Mrs. Joan Green

8VAC20-800-90-C

“The family day home shall obtain documentation of additional immunizations for a child who is not exempt from the immunization once every six months for children under the age of two years. Child #4 received documentation of additional immunizations more than 8 months after the original immunizations.”

8VAC20-800-180-A

“A tuberculosis (TB) screening is required every two years from the last screening. An updated TB screening for Caregiver #1 and Caregiver #2 were not completed and was overdue by more than five months.”

8VAC20-800-570-A

“The provider shall ensure that a caregiver does not exceed 16 points. Upon entering the home, the inspector found one assistant caregiver supervising 10 children (ages 16 months - 4 years old). The point total was 22. The assistant caregiver was alone for an undetermined amount of time prior to the inspection, and the provider returned to the home 5 minutes after assistant called provider.”

8VAC20-800-780-B

“Annually the provider shall review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and obtain the parents' signed acknowledgment of the review. Child #1, Child #2, and Child #3 did not have an annual review within the last 12 months.”

8VAC20-800-940-A

“Temperatures shall be maintained at or below 40?F in refrigerator compartments and at or below 0?F in the freezer compartments. Inspection of the freezer found the temperature to be 15?F. Food remained frozen in freezer.”

8VAC20-800-830-A

“The emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care. Fire drills were not completed for February 2026.”

8VAC20-800-800-B

“The provider shall review the emergency plan at least annually and update the plan as needed. The provider shall document in writing each review and update to the emergency plan. The provider had not updated the emergency preparedness plan since 8/22/2024.”

8VAC20-800-280

“Poisonous materials shall be stored in an area inaccessible to children. Scrubbing Bubbles and additional cleaning materials were left unlocked and accessible to children in the bathroom.”

8VAC20-800-800-B

“The provider shall review the emergency plan at least annually and update the plan as needed. The provider shall document in writing each review and update to the emergency plan. The provider had not updated the emergency preparedness plan since 8/22/2024.”

8VAC20-800-280

“Poisonous materials shall be stored in an area inaccessible to children. Scrubbing Bubbles and additional cleaning materials were left unlocked and accessible to children in the bathroom.”

8VAC20-800-90-C

“Repeat Violation: Documentation of additional immunizations is required once every six months for children under the age of two years. ' Child #1, 23 months old, last documented immunization was over 12 months ago.”

8VAC20-800-780-B

“Repeat Violation: Annually, the provider shall review with the parent the emergency contact information required in each child’s record to ensure the information is correct and shall obtain the parents signed acknowledgment of the review. Records for children #2 and #4 did not have a parent’s signature for an annual review of the emergency contact information. Child #2 had been in care for over a year. Child #4 had been in care for almost two years without any annual review.”

8VAC20-800-90-C

“Repeat Violation: Documentation of additional immunizations is required once every six months for children under the age of two years. ' Child #1, 23 months old, last documented immunization was over 12 months ago.”

8VAC20-800-780-B

“Repeat Violation: Annually, the provider shall review with the parent the emergency contact information required in each child’s record to ensure the information is correct and shall obtain the parents signed acknowledgment of the review. Records for children #2 and #4 did not have a parent’s signature for an annual review of the emergency contact information. Child #2 had been in care for over a year. Child #4 had been in care for almost two years without any annual review.”

8VAC20-800-780-B

“Based on child record review, no annual update was completed for children in care. Evidence: 1. Child #1 had an annual update dated 7/14/2023. 2. Child #4, with a start date of 9/6/2022, did not have a dated annual update. 3. Child #5, with a start date of 8/1/2023 did not have a dated annual update. 4. Child #6, with a start date of 8/1/2023 did not have a dated annual update. 5. Child #7, with a start date of 12/27/2022, did not have a dated annual update.”

8VAC20-800-100-A

“Based on child record review, the provider failed to obtain documentation of a physical examination for child in care. Evidence: 1. Child #3, start date 6/27/2024, did not have a copy of a physical in their file. 2. Provider stated they had asked parent for information but was only given immunization records.”

8VAC20-800-120-B

“Based on staff record review, the provider did not obtain documentation that two or more references as to character and reputation as well as competency were checked before employment. Evidence: Staff #2 with a hire date of 01/02/2023 did not have documentation of any reference checks.”

22.1-289.035-B-3

“Based on staff record review, staff did not have up to date Central Registry checks in employee files. Evidence: 1. Staff #1, with a hire date of 2002, did not have documentation of an updated Central Registry check. The last documented background check was dated in 2016. 2. Staff #3, with a hire date of 09/19/2016, did not have documentation of an updated Central Registry check. The last documented background check was dated in 2016. 3. Director acknowledged there were no updated checks.”

