1 is sitting on the floor of the classroom playing with a toy when staff 1 takes the toy away from him, picks him up by his underarms and sits him down on the area rug, resulting in child 1 falling onto his back. Child 1 begins to cry. 3. Center management confirmed that staff 1 did not demonstrate age and stage appropriate behavior guidance in the classroom.”

8VAC20-780-40-E

“Based on interviews, video footage and a review of the center’s policies, the center failed to ensure that the operational responsibilities of the licensee shall ensure that the center’s services are maintained in compliance with the center’s own policies and procedures that are required by these standards. Evidence: The center failed to follow their written policy for positive guidance and redirection as demonstrated by the following incident: 1. The center’s policy for positive guidance and redirection states ?No staff member is permitted to utilize the following means of punishment or redirection on any child: Hitting, shaking, biting, pinching, pulling, pushing, physical force or inflicting any other form of corporal punishment to hurt a child?restricting a child’s movement by binding, tying or any other type of physical restrain or timeout, including lifting or carrying a child.? a. On 12/8/22, child 1 (age 1 year) and child 2 (age 1 year) were pulled by their arm and sat down on the floor multiple times by staff 1. Staff 1 also took a toy out of child 1?s hands on two occasions and threw a soft foam rocker chair over the heads of the children onto the area rug where the children were standing. 2. Center management confirmed that staff 1 did not follow the center’s policy for positive guidance and redirection.”

8VAC20-790-600-D-1

“Based on record review and interview, the vendor did not 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. Evidence: 1. The record for staff 1 (date of hire: 4/26/22) does not contain documentation of current CPR certification. 2. The center director confirmed that the record for staff 1 is lacking documentation of current CPR certification.”

8VAC20-790-600-D-2

“Based on record review and interview, the vendor did not 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. The record for staff 1 (date of hire: 4/26/22) does not contain documentation of current first aid certification. 2. The center director confirmed that the record for staff 1 is lacking documentation of current first aid certification.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1 has a hire date of 3/31/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of New York within the past five years. The results of a central registry search from the state of New York was not available for staff 1. 2. Staff 2 has a hire date of 4/26/22. Staff 2 indicated on her sworn statement or affirmation that she has resided in the state of Nevada within the past five years. The results of a criminal history record information check and central registry search from the state of Nevada were not available for staff 2. 3. The center director confirmed that the out-of-state background checks for staff 1 and staff 2 have not been completed.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation is obtained that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child 1 (date of enrollment: 12/5/22) does not contain documentation of immunizations. 2. The center director confirmed that the record for child 1 is lacking documentation of immunizations.”

8VAC20-780-440-G

“Based on observation and interview, the center did not ensure that cribs shall be used for children under 12 months of age. Evidence: 1. In the infant room, child 3 (age 18 months) was asleep in a crib. When asked why a child over the age of 12 months was sleeping in a crib, the infant room staff stated that child 3 had been moved from the toddler room to the infant room due to the staff to child ratio in the toddler room and they did not have a cot for child 3 to sleep on in the infant room. 2. The center director confirmed that a child over the age of 12 months was sleeping in a crib in the infant room.”

8VAC20-780-140-A

“Based on record review and interview, the center did not 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. The record for child 2 (date of enrollment: 4/18/22) does not contain documentation of a physical examination. 2. The center director confirmed that the record for child 2 is lacking documentation of a physical examination.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was a spray bottle of Sanibet sanitizer on the diaper changing table in the toddler classroom and on the windowsill beside the diaper changing table in the two's classroom. Both bottles were accessible to the children in care. 2. The center director confirmed that the spray bottles of sanitizer in the toddler classroom and the two's classroom were not kept in a locked place.”

8VAC20-780-160-A

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening and shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff 3 (date of employment: 6/15/22) contains documentation of a negative tuberculosis screening dated 11/12/21, which is not within the last 30 calendar days of the date of employment. 2. The center director confirmed that the tuberculosis screening for staff 3 was not completed within the required timeframe.”

8VAC20-780-260-B

“Based on a review of center records and interview, the center did not ensure that annual approval from the health department shall be provided. Evidence: 1. There was no documentation of an annual health inspection for the center available for review during the inspection. 2. The center director confirmed that the annual health inspection for the center could not be located for review.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The record for child 1 (date of enrollment: 12/5/22) does not contain documentation of viewing proof of the child's identity and age. 2. The center director confirmed that the record for child 1 is lacking documentation of viewing proof of the child's identity and age.”

