Little Tikes Family Care II

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

“Based on interviews, the center failed to ensure that when staff are supervising children they shall always ensure their care, protection, and guidance. Evidence: Interviews revealed that staff #1 has been observed on multiple occasions yelling at the children and grabbing the children to force them to walk or sit.”

8VAC20-780-410-1 Complaint related: Yes

“Based on interviews and written statements, the center failed to ensure physical punishment and roughly handling a child are forbidden. Evidence: Interviews and written statements revealed that on 12/20/23, staff #1 grabbed child #1 by the wrist, forced the child to stand up, then pulled the child by the wrist, roughly sat the child down, and physically forced the child to stay sitting by holding down the child. Staff #1 was then observed yelling at child #1 to get up to get their diaper changed. When the child did not get up staff #1 walked over to child #1 and yanked the child by the wrist to force the child to stand up. The child then began crying.”

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

“Based on interviews, 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: Interviews revealed that staff #1 was observed yelling at child #1 as she grabbed the child by the wrist and forced the child to sit in time out. Staff #1 was yelling statements such as: 1. What happens when you don't listen? 2. If you don't what's gonna happen? 3. Get your tail up!”

8VAC20-780-280-B

“REPEAT VIOLATION Based on observation, the center failed to 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: There was a bottle of Febreze on top of the paper towel holder in the bathroom. The bottle states "caution" and "keep out of reach of children".”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that staff wash hands before and after a diaper change. Evidence: Staff #2 changed a child's diaper. Staff #2 did not wash their hands before or after the diaper change.”

8VAC20-780-550-P

“Based on record review it was determined the center did not ensure the written record of children's serious and minor injuries contained all of the required information. Evidence: The injury record for child #10 dated 7/24/23 did not contain the time and method of parent notification. The injury record for child #14 did not contain the time when parents were notified.”

8VAC20-780-570-B

“REPEAT VIOLATION Based on observation, the center failed to ensure that bottles shall not be used while the child is in his designated sleeping location. Evidence: Child A was in their crib trying to go to sleep. Staff #2 walked over to child A and gave the child a bottle to drink while in the crib.”

8VAC20-780-140-A

“Based on record review, the center failed to obtain documentation of a physical examination within 30 days of the first day of attendance. Evidence: The record for child #8, date of attendance 05/15/23, did not contain documentation of a physical examination.”

8VAC20-780-160-C

“Based on record review, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: The record for staff #6, contained a tuberculosis screening dated 10/23/21. A repeat screening was due on or before 10/23/23.”

8VAC20-780-70

“Based on record review, the center failed to document in a staff record the date of separation from employment. Evidence: Staff #4 is no longer employed at the center. The record did not have documented the date of separation from employment.”

8VAC20-780-245-L

“Based on observation, record review, and interview, the center failed to ensure that there shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: When the Licensing Inspector arrived staff #1, staff #2, and staff #3 were present. Review of the staff records for staff #1, staff #2, and staff #3 did not reveal documentation of daily health observation instruction. Interview with the Director confirmed that staff #1, staff #2, and staff #3 did not have instruction in performing the daily health observation of children and that there was no one on duty with instruction in performing daily health observation of children when the Licensing Inspector arrived.”

8VAC20-770-60-C-2

“Based on record review, the center failed to obtain the results of a central registry finding within 30 days of employment. Evidence: The record for staff #4, date of employment 10/23/23, did not contain the results of a central registry finding.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required before the child can attend the center. Evidence: The record for child #8, date of enrollment 05/15/23, did not contain documentation of immunizations.”

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

“Based on interviews, the center failed to ensure that when staff are supervising children they shall always ensure their care, protection, and guidance. Evidence: Interviews revealed that staff #1 has been observed on multiple occasions yelling at the children and grabbing the children to force them to walk or sit.”

8VAC20-780-410-1 Complaint related: Yes

“Based on interviews and written statements, the center failed to ensure physical punishment and roughly handling a child are forbidden. Evidence: Interviews and written statements revealed that on 12/20/23, staff #1 grabbed child #1 by the wrist, forced the child to stand up, then pulled the child by the wrist, roughly sat the child down, and physically forced the child to stay sitting by holding down the child. Staff #1 was then observed yelling at child #1 to get up to get their diaper changed. When the child did not get up staff #1 walked over to child #1 and yanked the child by the wrist to force the child to stand up. The child then began crying.”

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

“Based on interviews, 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: Interviews revealed that staff #1 was observed yelling at child #1 as she grabbed the child by the wrist and forced the child to sit in time out. Staff #1 was yelling statements such as: 1. What happens when you don't listen? 2. If you don't what's gonna happen? 3. Get your tail up!”

8VAC20-780-280-B

“REPEAT VIOLATION Based on observation, the center failed to 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: There was a bottle of Febreze on top of the paper towel holder in the bathroom. The bottle states "caution" and "keep out of reach of children".”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that staff wash hands before and after a diaper change. Evidence: Staff #2 changed a child's diaper. Staff #2 did not wash their hands before or after the diaper change.”