8VAC20-800-90-C

“Based on record review, the provider failed to obtain documentation of additional immunizations for children in care. Evidence: 1. Child #5 (age 13 months) did not have updated immunization records every six months. Immunization form was dated 10/05/2023. 2. Child #6 (age 13 months) did not have updated immunization records every six months. Immunization form was dated 10/05/2023.”

8VAC20-800-250-A

“Based on a home tour, the provider failed to ensure that areas of the home shall be maintained in a safe condition. Evidence: 1. Approximately 7 dangling charging cords were observed in the dining room area. 2. These cords were accessible to the children in care who were observed in the dining room area during the inspection.”

8VAC20-800-800-B

“Based on record review, an annual review of the emergency preparedness plan was not conducted. Evidence: The emergency preparedness plan that was posted was not updated annually. The last documented date of review was dated 2017.”

8VAC20-800-790

“Based on observation, the provider failed to ensure that the telephone number for the responsible person for emergency backup care shall be posted in a visible area close to the telephone. Evidence: 1. The telephone number for the provider's emergency backup caregiver was not posted. a. The provider confirmed that this information was not posted.”

8VAC20-800-830-B

“Based on record review and interview, the provider failed to ensure that shelter-in-place procedures shall be practiced a minimum of twice per year. Evidence: 1. The written emergency log for the FDH indicated that only one shelter-in-place practice drill had been conducted. 2. The provider confirmed that a second shelter drill had not been conducted.”

8VAC20-800-900-B

“Based on observation, the provider failed to ensure that children shall not be allowed to eat or drink while lying down. Evidence: 1. At approximately 12:20 pm child 1 and child 2 were put down for nap with a bottle of formula. Both children were observed drinking from their bottles while lying down. 2. Child 3 was placed in his crib with a sippy cup which he was drinking from while lying down in his crib.”

8VAC20-800-240-A

“Based on observation, the provider failed to ensure that areas of the home shall be maintained in a safe condition. Evidence: 1. Approximately 8 dangling cords were observed in the area beside the dining room table. a. These cords were accessible to the children in care who were observed in the dining room area during the inspection.”

8VAC20-800-100-A

“Based on record review and interview, the provider failed to obtain, for children in care, documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 4, enrollment date 01/03/2023, lacks documentation of a physical exam. 2. Child 7, enrollment date 01/03/2023, lacks documentation of a physical exam. 2. The provider verified that a physical exam was not on file for child 4 and child 7.”

8VAC20-800-780-B

“Based on record review, the provider failed to ensure that annually children's records will be reviewed with the parent to ensure that emergency contact information is correct and obtain the parent's signed acknowledgment of the review. Evidence: 1. The following children's records lacked documentation of annual review by the parent: a. The enrollment record for child 7 was last reviewed by the parent on 01/03/2023; b. The enrollment record for child 4 was last reviewed by the parent on 01/03/2023; c. The enrollment record for child 5 was last reviewed by the parent on 12/2019; d. The enrollment record for child 6 was last reviewed by the parent on 01/04/2021. 2. The provider confirmed that the above records had not been reviewed annually by each parent.”

8VAC20-800-70-A

“Based on record review, the provider failed to ensure that parents shall be provided with the written parent agreement. Evidence: 1. The enrollment record for child 1 and child 2 lacked a complete parent agreement. 2. The provider confirmed that a written parent agreement was not on file for child 1 and child 2.”

8VAC20-800-90-C

“Based on record review, the provider failed to obtain documentation of additional immunizations for children in care. Evidence: 1. Child 5, age 8 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday. a. The most recent immunizations on file were administered on 09/13/2016. 2. Child 6, age 5 years, lacked documentation of having received updated immunizations once between the child's fourth and sixth birthday. a. The most recent immunizations on file were administered on 10/12/2020. 3. Child 3, age 20 months, lacked documentation of having received updated immunizations once every six months for children under the age of two years. a. The most recent immunizations on file were administered on 01/23/2023. 4. The provider confirmed that updated immunization records had not been obtained for these children who were all in care during the inspection.”

8VAC20-800-240-A

“Based on observation, the provider failed to ensure that areas of the family day home, inside and outside, shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or could snag skin. Evidence: 1. The following safety hazards were observed during a review of the outdoor play area: a. The wood support and one wooden spindle were loose on the railing of the entrance/exit deck to the outdoor play area. This poses a potential fall/head entrapment hazard; b. An extension cord, electrical wire with attached socket, small metal chain, and a rusty metal tent pole were observed placed in a pile on a table located within the outdoor play area. These items are within easy reach of children. 2. Two metal coat hooks were attached to the wall outside of the preschool play room approximately 21 inches from the floor. These hooks are at face level of preschool children and could cause potential injury to the face/eye if a child were to fall or be pushed toward these protruding hooks.”