8VAC20-780-550-G

“Based on a review of the emergency drill log and interview, the center did not ensure that documentation of emergency practice drills contain all the required elements. Evidence: 1. The emergency drill log for the center does not include the method used for notification of the drill, any special conditions simulated or the weather conditions. 2. The center director confirmed that the center's emergency drill log does not contain the above required elements.”

8VAC20-780-570-A

“Based on observation and interview, the center did not ensure that when a child is placed in a high chair, the protective belt shall be fastened securely. Evidence: 1. In the infant room, there were 3 infants in high chairs that did not have the protective belt fastened around them. 2. The center director and infant room staff confirmed that the 3 infants did not have the protective belts fastened while in the high chairs.”

8VAC20-780-160-C

“Based on record review and interview, the center did not ensure that staff members shall obtain and submit the results of a follow-up tuberculosis screening at least every two years from the date of the initial screening. Evidence: 1. The most recent documented tuberculosis test or screening for staff 4 (date of hire: 9/15/20) is dated 9/17/20. Staff 4 was due for an updated tuberculosis screening in September 2022. 2. Staff 4 confirmed that her tuberculosis screening is expired.”

8VAC20-780-270-A

“Based on observation and interview, the center did not ensure that areas and equipment, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. On the playground, there is peeling and chipping paint under a window of the building, as well as on the baseboards of the building. There is also a broken screen on the outside of one of the windows. 2. On the center's bus used to transport children, there is a seat that is torn with exposed stuffing and a hole on the back of the seat. 3. The center director confirmed that the items listed above are not currently in a clean, safe and operable condition.”

8VAC20-790-600-D-1

“Based on record review and interview, the vendor did not 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. Evidence: 1. The record for staff 1 (date of hire: 4/26/22) does not contain documentation of current CPR certification. 2. The center director confirmed that the record for staff 1 is lacking documentation of current CPR certification.”

8VAC20-790-600-D-2

“Based on record review and interview, the vendor did not 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. The record for staff 1 (date of hire: 4/26/22) does not contain documentation of current first aid certification. 2. The center director confirmed that the record for staff 1 is lacking documentation of current first aid certification.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1 has a hire date of 3/31/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of New York within the past five years. The results of a central registry search from the state of New York was not available for staff 1. 2. Staff 2 has a hire date of 4/26/22. Staff 2 indicated on her sworn statement or affirmation that she has resided in the state of Nevada within the past five years. The results of a criminal history record information check and central registry search from the state of Nevada were not available for staff 2. 3. The center director confirmed that the out-of-state background checks for staff 1 and staff 2 have not been completed.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation is obtained that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child 1 (date of enrollment: 12/5/22) does not contain documentation of immunizations. 2. The center director confirmed that the record for child 1 is lacking documentation of immunizations.”

8VAC20-780-440-G

“Based on observation and interview, the center did not ensure that cribs shall be used for children under 12 months of age. Evidence: 1. In the infant room, child 3 (age 18 months) was asleep in a crib. When asked why a child over the age of 12 months was sleeping in a crib, the infant room staff stated that child 3 had been moved from the toddler room to the infant room due to the staff to child ratio in the toddler room and they did not have a cot for child 3 to sleep on in the infant room. 2. The center director confirmed that a child over the age of 12 months was sleeping in a crib in the infant room.”

8VAC20-780-140-A

“Based on record review and interview, the center did not 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. The record for child 2 (date of enrollment: 4/18/22) does not contain documentation of a physical examination. 2. The center director confirmed that the record for child 2 is lacking documentation of a physical examination.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was a spray bottle of Sanibet sanitizer on the diaper changing table in the toddler classroom and on the windowsill beside the diaper changing table in the two's classroom. Both bottles were accessible to the children in care. 2. The center director confirmed that the spray bottles of sanitizer in the toddler classroom and the two's classroom were not kept in a locked place.”

8VAC20-780-160-A

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening and shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff 3 (date of employment: 6/15/22) contains documentation of a negative tuberculosis screening dated 11/12/21, which is not within the last 30 calendar days of the date of employment. 2. The center director confirmed that the tuberculosis screening for staff 3 was not completed within the required timeframe.”

8VAC20-780-260-B

“Based on a review of center records and interview, the center did not ensure that annual approval from the health department shall be provided. Evidence: 1. There was no documentation of an annual health inspection for the center available for review during the inspection. 2. The center director confirmed that the annual health inspection for the center could not be located for review.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The record for child 1 (date of enrollment: 12/5/22) does not contain documentation of viewing proof of the child's identity and age. 2. The center director confirmed that the record for child 1 is lacking documentation of viewing proof of the child's identity and age.”