8VAC20-780-550-P

“Based on record review it was determined the center did not ensure the written record of children's serious and minor injuries contained all of the required information. Evidence: The injury record for child #10 dated 7/24/23 did not contain the time and method of parent notification. The injury record for child #14 did not contain the time when parents were notified.”

8VAC20-780-570-B

“REPEAT VIOLATION Based on observation, the center failed to ensure that bottles shall not be used while the child is in his designated sleeping location. Evidence: Child A was in their crib trying to go to sleep. Staff #2 walked over to child A and gave the child a bottle to drink while in the crib.”

8VAC20-780-140-A

“Based on record review, the center failed to obtain documentation of a physical examination within 30 days of the first day of attendance. Evidence: The record for child #8, date of attendance 05/15/23, did not contain documentation of a physical examination.”

8VAC20-780-160-C

“Based on record review, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: The record for staff #6, contained a tuberculosis screening dated 10/23/21. A repeat screening was due on or before 10/23/23.”

8VAC20-780-70

“Based on record review, the center failed to document in a staff record the date of separation from employment. Evidence: Staff #4 is no longer employed at the center. The record did not have documented the date of separation from employment.”

8VAC20-780-245-L

“Based on observation, record review, and interview, the center failed to ensure that there shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: When the Licensing Inspector arrived staff #1, staff #2, and staff #3 were present. Review of the staff records for staff #1, staff #2, and staff #3 did not reveal documentation of daily health observation instruction. Interview with the Director confirmed that staff #1, staff #2, and staff #3 did not have instruction in performing the daily health observation of children and that there was no one on duty with instruction in performing daily health observation of children when the Licensing Inspector arrived.”

8VAC20-770-60-C-2

“Based on record review, the center failed to obtain the results of a central registry finding within 30 days of employment. Evidence: The record for staff #4, date of employment 10/23/23, did not contain the results of a central registry finding.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required before the child can attend the center. Evidence: The record for child #8, date of enrollment 05/15/23, did not contain documentation of immunizations.”

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

“Based on interviews, the center failed to ensure that when staff are supervising children they shall always ensure their care, protection, and guidance. Evidence: Interviews revealed that staff #1 has been observed on multiple occasions yelling at the children and grabbing the children to force them to walk or sit.”

8VAC20-780-410-1 Complaint related: Yes

“Based on interviews and written statements, the center failed to ensure physical punishment and roughly handling a child are forbidden. Evidence: Interviews and written statements revealed that on 12/20/23, staff #1 grabbed child #1 by the wrist, forced the child to stand up, then pulled the child by the wrist, roughly sat the child down, and physically forced the child to stay sitting by holding down the child. Staff #1 was then observed yelling at child #1 to get up to get their diaper changed. When the child did not get up staff #1 walked over to child #1 and yanked the child by the wrist to force the child to stand up. The child then began crying.”

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

“Based on interviews, 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: Interviews revealed that staff #1 was observed yelling at child #1 as she grabbed the child by the wrist and forced the child to sit in time out. Staff #1 was yelling statements such as: 1. What happens when you don't listen? 2. If you don't what's gonna happen? 3. Get your tail up!”

8VAC20-780-280-B

“REPEAT VIOLATION Based on observation, the center failed to 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: There was a bottle of Febreze on top of the paper towel holder in the bathroom. The bottle states "caution" and "keep out of reach of children".”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that staff wash hands before and after a diaper change. Evidence: Staff #2 changed a child's diaper. Staff #2 did not wash their hands before or after the diaper change.”

8VAC20-780-550-P

“Based on record review it was determined the center did not ensure the written record of children's serious and minor injuries contained all of the required information. Evidence: The injury record for child #10 dated 7/24/23 did not contain the time and method of parent notification. The injury record for child #14 did not contain the time when parents were notified.”

8VAC20-780-570-B

“REPEAT VIOLATION Based on observation, the center failed to ensure that bottles shall not be used while the child is in his designated sleeping location. Evidence: Child A was in their crib trying to go to sleep. Staff #2 walked over to child A and gave the child a bottle to drink while in the crib.”

8VAC20-780-140-A

“Based on record review, the center failed to obtain documentation of a physical examination within 30 days of the first day of attendance. Evidence: The record for child #8, date of attendance 05/15/23, did not contain documentation of a physical examination.”

8VAC20-780-160-C

“Based on record review, the center failed to ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: The record for staff #6, contained a tuberculosis screening dated 10/23/21. A repeat screening was due on or before 10/23/23.”

8VAC20-780-70

“Based on record review, the center failed to document in a staff record the date of separation from employment. Evidence: Staff #4 is no longer employed at the center. The record did not have documented the date of separation from employment.”

8VAC20-780-245-L

“Based on observation, record review, and interview, the center failed to ensure that there shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. Evidence: When the Licensing Inspector arrived staff #1, staff #2, and staff #3 were present. Review of the staff records for staff #1, staff #2, and staff #3 did not reveal documentation of daily health observation instruction. Interview with the Director confirmed that staff #1, staff #2, and staff #3 did not have instruction in performing the daily health observation of children and that there was no one on duty with instruction in performing daily health observation of children when the Licensing Inspector arrived.”

