Mighty Minds, Little Hands International Preschool

8VAC20-780-520-A

“Based on review of over the counter skin products, the center failed to ensure that over-the-counter skins products shall not be kept beyond the expiration date of the product. Evidence: 1. In the Circus Classroom there was a tube of Desitin Diaper Ointment that expired in 12/2023. 2. Staff verified the expiration date on the tube of Desitin.”

8VAC20-780-270-A

“Based on observation, the center failed to ensure that all equipment inside and outside shall be maintained in safe and operable condition. Evidence: On the playground there was a playhouse that had a broken piece of plastic near one of the windows. There are sharp edges of plastic exposed.”

8VAC20-780-60-A-8

“Based on a review of medications and children records, the center failed to ensure that a written care plan for each child with a diagnosed food allergy was completed by a physician. Evidence: 1. Child #2 had emergency medication, (Epi-Pen and Benadryl), at the center. There was not an allergy plan completed by a physician regarding the steps to be taken in the event of a suspected or confirmed allergic reaction the child's record. 2. Administration verified that there was not an allergy plan completed by the physician.”

8VAC20-820-410-C

“Based on review of documentation, the center failed to implement the terms of the consent agreement. Evidence: 1. The consent agreement signed on 09/12/2023 state that, "prior to Mighty Minds Little Hands International Preschool LLC, accepting any money for deposit and prior to enrollment of the any child" to provide evidence of acknowledgment of receipt of all required parent notifications. 2. Child #1's date of enrollment was 10/02/2023. The acknowledgment receipt was signed by the parent on 10/10/2023. 3. Child #2's date of enrollment was 10/02/2023. The acknowledgment receipt was signed by the parent on 10/12/2023. 4. Child#3's date of enrollment was 10/26/2023. The acknowledgment receipt was signed by the parent on 10/26/2023.”

8VAC20-780-245-A

“Based on review of staff records, the center failed to ensure that staff complete a minimum of 16 hours of training annually. Evidence: 1. Staff #1 only completed 12 hours of annual training between August 2022-August 2023. 2. Staff verified that they only had completed 12 hours of training.”

22.1-289.035-B-4

“Based on review of staff records, the center failed to obtain out-of-state background checks on individuals who have resided out of Virginia within the past five years. Evidence: 1. Staff #2 indicated on a sworn disclosure statement dated 11/10/2023 that they had lived in one other state within the past five years. 2. Staff #2's date of hire was 11/13/2023, there was not a record of the out-of-state sex offender name check. 3. Staff #3 verified the date of hire for Staff #2, and that the out-of-state sex offender name check has not been completed.”

8VAC20-780-570-E

“Based on observation, the center failed to ensure that all prepared infant formula shall be labeled with the child's name. Evidence: 1. In the Rainbow Classroom there were three prepared bottles in the bottom drawer that was not labeled with the child's name. 2. Staff verified that bottles were not labeled with the child's name.”

8VAC20-780-245-A

“Based on review of staff records, the center failed to ensure that staff complete a minimum of 16 hours of training annually. Evidence: 1. Staff #1 only completed 12 hours of annual training between August 2022-August 2023. 2. Staff verified that they only had completed 12 hours of training.”

22.1-289.035-B-4

“Based on review of staff records, the center failed to obtain out-of-state background checks on individuals who have resided out of Virginia within the past five years. Evidence: 1. Staff #2 indicated on a sworn disclosure statement dated 11/10/2023 that they had lived in one other state within the past five years. 2. Staff #2's date of hire was 11/13/2023, there was not a record of the out-of-state sex offender name check. 3. Staff #3 verified the date of hire for Staff #2, and that the out-of-state sex offender name check has not been completed.”

8VAC20-780-570-E

“Based on observation, the center failed to ensure that all prepared infant formula shall be labeled with the child's name. Evidence: 1. In the Rainbow Classroom there were three prepared bottles in the bottom drawer that was not labeled with the child's name. 2. Staff verified that bottles were not labeled with the child's name.”

