Lil' Angels Day Care

8VAC20-780-160-A

“Based on review of staff records, the center did not ensure documentation of tuberculosis screening was completed at the time of employment and prior to coming into contact with children. Evidence: 1. The documentation for staff #1, employed 05/19/2023, was dated for 05/21/2023.”

22.1-289.035-B-2

“Based on a review of staff records and interview, the center did not ensure one staff member completed a national fingerprint check prior to the first day of employment. Evidence: 1. The national fingerprint check for Staff #1, employed 05/19/2023, contained results that were dated 05/23/2023. 2. Director confirmed the hire date of the staff is correct and acknowledged the results were late.”

22.1-289.035-B-3

“Based on review of staff records and interview, the center did not ensure to obtain a copy of the results of a search of the central registry prior to employment and by the end of 30th Day. Evidence: 1. Staff #1 (DOH 05/19/2023) had a central registry result on file dated 03/26/2024. 2. Leadership acknowledged there was no other documentation on record.”

8VAC20-780-130-E

“8VAC20-780-130-E Based on a review of children’s records, the center did not ensure that each child’s record contained documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. Child #1, 14 months of age, had immunization records dated 08/08/2023, 10/05/2023 and 07/23/2024. Child’s first day of attendance was 08/14/2023. 2. Child #5, 9 months of age, had one immunization record dated 01/18/2024. Child’s first day of attendance was 01/29/2024.”

8VAC20-780-140-A

“Based on a review of children’s records, the center did not ensure that each child 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 #2, first day of attendance 04/22/2024, did not have a physical examination in the file. 2. Director acknowledged the physical was missing from the file.”

8VAC20-780-130-A

“Description: Based on record review, the center did not ensure to obtain documentation that each child received immunizations required by the State Board of Health before the first day of attendance. Evidence: The record of child #3 (DOE 12/13/23) contained an immunization record date 3/14/24.”

8VAC20-780-130-E

“Description: Based on record review, the center did not obtain additional immunizations once every six months for children under the age of two years. Evidence: 1. Child #4 (DOE 3/16/21) had one immunization record dated 2/26/21. 2. Child #6 (DOE 4/26/21) had one immunization record dated 4/23/21 and a late immunization update dated 2/18/22. 3. Child #5 (DOE 7/17/23) had one immunization record dated 6/26/23 and a late immunization update dated 3/6/24.”

8VAC20-780-60-A

“Description: Based on child record review, the provider failed to ensure that two out of six child records contained required documentation. Evidence: Child #4 and Child #6 did not contain documentation of child updates and confirmation of up-to-date information in the child’s record as required by 8VAC20-780-420-E-3.”

8VAC20-780-240-C

“Description: Based on record review, the center did not ensure that the orientation training included all required topics. Evidence: The record for Staff #6 had documentation of an orientation training that did not include prevention of sudden infant death syndrome and use of safe sleep practices, prevention of shaken baby syndrome and abusive head trauma.”

8VAC20-780-270-A

“Description: Based on observation, the outside area of the center was not maintained in a clean, safe and operable condition. Evidence: 1. There was a total of 4 sets of coat hooks hanging from the fences outside that were all rusted. 2. A broken chair was found with multiple cracks that could entangle clothes or pinch skin.”

8VAC20-780-340-F

“Description: Based on observation, the center failed to ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: A child from the preschool room was observed walking unsupervised to another classroom to use the restroom.”

8VAC20-780-370-5

“Description: Based on observation, the infant plays spaces indoors and outside did not cumulatively offer equipment and toys that support large motor development. Evidence: 1. The infant room play space indoors did not have any equipment and toys that support large motor development. 2. The outside play area for infant room did not have any equipment and toys that support large motor development.”

8VAC20-780-500-A

“Description: Based on observation, staff failed to wash their hands before and after a diaper change and to ensure children's hands were washed after toileting. Evidence: 1. Staff #6 was observed putting on gloves to change an infant diaper without washing hands, changed the infant diaper, and did not wash hands after diapering the child. 2. In the infant room, the hands of two children were not washed after their diapers were changed.”

8VAC20-780-500-B

“Description: Based on observation, staff failed to sanitize the diapering surface after each use. Evidence: Staff #6 did not sanitize the diapering surface after the surface was cleaned.”

8VAC20-780-340-A

“Description: Based on observation, staff did not always ensure the care and protection of children. Evidence: 7 out of 7 booster seats in the center’s vehicle were expired. The expiration dates ranged from December 2010-December 2013.”