8VAC20-770-60-C-2

“Based on record review, the center failed to obtain the results of a central registry finding within 30 days of employment. Evidence: The record for staff #4, date of employment 10/23/23, did not contain the results of a central registry finding.”

8VAC20-780-130-A

“Based on record review, the center failed to obtain documentation that each child has received the immunizations required before the child can attend the center. Evidence: The record for child #8, date of enrollment 05/15/23, did not contain documentation of immunizations.”

8VAC20-780-40-H

“Based on documentation review, and interview, the center failed to provide evidence of current liability insurance. Evidence: The liability insurance that was provided had an expiration date of 08/19/2022. When asked for the updated liability insurance evidence the provider stated that she had not been sent a copy of the new policy.”

8VAC20-780-40-H

“Based on documentation review, and interview, the center failed to provide evidence of current liability insurance. Evidence: The liability insurance that was provided had an expiration date of 08/19/2022. When asked for the updated liability insurance evidence the provider stated that she had not been sent a copy of the new policy.”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that all staff submit documentation of a negative tuberculosis screening within the last 30 calendar days of the date of employment. Evidence: The record for staff #1, date of employment 06/20/2022, contained documentation of tuberculosis screening dated 09/03/2021.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that all staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #1, date of employment 06/20/2022, did not contain documentation of the completion of the VDOE sponsored orientation course.”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that all staff submit documentation of a negative tuberculosis screening within the last 30 calendar days of the date of employment. Evidence: The record for staff #1, date of employment 06/20/2022, contained documentation of tuberculosis screening dated 09/03/2021.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that all staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #1, date of employment 06/20/2022, did not contain documentation of the completion of the VDOE sponsored orientation course.”

8VAC20-780-160-A

“Based on records review, the center failed to ensure that all staff submit documentation of a negative tuberculosis screening within the last 30 calendar days of the date of employment. Evidence: The record for staff #1, date of employment 06/20/2022, contained documentation of tuberculosis screening dated 09/03/2021.”

8VAC20-780-240-A

“Based on records review, the center failed to ensure that all staff complete the Virginia Department of Education (VDOE) sponsored orientation course within 90 calendar days of employment. Evidence: The record for staff #1, date of employment 06/20/2022, did not contain documentation of the completion of the VDOE sponsored orientation course.”

8VAC20-780-560-J

“Based on interview, the center failed to ensure that the tables and highchair trays are sanitized before and after each use for feeding. Evidence: When asked how the tables and highchair trays are sanitized staff stated that they use disposable sanitizing wipes. Sanitizing means that ?the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry. If not using a bleach/water solution, the spray must be a commercial chemical disinfectant approved by the US EPA. The label should indicate ?hospital grade? germicide or disinfectant.”

8VAC20-780-450-C

“Based on interview, the center failed to ensure that crib sheets are washed daily. Evidence: When interviewed the Director stated that crib sheets are washed weekly.”

8VAC20-780-140-A

“Based on records review, the center failed to maintain documentation that each child has had a physical examination within 30 days after the first day of attendance. Evidence: The record for child #2, date of enrollment 8/30/21, did not contain documentation of a physical.”

8VAC20-780-60-A

“Based on records review, the center failed to maintain a separate record for each child enrolled. Evidence: The record for child #2, date of enrollment 8/30/21, did not contain the required information including 1) name, home address, and home phone number of the parent, 2) name and phone number of child’s physician, 3) name, address, and phone number of two designated people to call in an emergency, 4) names of persons authorized to pick up the child, 5) allergies and intolerance and actions to take in an emergency situation.”

8VAC20-780-260-B

“Based on records review, and interview, the center failed to obtain an annual inspection from the health department. Evidence: The most recent health inspection was conducted on 8/21/21. When interviewed the Director stated that she has tried multiple times to schedule the annual health inspection with the health department but they have not come out yet.”

8VAC20-780-560-J

“Based on interview, the center failed to ensure that the tables and highchair trays are sanitized before and after each use for feeding. Evidence: When asked how the tables and highchair trays are sanitized staff stated that they use disposable sanitizing wipes. Sanitizing means that ?the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry. If not using a bleach/water solution, the spray must be a commercial chemical disinfectant approved by the US EPA. The label should indicate ?hospital grade? germicide or disinfectant.”

8VAC20-780-450-C

“Based on interview, the center failed to ensure that crib sheets are washed daily. Evidence: When interviewed the Director stated that crib sheets are washed weekly.”

8VAC20-780-140-A

“Based on records review, the center failed to maintain documentation that each child has had a physical examination within 30 days after the first day of attendance. Evidence: The record for child #2, date of enrollment 8/30/21, did not contain documentation of a physical.”

8VAC20-780-60-A

“Based on records review, the center failed to maintain a separate record for each child enrolled. Evidence: The record for child #2, date of enrollment 8/30/21, did not contain the required information including 1) name, home address, and home phone number of the parent, 2) name and phone number of child’s physician, 3) name, address, and phone number of two designated people to call in an emergency, 4) names of persons authorized to pick up the child, 5) allergies and intolerance and actions to take in an emergency situation.”