8VAC20-780-60-A

“Based on review of children records, the center failed to ensure that all required information was in the children's records. Evidence: 1. Child #2 and Child #3's records did not contain the name, home address, and home phone number of the parent/guardian who has custody of the child. 2. Child #3's was missing the name, address, and phone number of one of the two required designated people to call in an emergency if the parent cannot be located.”

8VAC20-780-330-B

“Based on observation, the facility failed to ensure that resilient surfacing shall comply with minimum safety standards and shall be under and around all equipment with moving parts or climbing apparatus. Evidence:, There was bare ground exposed at the bottom of the blue slide and climbing wall on the large play equipment in the middle of the play area, and at the end of the red slide next to fence in the play area.”

8VAC20-780-500-A

“REPEAT VIOLATION: Based on observation, the children and staff's hands were not washed at all the required times. Evidence: 1. In the Infant Room,Staff #2 did not wash her hands before putting on gloves to complete a diaper change. 2. In the Infant Room, Staff #2, did not wash the child's hands with soap. She took the infant to the sink and ran the child's hands under warm water.”

8VAC20-780-570-B

“Based on observation, the center failed to ensure that bottles were not used while the child is in their designated sleeping location. Evidence: 1. On July 27, 2023 when the Licensing Inspector entered the Infant Classroom, an infant was observed in their crib drinking their bottle. 2. The crib was designated as the child's designated sleeping area. 3. Staff #2 verified that the child has a bottle in their designated sleeping area.”

8VAC20-780-140-A

“Based on review of children records, the center failed to obtain a physical examination before the child's first date of attendance, or within 30 days after the first day of attendance. Evidence: 1. Child #3's first date of attendance was 03/01/2023. The physical on file was dated 04/18/2023. 2. Staff #1 verified the date on the physical form.”

8VAC20-780-70

“Based on review of staff records, the center failed to ensure that two or more reference as to character and reputation as well as competency were checked before the first day of employment. Evidence: 1. Staff #2 date of employment was 06/26/2023. There were no completed references in the staff file. 2. Staff #5 verified the date of employment and that there were not any references on file.”

8VAC20-780-70

“Based on review of staff records, the center failed to ensure that two or more reference as to character and reputation as well as competency were checked before the first day of employment. Evidence: 1. Staff #2 date of employment was 06/26/2023. There were no completed references in the staff file. 2. Staff #5 verified the date of employment and that there were not any references on file.”

8VAC20-790-600-D-1

“Based on review of staff records, the center failed to ensure that all employees were certified in cardiopulmonary resuscitation (CPR) within 90 days of employment. Evidence: 1. Staff #2's date of hire was 07/05/2022. There was no documentation of CPR certification in the record. 2. Administration verified that Staff #2 is not certified in CPR.”

8VAC20-790-600-D-2

“Based on review of staff records, the center failed to ensure that all employees were certified in First Aid within 90 days of employment. Evidence: 1. Staff #2's date of hire was 07/05/2022. There was no documentation of First Aid certification in the record. 2. Administration verified that Staff #2 is not certified in First Aid.”

8VAC20-780-280-B

“REPEAT Based on observation, the center failed to ensure that all hazardous materials were kept in a locked location. Evidence: 1. In the Rainbow Classroom there was a spray bottle of bleach water sitting on the counter next to the diaper changing table, and a spray bottle of Febreze sitting on the shelve next to the microwave. 2. In the Pre-K restroom located in the classroom, there were two spray cans of Lysol Disinfectant Spray in a pink container located in bathtub. 3. The manufacturer's label stated "Keep Out of Reach of Children", and "Caution."”

8VAC20-780-500-B

“REPEAT Based on observation, the center failed to ensure that the diapering surface shall only be used for diapering or cleaning children. Evidence: On 05/08/2023, in the Circus Classroom, there was a small crochet blanket, Mickey Mouse stuffed toy, and a pack of diapers setting on top of the diapering surface.”

8VAC20-790-600-D-1

“Based on review of staff records, the center failed to ensure that all employees were certified in cardiopulmonary resuscitation (CPR) within 90 days of employment. Evidence: 1. Staff #2's date of hire was 07/05/2022. There was no documentation of CPR certification in the record. 2. Administration verified that Staff #2 is not certified in CPR.”