8VAC20-780-550-G

“Based on a review of the emergency drill log and interview, the center did not ensure that documentation of emergency practice drills contain all the required elements. Evidence: 1. The emergency drill log for the center does not include the method used for notification of the drill, any special conditions simulated or the weather conditions. 2. The center director confirmed that the center's emergency drill log does not contain the above required elements.”

8VAC20-780-570-A

“Based on observation and interview, the center did not ensure that when a child is placed in a high chair, the protective belt shall be fastened securely. Evidence: 1. In the infant room, there were 3 infants in high chairs that did not have the protective belt fastened around them. 2. The center director and infant room staff confirmed that the 3 infants did not have the protective belts fastened while in the high chairs.”

8VAC20-780-160-C

“Based on record review and interview, the center did not ensure that staff members shall obtain and submit the results of a follow-up tuberculosis screening at least every two years from the date of the initial screening. Evidence: 1. The most recent documented tuberculosis test or screening for staff 4 (date of hire: 9/15/20) is dated 9/17/20. Staff 4 was due for an updated tuberculosis screening in September 2022. 2. Staff 4 confirmed that her tuberculosis screening is expired.”

8VAC20-780-270-A

“Based on observation and interview, the center did not ensure that areas and equipment, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. On the playground, there is peeling and chipping paint under a window of the building, as well as on the baseboards of the building. There is also a broken screen on the outside of one of the windows. 2. On the center's bus used to transport children, there is a seat that is torn with exposed stuffing and a hole on the back of the seat. 3. The center director confirmed that the items listed above are not currently in a clean, safe and operable condition.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was an unlocked cabinet in the preschool classroom that contained a spray bottle of Sanibet sanitizer and a spray bottle of glass cleaner that were accessible to the children in care. 2. The center director confirmed that there were unlocked cleaning materials in the preschool classroom.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation was obtained that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of an immunization record. 1. The center director confirmed that the record for child 1 is lacking documentation of immunizations.”

8VAC20-780-160-A-2

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening and that documentation shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff 1 (date of hire: 2/17/22) contains documentation of a negative tuberculosis screening dated 12/17/20, which is more than 30 days prior to the date of hire. 2. The center director confirmed that staff 1's tuberculosis screening was not completed within the required timeframe.”

8VAC20-780-140-A

“Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within one month after attendance. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of a physical examination. 2. The center director confirmed that the record for child 1 is lacking documentation of a physical examination.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was an unlocked cabinet in the preschool classroom that contained a spray bottle of Sanibet sanitizer and a spray bottle of glass cleaner that were accessible to the children in care. 2. The center director confirmed that there were unlocked cleaning materials in the preschool classroom.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation was obtained that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of an immunization record. 1. The center director confirmed that the record for child 1 is lacking documentation of immunizations.”

8VAC20-780-160-A-2

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening and that documentation shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff 1 (date of hire: 2/17/22) contains documentation of a negative tuberculosis screening dated 12/17/20, which is more than 30 days prior to the date of hire. 2. The center director confirmed that staff 1's tuberculosis screening was not completed within the required timeframe.”

8VAC20-780-140-A

“Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within one month after attendance. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of a physical examination. 2. The center director confirmed that the record for child 1 is lacking documentation of a physical examination.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was an unlocked cabinet in the preschool classroom that contained a spray bottle of Sanibet sanitizer and a spray bottle of glass cleaner that were accessible to the children in care. 2. The center director confirmed that there were unlocked cleaning materials in the preschool classroom.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation was obtained that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of an immunization record. 1. The center director confirmed that the record for child 1 is lacking documentation of immunizations.”

8VAC20-780-160-A-2

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening and that documentation shall have been completed within the last 30 calendar days of the date of employment. Evidence: 1. The record for staff 1 (date of hire: 2/17/22) contains documentation of a negative tuberculosis screening dated 12/17/20, which is more than 30 days prior to the date of hire. 2. The center director confirmed that staff 1's tuberculosis screening was not completed within the required timeframe.”

8VAC20-780-140-A

“Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within one month after attendance. Evidence: 1. The record for child 1 (date of enrollment: 11/16/21) does not contain documentation of a physical examination. 2. The center director confirmed that the record for child 1 is lacking documentation of a physical examination.”