8VAC20-780-260-B

“Based on records review, and interview, the center failed to obtain an annual inspection from the health department. Evidence: The most recent health inspection was conducted on 8/21/21. When interviewed the Director stated that she has tried multiple times to schedule the annual health inspection with the health department but they have not come out yet.”

8VAC20-780-380-A-1

“Based on observation and interview, the center failed to ensure that toddlers and preschoolers have outdoor activity for at least one hour per day. Evidence: There is no designated outdoor play area at the center. When asked how the toddlers and preschoolers get outdoor activity, the Director stated that she takes them to the local park to play in her personal vehicle but does not do so every day. The Director stated that the personal vehicle can hold 5 children. On the day of the visit there were 7 toddlers and preschoolers.”

8VAC20-780-60-A

“Based on records review and interview, the center failed to maintain and keep at the center a separate record for each child enrolled. Evidence: Child #1, date of enrollment 09/12/2022, did not have a record at the center. When asked, the Director stated that she had given all of the paperwork to the parent and she hadn?t brought it back yet.”

8VAC20-780-130-A

“Based on records review, the center failed to obtain documentation that each child has received the required immunizations before the child can attend the center. Evidence: The center did not have for Child #1, date of enrollment 09/12/2022 and in attendance the date of the inspection, documentation of immunizations.”

8VAC20-780-90-A

“Based on records review, and interview, the center failed to have a written agreement between the parent and center by the first day of the child’s attendance. Evidence: Child #1, enrolled 09/12/2022 and in attendance on the date of the inspection, did not have a record at the center. When asked about the written agreement, the Director stated that she had given all of the paperwork to the parent and she hadn?t brought it back yet”

8VAC20-780-260-A

“Based on records review, and interview, the center failed to document that an evacuation drill took place each month. Evidence: The last evacuation drill that was documented was on 7/28/22. When asked, the Director stated that they did the drill in August but forgot to write it down.”

8VAC20-780-280-B

“Based on observation, the center failed to ensure that hazardous substances such as cleaning materials were kept in a locked place that prevents access by children. Evidence: 1) There was an aerosol can of Disinfectant spray labeled ?warning? and ?keep out of reach of children? on top of the shelf directly beside the changing table. 2) There was a bottle of Lysol spray and a bottle of Clorox spray on top of the paper towel dispenser in the bathroom.”

8VAC20-780-500-B

“Based on observation, the center failed to ensure that the diaper surface was cleaned and sanitized after a child’s diaper is changed. Evidence: After changing a child’s diaper, staff #3 wiped the diaper pad surface with a disposable wipe.”

8VAC20-780-570-B

“Based on observation, and interview, the center failed to ensure that bottles were not used while the child is in the designated sleeping location. Evidence: Child #1, age 13 months, was lying in a crib while drinking a bottle.”

8VAC20-780-340-F

“Based on observation, the center failed to ensure that children under 10 years of age were within actual sight and sound supervision of staff. Evidence: 1) There were 3 infants and 2 staff with the infant age group. 2) One staff left the infant room to change a diaper and then took the infant into the bathroom to wash hands. 3) While the staff was washing the infant’s hands the phone rang and the other staff member left 2 infants in the room unsupervised to go answer the phone.”

8VAC20-780-560-G

“Based on observation, the center failed to ensure that when food is brought from home it is labeled in a way that identifies the owner. Evidence: Child #1 was observed drinking a bottle. The bottle did not have a label on it that identified the owner.”

8VAC20-780-410-2

“Based on observation, and interview, the center failed to ensure that a child was not enclosed in a small confined space or any space that the child cannot freely exit himself. Evidence: 1) Child #1, age 21 months, was sleeping on a cot in the corner of the room that was surrounded on all sides by a rectangular children’s play gate. 2) When asked, staff #2 stated that the child is placed there during naptime because she refuses to stay on her cot and keeps the other children awake.”

8VAC20-780-350-I

“Based on observation, records review, and interview, the center failed to follow staff-to-children ratio and group size requirement for children ages 16 months through preschool age during the designated rest period. Evidence: 1) The Licensing Inspector arrived at 1:24 pm. Upon entry to the center there were 2 staff members and 18 children in the building. 2) There were 4 infants sleeping in cribs requiring one staff member at all times; there were 4 children (ages 16 months to 24 months) and sleeping on cots; there were 3 preschool age children sleeping on cots; there were 7 school aged children sleeping on cots. 3) For children 16 months through 24 months of age the required ratio for the designated rest period is one staff per 10 children only if, in addition to the staff required by rest period ratios, an additional staff member shall always be available on-site to offer immediate assistance. There was no additional staff person. 4) Records review indicated that the youngest child in care was 10 months old. 5) Two other staff members arrived approximately 30 minutes after the Inspector arrived. 6) When interviewed the Director stated that the other two staff members were not in the building because they were on their lunch break and she thought that ratio doubled during nap time.”

8VAC20-780-340-F

“Based on observation, and interview, the center failed to ensure that children under 10 years of age were within actual sight and sound supervision of staff. Evidence: 1) The Licensing Inspector arrived at 1:24 pm. Upon entry to the center there were 2 staff members and 18 children in the building. 2) There were 3 preschool age children sleeping in a separate room with the light off. 3) There was not a staff member in the room with them.”