8VAC20-790-600-D-2

“Based on review of staff records, the center failed to ensure that all employees were certified in First Aid within 90 days of employment. Evidence: 1. Staff #2's date of hire was 07/05/2022. There was no documentation of First Aid certification in the record. 2. Administration verified that Staff #2 is not certified in First Aid.”

8VAC20-780-280-B

“REPEAT Based on observation, the center failed to ensure that all hazardous materials were kept in a locked location. Evidence: 1. In the Rainbow Classroom there was a spray bottle of bleach water sitting on the counter next to the diaper changing table, and a spray bottle of Febreze sitting on the shelve next to the microwave. 2. In the Pre-K restroom located in the classroom, there were two spray cans of Lysol Disinfectant Spray in a pink container located in bathtub. 3. The manufacturer's label stated "Keep Out of Reach of Children", and "Caution."”

8VAC20-780-500-B

“REPEAT Based on observation, the center failed to ensure that the diapering surface shall only be used for diapering or cleaning children. Evidence: On 05/08/2023, in the Circus Classroom, there was a small crochet blanket, Mickey Mouse stuffed toy, and a pack of diapers setting on top of the diapering surface.”

8VAC20-780-130-A

“Based on review of children records, the center failed to ensure that immunizations were obtained and on file prior to the first date of attendance. Evidence: 1. Child #1's first date of attendance was 03/13/2023. The immunizations on file were dated 03/17/2023. 2. Child #2's first date of attendance was 03/01/2023. The immunizations on file were dated 03/02/2023. 3. Staff #1 verified the first date of attendance for Child #1 and Child #2 and the date on the immunizations.”

8VAC20-780-130-A

“Based on review of children records, the center failed to ensure that immunizations were obtained and on file prior to the first date of attendance. Evidence: 1. Child #1's first date of attendance was 03/13/2023. The immunizations on file were dated 03/17/2023. 2. Child #2's first date of attendance was 03/01/2023. The immunizations on file were dated 03/02/2023. 3. Staff #1 verified the first date of attendance for Child #1 and Child #2 and the date on the immunizations.”

8VAC20-780-280-B

“Based on observation and interview, the center failed to ensure that all hazardous materials were kept in a locked location. Evidence: 1. In Classroom #1 there was a spray bottle that was labeled bleach water sitting on the shelf above the microwave, and a can of Lysol Disinfectant Spray sitting on the second shelf next to the toilet in the restroom that the children use. 2. On the front of the can of Lysol Disinfectant Spray it states, ?Caution? and ?keep out of reach of children.? 3. Staff #3 verified that the spray bottle of bleach water and the Lysol Disinfectant spray were not in a locked location.”

8VAC20-820-120-E-3

“Based on observation of posted information, the center failed ensure that the Superintendent’s intent to revoke the license of the child day center was posted in a prominent place at each public entrance of the facility to advise consumers of serious or persistent violations. Evidence: The Notice of Intent to Revoke License provided by the Virginia Department of Education, signed by the Director of the Office of Child Care Health & Safety on February 2, 2023, was not posted in a prominent place at each public entrance of the facility to advise consumers of serious or persistent violations.”

8VAC20-780-160-C

“Based on interview and review of staff records, the center failed to ensure that at least every two years from the date of the initial screening or testing, a staff member obtained and submitted the results of a follow-up tuberculosis screening. Evidence: 1. The most recent tuberculosis test in the record for Staff #1 is dated 01/21/2021. 2. Staff #1 verified the date of the tuberculosis test on file, and that a follow-up tuberculosis screening had not been obtained.”

8VAC20-790-600-F

“Based on review of staff records, the center failed to ensure that departments health and safety course was taken annually. Evidence: 1. Staff #3 did not have a 2022 Annual Virginia Health and Safety Update in her file. The last updated training was dated April 21, 2021. 2. Staff verified that the training had not been taken in 2022.”

8VAC20-780-510-P

“Based on review of medication, the center failed to ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Evidence: In Classroom #1 on 12/16/2022, Child #1 had a prescription diaper ointment (Triamcinolone Cream). The medication authorization form signed by the parent dated 05/09/2022 was only current for 10 business days and expired on 05/23/2022. A new medication authorization form had not been completed.”