8VAC20-780-130-A

“Description: Based on record review, the center did not ensure to obtain documentation that each child received immunizations required by the State Board of Health before the first day of attendance. Evidence: The record of child #3 (DOE 12/13/23) contained an immunization record date 3/14/24.”

8VAC20-780-130-E

“Description: Based on record review, the center did not obtain additional immunizations once every six months for children under the age of two years. Evidence: 1. Child #4 (DOE 3/16/21) had one immunization record dated 2/26/21. 2. Child #6 (DOE 4/26/21) had one immunization record dated 4/23/21 and a late immunization update dated 2/18/22. 3. Child #5 (DOE 7/17/23) had one immunization record dated 6/26/23 and a late immunization update dated 3/6/24.”

8VAC20-780-60-A

“Description: Based on child record review, the provider failed to ensure that two out of six child records contained required documentation. Evidence: Child #4 and Child #6 did not contain documentation of child updates and confirmation of up-to-date information in the child’s record as required by 8VAC20-780-420-E-3.”

8VAC20-780-240-C

“Description: Based on record review, the center did not ensure that the orientation training included all required topics. Evidence: The record for Staff #6 had documentation of an orientation training that did not include prevention of sudden infant death syndrome and use of safe sleep practices, prevention of shaken baby syndrome and abusive head trauma.”

8VAC20-780-270-A

“Description: Based on observation, the outside area of the center was not maintained in a clean, safe and operable condition. Evidence: 1. There was a total of 4 sets of coat hooks hanging from the fences outside that were all rusted. 2. A broken chair was found with multiple cracks that could entangle clothes or pinch skin.”

8VAC20-780-340-F

“Description: Based on observation, the center failed to ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: A child from the preschool room was observed walking unsupervised to another classroom to use the restroom.”

8VAC20-780-370-5

“Description: Based on observation, the infant plays spaces indoors and outside did not cumulatively offer equipment and toys that support large motor development. Evidence: 1. The infant room play space indoors did not have any equipment and toys that support large motor development. 2. The outside play area for infant room did not have any equipment and toys that support large motor development.”

8VAC20-780-500-A

“Description: Based on observation, staff failed to wash their hands before and after a diaper change and to ensure children's hands were washed after toileting. Evidence: 1. Staff #6 was observed putting on gloves to change an infant diaper without washing hands, changed the infant diaper, and did not wash hands after diapering the child. 2. In the infant room, the hands of two children were not washed after their diapers were changed.”

8VAC20-780-500-B

“Description: Based on observation, staff failed to sanitize the diapering surface after each use. Evidence: Staff #6 did not sanitize the diapering surface after the surface was cleaned.”

8VAC20-780-340-A

“Description: Based on observation, staff did not always ensure the care and protection of children. Evidence: 7 out of 7 booster seats in the center’s vehicle were expired. The expiration dates ranged from December 2010-December 2013.”

8VAC20-780-40-M

“Repeat Violation Based on observation and interview, the center did not ensure to maintain a current written list of all children's allergies, sensitivities, and dietary restrictions which is dated and kept confidential in each room or area where children are present. Evidence: In room #1, the allergy list was not posted. Child A is enrolled in room #1 and has allergies to specific foods.”

8VAC20-780-160-C

“Based on a review of staff records, the center did not ensure that subsequent communicable tuberculosis (TB) screenings were conducted at least every two years from the date of the initial screening. Evidence: 1. The record for staff #3 (date of last TB screening 8/26/21) did not contain updated TB screening results as of 02/15/2024.”

8VAC20-780-130-E

“Based on review of five children's records and interview, the center did not ensure to obtain documentation of additional immunizations once every six months for one child under the age of two years as required. Evidence: 1. The record of child #4 (enrolled: 4/26/21) contained an immunization record dated 4/23/21 and 2/18/22. Child #4 was required to have an documentation of additional immunization once every six months. 2. Administration acknowledged that the immunization update was missing.”

8VAC20-780-550-F

“Based on record review, the licensee did not ensure that there was a minimum of one lockdown drill practiced, yearly. Evidence: The facility did not have documentation of a lockdown drill for 2023.”

8VAC20-780-350-B-1

“Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children. Evidence: 1. Staff #1 was left alone to supervise 7 infant children in room #1 for approximately four minutes while staff #2 cleaned the highchairs in the cafeteria area outside of room #1.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: On the preschool playground, there are 9 buckets holding cement to anchor poles of the shelter play area. The 9 buckets were cracked, had sharp edges, and areas where a child could pinch skin.”