8VAC20-780-240-B

“Based on records review, the center failed to document that staff completed orientation training no later than 7 days of the date of assuming job responsibilities. Evidence: Staff #3?s file, date of hire 2/1/22, did not contain documentation of orientation.”

8VAC20-780-90-A

“Based on records review, and interview, the center failed to obtain a written agreement between the parent and center giving authorization for emergency medical care, a statement that the center will notify the parent when the child becomes ill, or a statement that the parent will inform the center within 24 hours of any communicable disease. Evidence: Child #1?s file did not have a parent agreement. When interviewed the Director acknowledged that the agreement was not in the file.”

8VAC20-780-70

“Based on records review, the center failed to ensure that staff records contained evidence that two or more references as to character and reputation as well as competency were checked prior to employment. Evidence: 1) 3 out of 4 staff records (staff #2, staff #3, and staff #4) reviewed did not contain references.”

8VAC20-780-60-A

“Based on records review, the center failed to maintain the required documentation in each child’s file. Evidence: 1) Child #1?s file did not list any authorized pick up’s and only had 1 emergency contact written down. 2) Child #3?s file did not have a phone number for the parent or a phone number for the child’s physician”

8VAC20-780-570-B

“Based on observation, and interview, the center failed to ensure that bottles were not used while the child is in the designated sleeping location. Evidence: Child #5, age 10 months, was lying in a crib while drinking a bottle.”

8VAC20-780-160-A

“Based on observation, a review of staff records and interview on July 21, 2022, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #2 (hired July 21, 2022) did not contain documentation of a tuberculosis screening. Staff #2 was observed caring for children. Administration confirmed staff #2 didn't have a tuberculosis screening.”

8VAC20-770-60-B

“Based on a review of records and interview on July 21, 2022, the center did not ensure to obtain a sworn statement from each staff prior to employment. Evidence: The record of staff #2 (hired on July 21, 2022) did not contain documentation of a sworn statement. Administration confirmed the center did not obtain a sworn statement from staff #2 yet.”

8VAC20-780-240-B

“Based on observation, record review and interview on July 21, 2022, the center did not ensure that staff shall complete orientation training in Subsection C prior to the staff member working alone with children. Evidence: 1. Staff #2 (hired July 21, 2022) was observed working alone with children. 2. The record of staff #2 did not contain documentation of orientation. 3. Administration stated orientation had not been completed with staff #2.”

8VAC20-780-530-A-1

“Based on a review of records and interview on July 21, 2022, the center did not ensure at least one staff in each classroom or area where children are present had a current CPR certification. Evidence: 1. Staff #2 was observed working alone with children. 2. Staff #2's record did not contain documentation of CPR certification. 3. Administration stated that it was staff #2's first day of employment and confirmed that staff #2 was not certified in CPR.”

8VAC20-780-530-A-2

“Based on observation, a review of records and interview on July 21, 2022, the center did not ensure at least one staff in each classroom or area where children are present had a current First Aid certification. Evidence: 1. Staff #2 was observed working alone with children. 2. Staff #2's record did not contain documentation of first aid certification. 3. Administration stated that it was staff #2's first day of employment and confirmed that staff #2 was not certified in first aid.”

8VAC20-780-530-C

“Based on observation and interview on July 21, 2022, the center failed to ensure there are at least two staff members who are certified in First Aid and CPR on the premises during the center's hours of operation. Evidence: Two staff were observed on the premises and caring for children at the start of the inspection at 8:35am. Administration confirmed staff #2 was just starting employment on this date and was not certified in first aid and cpr.”

8VAC20-780-350-B-2

“Based on observation, interview, and record review on July 21, 2022, the center did not ensure to maintain the required ratio of one staff for every 5 children ages 16 months up to 24 months. Evidence: In the preschool room(2-5 year olds) there was one staff with 6 children. Child #1 was identified by staff as being 2 years old but after an interview with administration and record review it was determined that child #1 is 19 months old.”

8VAC20-780-350-B-1

“Based on observation on July 21, 2022, the center did not ensure to maintain the required ratio of one staff to every four children ages birth to 16 months. Evidence: In the infant room there was 1 staff member with 5 children. The youngest child in the room is 9 months old.”

8VAC20-780-340-F

“Based on observation and interview on July 21, 2022, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: Staff #1, assigned to the infant/toddler area, was observed cleaning up from breakfast just outside of the infant/toddler area, for approximately 7 minutes. Staff #1 was observed to have her back to the infants/toddlers while cleaning. There were 5 infant/toddlers left in the infant/toddler area without staff directly supervising, the youngest child is 9 months old. During this time, child #2 (age 21 months) left the infant/toddler area to play with a toy next to the front desk, and Staff #1 was unaware the child left the enclosed infant/toddler area. Another staff member saw child #2 next to the front desk and picked the child up and returned the child to the infant/toddler area. Staff #1 reported to the inspector that she would turn around occasionally while cleaning to see the children, but this behavior was not observed during the approximately 7 minutes that the staff was cleaning up from breakfast. Staff #1 acknowledged that she was unaware child #2 left the area and was heard asking the child if the child climbed the gate.”