8VAC20-780-510-L

“Based on observation, the center failed to ensure that all prescription medication was kept in a locked location. Evidence: In Classroom #1 there was a jar of prescription diaper ointment, Triamcinolone Cream, in an open storage container on the shelf with the rest of the diaper ointments. The container was not in a locked location.”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that children’s and staff’s hands were washed at all the required time. Evidence: 1. On December 16, 2022, the Licensing Inspector observed a routine diaper changing time in Classroom #1. 2. Three children were observed during the process. Staff #1 did not wash her hands before or after changing each child. 3. All three children that were observed during diaper changing time did not wash their hands after having their diapers changed.”

8VAC20-780-240-B

“Based on review of staff records, the center failed to ensure that orientation training was completed within seven days of the date of hire. Evidence: 1. Staff #6?s date of employment was 11/02/2022. The orientation documentation on file was dated that it was completed on 11/28/2022. 2. Administration verified that the orientation had been completed late.”

8VAC20-780-40-E

“Based on review of the employee handbook and medication policy, the licensee failed to ensure that the center’s activities and services are maintained in compliance with the center’s own policy and procedures required by these standards. Evidence: 1. In the Employee Handbook, the medication policy states, ?all medications should be in the original containers and stored in a LOCKED area?, and ?Parent’s authorizations for medications will include a duration providing an expiration date or will be renewed after 10 working days.? 2. In Classroom #1 there was a prescription diaper ointment, (Triamcinolone Cream), in a container on the shelf with the rest of the over-the counter skin products. The container was not locked or in a locked area. 3. Child#1 had a prescription diaper ointment, (Triamcinolone Cream) on site on 12/16/2022. The parent authorization form was completed on 05/09/2022 and expired on 05/23/2022. The authorization was not renewed after 10 working days.”

8VAC20-780-160-C

“Based on review of staff records, the center failed to ensure that an updated tuberculosis screening/test was obtained at least every two years from the date of the initial screening/test. Evidence: 1. Staff #2?s tuberculosis screening on file was dated 10/14/2020. A new tuberculosis screening/test was required by 10/14/2022. 2. Staff #3?s tuberculosis screening on file was dated 02/06/2020. A new tuberculosis screening/test was required by 02/06/2022. 3. Administration verified the dates on the tuberculosis screening on file, and verified that the staff had not obtained new tuberculosis screening/test.”

8VAC20-780-160-A

“Based on review of staff records, the center failed to ensure that each staff member submitted documentation of a negative tuberculosis screening completed within the last 30 calendar days of the date of employment and prior to coming into contact with children. Evidence: 1. Staff #6?s date of hire was 11/02/2022. There TB test on file was dated 07/15/2021.The TB test was more than 30 days prior to the date of hire. 2. Staff #7?s date of hire was 11/04/2022. The tuberculosis screening on file was dated 11/18/2022. 3. Administration verified that Staff #7 had began working in the classroom before the tuberculosis screening/test was on file.”

8VAC20-780-130-E

“Based on review of children records, the center failed to obtain documentation of additional immunizations one every six months for children under the age of two. Evidence: 1. The last immunizations on file for child #3 (age 19 months) were dated 04/26/2022. Documentation of additional immunizations were required in October 2022. 2. Staff verified that there were not updated immunizations in the child’s file.”

8VAC20-770-60-C-2

“Based on a review of staff records, the center failed to have central registry findings within 30 days of employment. Evidence: 1. Staff #1's date of employment was 03/04/2022. There was not a completed central registry finding on file. 2. Staff #4?s date of employment was 09/20/2022. There was not a completed central registry finding on file. 3. Staff #5?s date of employment was 02/28/2022. There was not a completed central registry finding on file. 4. Staff #6?s employment was 11/02/2022. There was not a completed central registry find on file. 5. Staff #7?s date of employment was 11/04/2022. There was not a completed central registry finding on file.”