8VAC20-780-60-A

“Based on a review of children's records, the center did not ensure that each record contains all required information. Evidence: 1. The record for child #2 had a list of foods from an allergy test that documented the allergies and sensitives to specific foods. The record did not have a written care plan that included instructions from a physician regarding the foot to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. 2. The administrator stated that the record did not have a written care plan.”

8VAC20-780-40-M

“Repeat Violation Based on observation and interview, the center did not ensure to maintain a current written list of all children's allergies, sensitivities, and dietary restrictions which is dated and kept confidential in each room or area where children are present. Evidence: In room #1, the allergy list was not posted. Child A is enrolled in room #1 and has allergies to specific foods.”

8VAC20-780-160-C

“Based on a review of staff records, the center did not ensure that subsequent communicable tuberculosis (TB) screenings were conducted at least every two years from the date of the initial screening. Evidence: 1. The record for staff #3 (date of last TB screening 8/26/21) did not contain updated TB screening results as of 02/15/2024.”

8VAC20-780-130-E

“Based on review of five children's records and interview, the center did not ensure to obtain documentation of additional immunizations once every six months for one child under the age of two years as required. Evidence: 1. The record of child #4 (enrolled: 4/26/21) contained an immunization record dated 4/23/21 and 2/18/22. Child #4 was required to have an documentation of additional immunization once every six months. 2. Administration acknowledged that the immunization update was missing.”

8VAC20-780-550-F

“Based on record review, the licensee did not ensure that there was a minimum of one lockdown drill practiced, yearly. Evidence: The facility did not have documentation of a lockdown drill for 2023.”

8VAC20-780-350-B-1

“Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children. Evidence: 1. Staff #1 was left alone to supervise 7 infant children in room #1 for approximately four minutes while staff #2 cleaned the highchairs in the cafeteria area outside of room #1.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: On the preschool playground, there are 9 buckets holding cement to anchor poles of the shelter play area. The 9 buckets were cracked, had sharp edges, and areas where a child could pinch skin.”

8VAC20-780-60-A

“Based on a review of children's records, the center did not ensure that each record contains all required information. Evidence: 1. The record for child #2 had a list of foods from an allergy test that documented the allergies and sensitives to specific foods. The record did not have a written care plan that included instructions from a physician regarding the foot to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. 2. The administrator stated that the record did not have a written care plan.”

8VAC20-790-600-F

“Based on records review, the center failed to ensure that staff who work directly with children, shall annually attend the departments 3 hour health and safety update course. Evidence: The record for staff #3, date of employment 04/04/13, contained a 3 hour health and safety course certificate dated 07/16/2021. There was not an updated training for 2022.”

8VAC20-780-40-M

“Based on observation, and interview, the center failed to maintain in a way that is accessible to all staff who work with children, a current, dated, written list of all children’s allergies, sensitivities, and dietary restrictions documented in the allergy plan. The list must be kept in each room or area where children are present. Evidence: 1) When interviewed, staff in classroom #3, did not know if there was an allergy list or where it was. 2) The allergy list posted in classroom #2, did not have a date on it. 3) Staff in classroom #5 had an allergy list but stated that it was not current because there were children listed on the list that no longer attend the center. 4) The Director acknowledged that the allergy list was not current.”

8VAC20-790-600-F

“Based on records review, the center failed to ensure that staff who work directly with children, shall annually attend the departments 3 hour health and safety update course. Evidence: The record for staff #3, date of employment 04/04/13, contained a 3 hour health and safety course certificate dated 07/16/2021. There was not an updated training for 2022.”

8VAC20-780-40-M

“Based on observation, and interview, the center failed to maintain in a way that is accessible to all staff who work with children, a current, dated, written list of all children’s allergies, sensitivities, and dietary restrictions documented in the allergy plan. The list must be kept in each room or area where children are present. Evidence: 1) When interviewed, staff in classroom #3, did not know if there was an allergy list or where it was. 2) The allergy list posted in classroom #2, did not have a date on it. 3) Staff in classroom #5 had an allergy list but stated that it was not current because there were children listed on the list that no longer attend the center. 4) The Director acknowledged that the allergy list was not current.”

8VAC20-790-600-D-2

“Based on records review, and interview, the center 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. Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in First Aid. The Director acknowledged that staff #2 did not have current certification in First Aid.”

8VAC20-790-600-D-1

“Based on records review, and interview, the center 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). Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in CPR. The Director acknowledged that staff #2 did not have current certification in CPR.”