8VAC20-780-340-D

“Based on observation, record review and interview, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader or program director is regularly present. Evidence: 1. During the inspection staff #1 was observed as the only staff in the infant room and staff #2 was observed as the only staff in the preschool room. 2. The records of staff #1 and staff #2 did not contain documentation of program leader qualifications. 3. Administration stated that Staff #1 still did not have qualifications and that staff #2 was just hired and this was staff #2's first day and that she didn't have program leader qualifications.”

8VAC20-780-500-A

“Based on observation and interview on July 21, 2022, the center did not ensure that children's hands are washed with soap and running water after toileting. Evidence: Staff was observed changing a child's diaper. After the diaper change the child was placed back in the infant/toddler area and began playing with toys. The staff acknowledged that she didn't wash the child's hands after diapering.”

8VAC20-780-500-B

“Based on observation and interview on July 21, 2022, the center did not ensure the diapering surface shall be cleaned and sanitized after each use. Evidence: Staff was observed, after diapering, to not clean and sanitize the changing pad. The staff acknowledged the changing pad was not cleaned and sanitized after the diaper change.”

8VAC20-780-160-A

“Based on observation, a review of staff records and interview on July 21, 2022, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #2 (hired July 21, 2022) did not contain documentation of a tuberculosis screening. Staff #2 was observed caring for children. Administration confirmed staff #2 didn't have a tuberculosis screening.”

8VAC20-770-60-B

“Based on a review of records and interview on July 21, 2022, the center did not ensure to obtain a sworn statement from each staff prior to employment. Evidence: The record of staff #2 (hired on July 21, 2022) did not contain documentation of a sworn statement. Administration confirmed the center did not obtain a sworn statement from staff #2 yet.”

8VAC20-780-240-B

“Based on observation, record review and interview on July 21, 2022, the center did not ensure that staff shall complete orientation training in Subsection C prior to the staff member working alone with children. Evidence: 1. Staff #2 (hired July 21, 2022) was observed working alone with children. 2. The record of staff #2 did not contain documentation of orientation. 3. Administration stated orientation had not been completed with staff #2.”

8VAC20-780-530-A-1

“Based on a review of records and interview on July 21, 2022, the center did not ensure at least one staff in each classroom or area where children are present had a current CPR certification. Evidence: 1. Staff #2 was observed working alone with children. 2. Staff #2's record did not contain documentation of CPR certification. 3. Administration stated that it was staff #2's first day of employment and confirmed that staff #2 was not certified in CPR.”

8VAC20-780-530-A-2

“Based on observation, a review of records and interview on July 21, 2022, the center did not ensure at least one staff in each classroom or area where children are present had a current First Aid certification. Evidence: 1. Staff #2 was observed working alone with children. 2. Staff #2's record did not contain documentation of first aid certification. 3. Administration stated that it was staff #2's first day of employment and confirmed that staff #2 was not certified in first aid.”

8VAC20-780-530-C

“Based on observation and interview on July 21, 2022, the center failed to ensure there are at least two staff members who are certified in First Aid and CPR on the premises during the center's hours of operation. Evidence: Two staff were observed on the premises and caring for children at the start of the inspection at 8:35am. Administration confirmed staff #2 was just starting employment on this date and was not certified in first aid and cpr.”

8VAC20-780-350-B-2

“Based on observation, interview, and record review on July 21, 2022, the center did not ensure to maintain the required ratio of one staff for every 5 children ages 16 months up to 24 months. Evidence: In the preschool room(2-5 year olds) there was one staff with 6 children. Child #1 was identified by staff as being 2 years old but after an interview with administration and record review it was determined that child #1 is 19 months old.”

8VAC20-780-350-B-1

“Based on observation on July 21, 2022, the center did not ensure to maintain the required ratio of one staff to every four children ages birth to 16 months. Evidence: In the infant room there was 1 staff member with 5 children. The youngest child in the room is 9 months old.”

8VAC20-780-340-F

“Based on observation and interview on July 21, 2022, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: Staff #1, assigned to the infant/toddler area, was observed cleaning up from breakfast just outside of the infant/toddler area, for approximately 7 minutes. Staff #1 was observed to have her back to the infants/toddlers while cleaning. There were 5 infant/toddlers left in the infant/toddler area without staff directly supervising, the youngest child is 9 months old. During this time, child #2 (age 21 months) left the infant/toddler area to play with a toy next to the front desk, and Staff #1 was unaware the child left the enclosed infant/toddler area. Another staff member saw child #2 next to the front desk and picked the child up and returned the child to the infant/toddler area. Staff #1 reported to the inspector that she would turn around occasionally while cleaning to see the children, but this behavior was not observed during the approximately 7 minutes that the staff was cleaning up from breakfast. Staff #1 acknowledged that she was unaware child #2 left the area and was heard asking the child if the child climbed the gate.”