22.1-289.035-B-2

“Based on review of staff files, the center failed to ensure that a national criminal history background check was on file prior to the first day of employment. Evidence: 1. Staff #4?s first day of employment and orientation was 09/20/2022. The national criminal history background check on file was dated 09/22/2022. 2. Staff #6?s first day of employment and orientation was 11/02/2022. There was not a completed national criminal history background check on file for Staff #6. Staff #6 was observed to be working with a group of children by herself in Classroom #2. Staff #6 verified she started employment on 11/02/2022. 3. Staff #7?s first day of employment and orientation was 11/04/2022. The national criminal history background check on file was dated 11/16/2022.”

22.1-289.023-B

“Based on observation, the center failed to post a copy of the special order issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The Special Order dated August 31, 2022, was not posted anywhere in the facility. 2. Administration verified that the Special Order was not posted.”

22.1-289.023-A

“Based on observation, the center failed to post a copy of the notice of intent issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The Notice of Intent dated May 11, 2022, was not posted anywhere in the facility. 2. Administration verified that the Notice of Intent was not posted.”

8VAC20-780-500-B

“Based on observation of the diapering routine, the facility failed to ensure that the diapering surface was cleaned and sanitized, and diapers were disposed of as required. Evidence: 1. Staff #1 was observed changing three children’s diapers. Staff #1 did not use the foot pedal 2 out of 3 times to dispose of the soiled diaper. She lifted the lid of the trashcan with her hand and placed the soiled diaper inside the trash can. 2. Staff #1 was observed changing three children’s diapers. Staff #1 sprayed the surface with the bleach spray disinfectant, and immediately wiped it off of the surface. She did not first clean the surface with soap and water, nor did she allow the bleach spray disinfectant to air dry.”

8VAC20-790-600-F

“Based on review of staff records, the center failed to ensure that departments health and safety course was taken annually. Evidence: 1. Staff #3 did not have a 2022 Annual Virginia Health and Safety Update in her file. The last updated training was dated April 21, 2021. 2. Staff verified that the training had not been taken in 2022.”

8VAC20-780-510-P

“Based on review of medication, the center failed to ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Evidence: In Classroom #1 on 12/16/2022, Child #1 had a prescription diaper ointment (Triamcinolone Cream). The medication authorization form signed by the parent dated 05/09/2022 was only current for 10 business days and expired on 05/23/2022. A new medication authorization form had not been completed.”

8VAC20-780-510-L

“Based on observation, the center failed to ensure that all prescription medication was kept in a locked location. Evidence: In Classroom #1 there was a jar of prescription diaper ointment, Triamcinolone Cream, in an open storage container on the shelf with the rest of the diaper ointments. The container was not in a locked location.”

8VAC20-780-500-A

“Based on observation, the center failed to ensure that children’s and staff’s hands were washed at all the required time. Evidence: 1. On December 16, 2022, the Licensing Inspector observed a routine diaper changing time in Classroom #1. 2. Three children were observed during the process. Staff #1 did not wash her hands before or after changing each child. 3. All three children that were observed during diaper changing time did not wash their hands after having their diapers changed.”

8VAC20-780-240-B

“Based on review of staff records, the center failed to ensure that orientation training was completed within seven days of the date of hire. Evidence: 1. Staff #6?s date of employment was 11/02/2022. The orientation documentation on file was dated that it was completed on 11/28/2022. 2. Administration verified that the orientation had been completed late.”

8VAC20-780-40-E

“Based on review of the employee handbook and medication policy, the licensee failed to ensure that the center’s activities and services are maintained in compliance with the center’s own policy and procedures required by these standards. Evidence: 1. In the Employee Handbook, the medication policy states, ?all medications should be in the original containers and stored in a LOCKED area?, and ?Parent’s authorizations for medications will include a duration providing an expiration date or will be renewed after 10 working days.? 2. In Classroom #1 there was a prescription diaper ointment, (Triamcinolone Cream), in a container on the shelf with the rest of the over-the counter skin products. The container was not locked or in a locked area. 3. Child#1 had a prescription diaper ointment, (Triamcinolone Cream) on site on 12/16/2022. The parent authorization form was completed on 05/09/2022 and expired on 05/23/2022. The authorization was not renewed after 10 working days.”