8VAC20-780-550-D

“Based on documentation review, and interview, the center failed to document monthly practice evacuation drills. Evidence: Review of the evacuation drill documentation revealed no drills were documented for the months of August, September, October, November, or December of 2022. The Director acknowledged that the drills were not documented for those months.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member submits documentation of a negative tuberculosis screening no more than 30 calendar days prior to the date of employment. Evidence: The record for staff #2, date of employment 10/11/22, contained documentation of tuberculosis screening dated 8/20/21.”

8VAC20-790-600-D-2

“Based on records review, and interview, the center 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. Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in First Aid. The Director acknowledged that staff #2 did not have current certification in First Aid.”

8VAC20-790-600-D-1

“Based on records review, and interview, the center 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). Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in CPR. The Director acknowledged that staff #2 did not have current certification in CPR.”

8VAC20-780-550-D

“Based on documentation review, and interview, the center failed to document monthly practice evacuation drills. Evidence: Review of the evacuation drill documentation revealed no drills were documented for the months of August, September, October, November, or December of 2022. The Director acknowledged that the drills were not documented for those months.”

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member submits documentation of a negative tuberculosis screening no more than 30 calendar days prior to the date of employment. Evidence: The record for staff #2, date of employment 10/11/22, contained documentation of tuberculosis screening dated 8/20/21.”

22.1-289.035-B-2

“Based on records review, and interview, the center did not ensure that the national background check was completed on staff #5 prior to employment. Evidence: Staff #5?s file (employed-07/25/22) did not contain documentation of completion of a national background check. Staff #5 was seen working in the classroom. When interviewed the Director stated that the fingerprints results were sent but that she didn?t know where she had placed them.”

8VAC20-780-70

“Based on observation, the center did not ensure to have two or more references as to character and reputation as well as competency checked before employment. Evidence: 2 out of 5 staff records reviewed did not include reference checks.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was dated. Evidence: 3 out of 6 bottles had no date written on the bottle.”

8VAC20-780-550-P

“Based on a review of records, the center did not ensure that injury reports contain the date that the parent was notified of the injury, how the parent was notified, or future action to prevent recurrence. Evidence: 5 out of 5 injury reports reviewed did not contain a space for this information.”

22.1-289.035-B-2

“Based on records review, and interview, the center did not ensure that the national background check was completed on staff #5 prior to employment. Evidence: Staff #5?s file (employed-07/25/22) did not contain documentation of completion of a national background check. Staff #5 was seen working in the classroom. When interviewed the Director stated that the fingerprints results were sent but that she didn?t know where she had placed them.”

8VAC20-780-70

“Based on observation, the center did not ensure to have two or more references as to character and reputation as well as competency checked before employment. Evidence: 2 out of 5 staff records reviewed did not include reference checks.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was dated. Evidence: 3 out of 6 bottles had no date written on the bottle.”

8VAC20-780-550-P

“Based on a review of records, the center did not ensure that injury reports contain the date that the parent was notified of the injury, how the parent was notified, or future action to prevent recurrence. Evidence: 5 out of 5 injury reports reviewed did not contain a space for this information.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that all hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In bathroom #1, there was one container of Clorox labeled ?Caution? and ?Hazard?, one container of air wick lavender spray labeled ?Keep Out of Reach of Children,? ?Caution,? and ?Hazard?, and one bottle of Isopropyl Alcohol labeled ?Flammable,? Caution,? and ?Keep Out of Reach of Children? in a cabinet accessible by children”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. At the bottom of the stairs leading to classroom #4, there was a hole in the wall with exposed dry wall. 2. The Director stated that she was aware of the hole in the drywall.”

8VAC20-790-600-F

“Based on review, the facility did not ensure staff complete the annual Health and Safety Update Training for subsidy vendors. Evidence: 1. The records for staff #1 and staff #2 did not have documentation of the Annual Virginia Health and Safety Update training course at the time of the inspection.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that all hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In bathroom #1, there was one container of Clorox labeled ?Caution? and ?Hazard?, one container of air wick lavender spray labeled ?Keep Out of Reach of Children,? ?Caution,? and ?Hazard?, and one bottle of Isopropyl Alcohol labeled ?Flammable,? Caution,? and ?Keep Out of Reach of Children? in a cabinet accessible by children”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. At the bottom of the stairs leading to classroom #4, there was a hole in the wall with exposed dry wall. 2. The Director stated that she was aware of the hole in the drywall.”

8VAC20-790-600-F

“Based on review, the facility did not ensure staff complete the annual Health and Safety Update Training for subsidy vendors. Evidence: 1. The records for staff #1 and staff #2 did not have documentation of the Annual Virginia Health and Safety Update training course at the time of the inspection.”