8VAC20-780-340-D

“Based on observation, record review and interview, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader or program director is regularly present. Evidence: 1. During the inspection staff #1 was observed as the only staff in the infant room and staff #2 was observed as the only staff in the preschool room. 2. The records of staff #1 and staff #2 did not contain documentation of program leader qualifications. 3. Administration stated that Staff #1 still did not have qualifications and that staff #2 was just hired and this was staff #2's first day and that she didn't have program leader qualifications.”

8VAC20-780-500-A

“Based on observation and interview on July 21, 2022, the center did not ensure that children's hands are washed with soap and running water after toileting. Evidence: Staff was observed changing a child's diaper. After the diaper change the child was placed back in the infant/toddler area and began playing with toys. The staff acknowledged that she didn't wash the child's hands after diapering.”

8VAC20-780-500-B

“Based on observation and interview on July 21, 2022, the center did not ensure the diapering surface shall be cleaned and sanitized after each use. Evidence: Staff was observed, after diapering, to not clean and sanitize the changing pad. The staff acknowledged the changing pad was not cleaned and sanitized after the diaper change.”

8VAC20-780-580-L

“Based on an interview with administration, the center did not ensure to obtain parental permission for transportation and field trips before the scheduled activity. Evidence: Administration reported that daily outdoor time in February was conducted at a private home away from the center. Administration stated that starting on March 7, 2022, the outdoor time is at a local park. Administration reported transporting two children for outdoor time. Administration reported they did not obtain parental permission.”

22.1-289.035-B-2

“Based on a review of records, the center did not ensure to obtain a fingerprint based national criminal record check prior to the first day of employment for each staff. Evidence: The record of staff #3 (hired 3/1/22) contained documentation of fingerprints dated 3/3/22.”

8VAC20-780-520-C

“Based on observation and interview, the center did not ensure infant records contained documentation of written parent authorization for diaper ointment or cream. Evidence: During the inspection two diaper ointments were observed in the infant area of the center. A staff member in the class stated the ointments were being used. Administration stated parent authorization forms were not obtained.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: There was a can of smoke odor eliminator resting on the handicap grab bar in the bathroom used by children. The label on the can of smoke odor eliminator stated "keep out of reach of children and warning."”

8VAC20-780-130-A

“Based on a review of children's records, the center did not ensure to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: The record of child #1 (enrolled 2/10/22) contained documentation of immunizations dated 2/25/22.”

8VAC20-780-130-E

“Based on a review of children's records and interview, the center did not ensure to obtain documentation of immunizations once every six months for children under the age of two years. Evidence: The record of child #2 (DOB 4/28/21) contained documentation of immunizations dated 9/3/21. Administration confirmed the additional immunizations were not obtained.”

8VAC20-780-140-B

“Based on a review of children's records, a physical exam that was completed prior to a child's first date of attendance was not dated within three months prior to attendance for a child that was 11 months old at the time of enrollment. Evidence: Child #2 was 11 months old on their first date of enrollment (2/9/22) and the physical that was provided was dated 9/10/21.”

8VAC20-780-160-A-1

“Based on a review of staff records and interview, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #3 (hired 3/1/22) contained documentation of a tuberculosis screening dated 3/7/22. Administration acknowledged the tuberculosis screening was late.”

8VAC20-780-160-B

“Based on a review of staff records and interview, the center failed to obtain an acceptable form of documentation of tuberculosis screening for one record. Evidence: The record of staff #2 (hired 3/1/22) contained documentation of a tuberculosis screening that was not signed by a physician, physician's designee or an official of the local health department. 2. Administration acknowledged the screening was not signed.”

8VAC20-780-340-D

“Based on observation and interview, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader or program director is regularly present. Evidence: During the inspection staff #2 was observed as the only staff in the infant room and staff #3 was observed as the only staff in the preschool room. During an interview with administration it was determined that staff #2 and staff #3 were hired as the program leaders but do not meet the qualifications of program leader.”

8VAC20-780-580-L

“Based on an interview with administration, the center did not ensure to obtain parental permission for transportation and field trips before the scheduled activity. Evidence: Administration reported that daily outdoor time in February was conducted at a private home away from the center. Administration stated that starting on March 7, 2022, the outdoor time is at a local park. Administration reported transporting two children for outdoor time. Administration reported they did not obtain parental permission.”

22.1-289.035-B-2

“Based on a review of records, the center did not ensure to obtain a fingerprint based national criminal record check prior to the first day of employment for each staff. Evidence: The record of staff #3 (hired 3/1/22) contained documentation of fingerprints dated 3/3/22.”

8VAC20-780-520-C

“Based on observation and interview, the center did not ensure infant records contained documentation of written parent authorization for diaper ointment or cream. Evidence: During the inspection two diaper ointments were observed in the infant area of the center. A staff member in the class stated the ointments were being used. Administration stated parent authorization forms were not obtained.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: There was a can of smoke odor eliminator resting on the handicap grab bar in the bathroom used by children. The label on the can of smoke odor eliminator stated "keep out of reach of children and warning."”

8VAC20-780-130-A

“Based on a review of children's records, the center did not ensure to obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: The record of child #1 (enrolled 2/10/22) contained documentation of immunizations dated 2/25/22.”