8VAC20-780-160-C

“Based on review of staff records, the center failed to ensure that an updated tuberculosis screening/test was obtained at least every two years from the date of the initial screening/test. Evidence: 1. Staff #2?s tuberculosis screening on file was dated 10/14/2020. A new tuberculosis screening/test was required by 10/14/2022. 2. Staff #3?s tuberculosis screening on file was dated 02/06/2020. A new tuberculosis screening/test was required by 02/06/2022. 3. Administration verified the dates on the tuberculosis screening on file, and verified that the staff had not obtained new tuberculosis screening/test.”

8VAC20-780-160-A

“Based on review of staff records, the center failed to ensure that each staff member submitted documentation of a negative tuberculosis screening completed within the last 30 calendar days of the date of employment and prior to coming into contact with children. Evidence: 1. Staff #6?s date of hire was 11/02/2022. There TB test on file was dated 07/15/2021.The TB test was more than 30 days prior to the date of hire. 2. Staff #7?s date of hire was 11/04/2022. The tuberculosis screening on file was dated 11/18/2022. 3. Administration verified that Staff #7 had began working in the classroom before the tuberculosis screening/test was on file.”

8VAC20-780-130-E

“Based on review of children records, the center failed to obtain documentation of additional immunizations one every six months for children under the age of two. Evidence: 1. The last immunizations on file for child #3 (age 19 months) were dated 04/26/2022. Documentation of additional immunizations were required in October 2022. 2. Staff verified that there were not updated immunizations in the child’s file.”

8VAC20-770-60-C-2

“Based on a review of staff records, the center failed to have central registry findings within 30 days of employment. Evidence: 1. Staff #1's date of employment was 03/04/2022. There was not a completed central registry finding on file. 2. Staff #4?s date of employment was 09/20/2022. There was not a completed central registry finding on file. 3. Staff #5?s date of employment was 02/28/2022. There was not a completed central registry finding on file. 4. Staff #6?s employment was 11/02/2022. There was not a completed central registry find on file. 5. Staff #7?s date of employment was 11/04/2022. There was not a completed central registry finding on file.”

22.1-289.035-B-2

“Based on review of staff files, the center failed to ensure that a national criminal history background check was on file prior to the first day of employment. Evidence: 1. Staff #4?s first day of employment and orientation was 09/20/2022. The national criminal history background check on file was dated 09/22/2022. 2. Staff #6?s first day of employment and orientation was 11/02/2022. There was not a completed national criminal history background check on file for Staff #6. Staff #6 was observed to be working with a group of children by herself in Classroom #2. Staff #6 verified she started employment on 11/02/2022. 3. Staff #7?s first day of employment and orientation was 11/04/2022. The national criminal history background check on file was dated 11/16/2022.”

22.1-289.023-B

“Based on observation, the center failed to post a copy of the special order issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The Special Order dated August 31, 2022, was not posted anywhere in the facility. 2. Administration verified that the Special Order was not posted.”

22.1-289.023-A

“Based on observation, the center failed to post a copy of the notice of intent issued by the department in a prominent place at each public entrance of the licensed premises to advise consumers of serious or persistent violations. Evidence: 1. The Notice of Intent dated May 11, 2022, was not posted anywhere in the facility. 2. Administration verified that the Notice of Intent was not posted.”

8VAC20-780-500-B

“Based on observation of the diapering routine, the facility failed to ensure that the diapering surface was cleaned and sanitized, and diapers were disposed of as required. Evidence: 1. Staff #1 was observed changing three children’s diapers. Staff #1 did not use the foot pedal 2 out of 3 times to dispose of the soiled diaper. She lifted the lid of the trashcan with her hand and placed the soiled diaper inside the trash can. 2. Staff #1 was observed changing three children’s diapers. Staff #1 sprayed the surface with the bleach spray disinfectant, and immediately wiped it off of the surface. She did not first clean the surface with soap and water, nor did she allow the bleach spray disinfectant to air dry.”

8VAC20-780-550-D

“Based on review of evacuation drills, the center failed to conduct a monthly evacuation drill. Evidence: 1. There was no documentation of a April 2022 evacuation drill being completed. 2. Administration verified that an evacuation drill had not been completed.”

8VAC20-780-550-P

“Based on review of injury reports, the center failed to ensure that all required information was documented. Evidence: 1. The injury report dated 04/21/2022 was missing the date the parents/guardians were notified, time of notification, and future action to prevent reoccurrence. 2. Administration verified that the report did contain all the required information.”

8VAC20-780-550-D

“Based on review of evacuation drills, the center failed to conduct a monthly evacuation drill. Evidence: 1. There was no documentation of a April 2022 evacuation drill being completed. 2. Administration verified that an evacuation drill had not been completed.”

8VAC20-780-550-P

“Based on review of injury reports, the center failed to ensure that all required information was documented. Evidence: 1. The injury report dated 04/21/2022 was missing the date the parents/guardians were notified, time of notification, and future action to prevent reoccurrence. 2. Administration verified that the report did contain all the required information.”

8VAC20-790-600-F

“Based on review of staff files, the center failed to ensure that the annual health and safety training course was taken annually. Evidence: 1. Staff #5's file did not contain documentation that the three hour annual health and safety training was completed during 2021. 2. Staff #6's file did not contain documentation that the three hour annual health and safety training was completed during 2021. 3. Staff verified that the annual health and safety training had not been completed for Staff #5 and Staff #6.”

8VAC20-790-600-F

“Based on review of staff files, the center failed to ensure that the annual health and safety training course was taken annually. Evidence: 1. Staff #5's file did not contain documentation that the three hour annual health and safety training was completed during 2021. 2. Staff #6's file did not contain documentation that the three hour annual health and safety training was completed during 2021. 3. Staff verified that the annual health and safety training had not been completed for Staff #5 and Staff #6.”

8VAC20-780-400-B

“Based on review of classroom video footage dated 11/30/2021, the center failed to use behavioral guidance that was constructive in nature age, and stage appropriate, and intended to redirect the children to appropriate behavior and resolve conflicts. Evidence: 1. Video footage from 11/30/2021 at approximately 2:23 P.M., shows a child waking up from a nap and crawling off the cot. Staff #1 walks over to the child and using her foot pushes the child back on the cot. 2. Video footage from 11/30/2021 at approximately 2:36 P.M>, shows a child take a sippy cup to Staff #1. Staff #1 knocks the sippy cup out of the child's hands with her hands, and tosses the sippy cup back to another cot. Staff #1 grabs the child by the mid-arm and pulls them down to the cot from a standing position.”

8VAC20-780-40-E

“Based on review of policies and procedures and classroom video footage dated 03/13/2019, the operational responsibilities of the licensee did not ensure that the center's activities and services are maintained in compliance with the center's own policies and procedures that are required by these standards. Evidence: 1. In the Employee Handbook on page 11 & 12 the Discipline Policy states ?The goal of discipline is to maintain a safe and fair environment that encourages growth and development of the child’s self-esteem. This type of environment encourages the building of interpersonal competence and fosters self-discipline: Discipline shall include positive guidance, redirection, modeling of constructive handling of feelings and resolution of interpersonal conflict, setting of clear cut limits, and use of logical non-punitive consequences.? 2. On 11/30/2021 at approximately 2:04 P.M., Child #1 (age 20 months), was placed into a bucket seat at table by Staff #1. Staff #1 placed the security belt on the child. Child #1 was in the bucket seat for approximately 28 minutes. In the video at 2:15 P.M. and again at 2:29 P.M. you can see Child #1 trying to get out of the bucket seat. Staff #1 is observed sitting next to the child on her cell phone. He can be seen twisting in the seat, and pushing his hands on the top of the table trying to get out of the bucket seat. Staff #2 stated that Child #1 was placed in the chair because he would not sleep, and that they, (Staff #1 and Staff# 2), were afraid he would walk around and walk on top of the sleeping children. 3. In the Employee Handbook on page 9 under Important Policies it states, ?Anytime you have to handle a child that needs to be lifted up, you must ALWAYS lift children underneath of their armpits.? 4. When Staff #1 removes Child #1 from the bucket seat she, (Staff #1), grabs Child #1 by one arm and places the other hand under the inner thigh and moves Child #1 back to his cot. 5. At 3:40 p.m. Staff #1 can be seen pulling a child off the cot by one arm from a sitting position. 6. In the Employee Handbook on page 12 under Handwashing it states, ?Hands will be washed before and after snack, bathroom use, nose blowing or wiping, after outside play, and after handling children. Infant and Toddler teachers will need to wash hands after discarding gloves.? 7. Staff #1 did not wash her hands before or after changing the children, or in between diaper changes.”