8VAC20-780-130-E

“Based on a review of children's records and interview, the center did not ensure to obtain documentation of immunizations once every six months for children under the age of two years. Evidence: The record of child #2 (DOB 4/28/21) contained documentation of immunizations dated 9/3/21. Administration confirmed the additional immunizations were not obtained.”

8VAC20-780-140-B

“Based on a review of children's records, a physical exam that was completed prior to a child's first date of attendance was not dated within three months prior to attendance for a child that was 11 months old at the time of enrollment. Evidence: Child #2 was 11 months old on their first date of enrollment (2/9/22) and the physical that was provided was dated 9/10/21.”

8VAC20-780-160-A-1

“Based on a review of staff records and interview, the center did not ensure that each staff submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: The record of staff #3 (hired 3/1/22) contained documentation of a tuberculosis screening dated 3/7/22. Administration acknowledged the tuberculosis screening was late.”

8VAC20-780-160-B

“Based on a review of staff records and interview, the center failed to obtain an acceptable form of documentation of tuberculosis screening for one record. Evidence: The record of staff #2 (hired 3/1/22) contained documentation of a tuberculosis screening that was not signed by a physician, physician's designee or an official of the local health department. 2. Administration acknowledged the screening was not signed.”

8VAC20-780-340-D

“Based on observation and interview, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader or program director is regularly present. Evidence: During the inspection staff #2 was observed as the only staff in the infant room and staff #3 was observed as the only staff in the preschool room. During an interview with administration it was determined that staff #2 and staff #3 were hired as the program leaders but do not meet the qualifications of program leader.”

22VAC40-191-40-C-1-A

“Based on a review of owner record and interview on October 27, 2021, the center did not ensure to obtain the results of a central registry check and sworn statement of affirmation upon application for licensure or registration as a child welfare agency. Evidence: 1. The record of the Owner did not contain documentation of a sworn statement. The sworn statement was completed during the inspection. 2. The owner acknowledged the sworn statement was not complete when it was asked for.”

22VAC40-191-40-C-1-B

“Based on a review of agent record and interview on October 27, 2021, the center did not ensure to obtain the results of a central registry check and sworn statement of affirmation upon application for licensure or registration as a child welfare agency. Evidence: 1. The record of Agent #1 did not contain documentation of central registry results and a sworn statement. The sworn statement was completed during the inspection. 2. Administration acknowledged the results of the central registry were not in the record.”

22VAC40-185-240-B

“Based on a review of the center's policies and procedures, the center did not ensure that the required components were included in the staff handbook. Evidence: The staff handbook did not address the following policies: 1. Procedures for supervising a child who may arrive after scheduled classes or activities including field trips have begun; 2. Procedures to confirm absence of a child when the child is scheduled to arrive from another program or from an agency responsible for transporting the child to the center; 3. Procedures for identifying where attending children are at all times, including procedures to ensure that all children are accounted for before leaving a field trip site and upon return to the center; 4. Procedures for action in case of lost or missing children, ill or injured children, medical emergencies, and general emergencies; 5. Policy for any administration of medication; 6. Emergency evacuation, relocation, shelter-in-place, and lockdown procedures; and 7. Precautions in transporting children, if applicable.”

22VAC40-185-270-A

“Based on observation on October 27, 2021, 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. The preschool area contained peeling paint approximately 1.5 x 2 inches in size. 2. The cubbies in the preschool area had multiple areas of the unit with chipped and peeling paint.”

22VAC40-185-550-A

“Based on interview on October 27, 2021 and review of records, the center did not ensure to have an emergency preparedness plan that addresses staff responsibility and facility readiness with respect to emergency evacuation and shelter-in-place. The plan, which shall be developed in consultation with local or state authorities, shall include the most likely to occur emergency scenario or scenarios, including fire, severe storms, loss of utilities, natural disaster, chemical spills, intruder, violence at or near the center, terrorism specific to the locality, and other situations, including facility damage that requires evacuation, lockdown, or shelter-in-place. Evidence: 1. Administration stated the center's emergency plan was not developed in consultation with local or state authorities. 2. After review of the emergency preparedness plan it did not contain a plan to include intruder and terrorism.”

22VAC40-185-550-B

“Based on a review of records, the center did not ensure the emergency preparedness plan contains all the procedural components. Evidence: 1. The procedural components did not contain documentation for sounding of alarms, such as intruder, shelter-in-place, or chemical hazard. 2. The emergency communication did not contain the a.) establishment of center emergency officer and back-up officer to include 24-hour contact telephone number for each; b.) notification of local authorities, such as fire and rescue, law enforcement, emergency medical services, poison control, health department, and parents and local media; and c. Availability and primary use of communication tools. 3. Evacuation plan did not include a.) Assembly points, head counts, primary and secondary means of egress, and complete evacuation of the buildings; b.) Securing of essential documents and special healthcare supplies to be carried to the designated assembly points c.) Method of communication after the evacuation; 4. The shelter-in-place did not contain a.) scenario applicability, for a tornado, inside assembly points, head counts, and primary and secondary means of access and egress; b.) Securing of essential documents, and special health supplies to be carried to the designated assembly points; c.) Method of communication after the shelter-in-place”