8VAC20-780-500-A

“Based on review of classroom video footage dated 11/30/2021, children and staff were not washed at the required times. Evidence: 1. Between 3:05 P.M. and 3:40 P.M. Staff #1 changed approximately 10 children’s diapers. The children’s diapers were changed and the children were immediately placed in the bucket seats at the table for snack. None of the children hands were washed with water and soap, or a wipe after having their diaper changed, or before being placed at the table for snack. 2. Staff #1 did not wash her hands before or after changing the children, or in between diaper changes.”

8VAC20-780-500-B

“8VAC20-780-500-B?Risk A2 Based on review of classroom video footage dated 11/30/2021, the center failed to follow all diapering requirements. Evidence: Between 3:05 P.M. and 3:40 P.M., Staff #1 changed approximately 10 children’s diapers. The changing table was not cleaned or sanitized after each child was changed.”

8VAC20-780-550-O

“Based on review of classroom video footage dated 11/30/2021 and interviews, the center failed to notify the parents of any known injuries. Evidence: 1. Child #1 was picked up from care at approximately 4:00 P.M., on 11/30/2021. The parents of Child #1 noticed at 5:00 P.M., when getting ready for a bath the child was saying "ouch". When they removed his pants there was a red mark that was an outline of three fingers. 2. At approximately 3:44 P.M., Staff #1 can be seen applying ointment to the child left upper thigh. 3. At approximately 3:47 P.M., Staff #1 grabs a cold compress and applies it to Child #1 leg. 4. Interviews with Staff #4, on (12/7/201), revealed that Staff #4 had text Staff #1 a picture that was sent to her by the parents. Staff #1 stated it happened at naptime and she was holding Child #1 too tightly.”

8VAC20-780-410-1

“Based on review of classroom video footage and interviews, the center failed to ensure children were not roughly handled or restricted movement through binding. Evidence: 1. Review of video footage revealed the following: a. At approximately 2:04 P.M., Child #1 (age 20 months), was placed into a bucket seat at a table by Staff #1. Staff #1 placed the safety belt on the child. b. Child #1 was in the bucket seat for approximately 28 minutes. c. At approximately 2:15 P.M., and 2:29 P.M., Child #1 can be seen twisting in the seat, and pushing his hands on the top of the table trying to get out of the bucket seat. d. At 2:32 P.M., Staff #1 removed Child #1 from the bucket seat. Staff #1 grabs Child #1 by one arm and places the other hand under the inner thigh and moves Child #1 back to hi cot. e. At 3:40 P.M., Staff #1 can be seen pulling a child off the cot by one arm from a sitting position. Staff #1 takes the child to the changing table. Staff #1 pushes the child on the chest to get them to lay down to change the diaper. f. At approximately 3:44 P.M., Staff #1 can be seen applying an ointment to the upper left thigh of Child #1. g. At approximately 3:47 P.M., Staff #1 grabs a cold compress and takes Child #1 and sits at the table with the children eating snack and applies the ice pack to the area. 2. Interviews with Staff #2, on (12/07/2021), revealed that Child #1 was placed in the chair because he would not sleep, and that they, (Staff #1 and Staff #2), were afraid he would walk around and walk on top of the sleeping children. 3. Interview with Staff #4, on (12/07/2021), revealed that Staff #4 text Staff #1 a picture that was sent to her by the parents. Staff #1 stated it happened at naptime and she was holding Child #1 too tightly.”