22.1-289.035-A

“Based on record review and interview, the provider failed to obtain for all applicants, caregivers and household members a fingerprint background check every five years. Evidence: 1. The most recent fingerprint background check for caregiver 2 was conducted on 04/27/2018; 2. The most recent fingerprint background check for caregiver 3 was conducted on 05/07/2018; 3. The most recent fingerprint background check for caregiver 4 was conducted on 05/04/2018; 4. The most recent fingerprint background check for household member 1 was conducted on 05/08/2018 5. The provider verified that these background checks had not been updated.”

8VAC20-800-540-A

“Based on observation, the provider failed to ensure that Infant carrier seats shall be used according to the manufacturer's instructions. Evidence: 1. When the inspector arrived at approximately 10:05 am child 1, age 5 months, was observed sitting in an infant carrier seat that had been hooked over a chair in the living room of the home. a. The plastic carrier handle had been placed over the back of a chair so that the chair was sitting on top of the couch cushion. 2. The manufacturer label, placed on this chair, states the product should never be used on any elevated or soft surface due to potential for fall or tipping over. The label additionally states, "Use only on floor."”

22.1-289.035-B-2

“Based on record review and interview, the provider failed to obtain a fingerprint background check for all caregivers prior to employment. Evidence: 1. Caregiver 1, hire date 01/02/2023, lacked the results of a fingerprint background check. 2. The provider confirmed that a fingerprint background check had not been obtained for caregiver 1.”

8VAC20-800-690-D

“Based on interview, the provider failed to ensure that the diapering surface shall be cleaned after each use. Evidence: 1. The provider stated that the diapering surface was sanitized after each diaper change however, the surface was not cleaned prior to sanitizing as required.”

8VAC20-790-250-B

“Based on record review and interview, the vendor failed to ensure that within the first 90 days of employment or service all caregivers shall complete Virginia Preservice Training for Child Care Staff sponsored by the Department of Education. Evidence: 1. Caregiver 1, hire date 01/02/2023 lacks documentation of completion of Virginia Preservice Training. a. The provider confirmed that caregiver 1 had not completed this training.”

8VAC20-800-240-A

“Based on observation, the provider failed to ensure that areas of the family day home, inside and outside, shall be maintained in a safe condition. Unsafe conditions shall include, but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or could snag skin. Evidence: 1. The following safety hazards were observed during a review of the outdoor play area: a. The wood support and one wooden spindle were loose on the railing of the entrance/exit deck to the outdoor play area. This poses a potential fall/head entrapment hazard; b. An extension cord, electrical wire with attached socket, small metal chain, and a rusty metal tent pole were observed placed in a pile on a table located within the outdoor play area. These items are within easy reach of children. 2. Two metal coat hooks were attached to the wall outside of the preschool play room approximately 21 inches from the floor. These hooks are at face level of preschool children and could cause potential injury to the face/eye if a child were to fall or be pushed toward these protruding hooks.”

22.1-289.035-A

“Based on record review and interview, the provider failed to obtain for all applicants, caregivers and household members a fingerprint background check every five years. Evidence: 1. The most recent fingerprint background check for caregiver 2 was conducted on 04/27/2018; 2. The most recent fingerprint background check for caregiver 3 was conducted on 05/07/2018; 3. The most recent fingerprint background check for caregiver 4 was conducted on 05/04/2018; 4. The most recent fingerprint background check for household member 1 was conducted on 05/08/2018 5. The provider verified that these background checks had not been updated.”

8VAC20-800-540-A

“Based on observation, the provider failed to ensure that Infant carrier seats shall be used according to the manufacturer's instructions. Evidence: 1. When the inspector arrived at approximately 10:05 am child 1, age 5 months, was observed sitting in an infant carrier seat that had been hooked over a chair in the living room of the home. a. The plastic carrier handle had been placed over the back of a chair so that the chair was sitting on top of the couch cushion. 2. The manufacturer label, placed on this chair, states the product should never be used on any elevated or soft surface due to potential for fall or tipping over. The label additionally states, "Use only on floor."”

22.1-289.035-B-2

“Based on record review and interview, the provider failed to obtain a fingerprint background check for all caregivers prior to employment. Evidence: 1. Caregiver 1, hire date 01/02/2023, lacked the results of a fingerprint background check. 2. The provider confirmed that a fingerprint background check had not been obtained for caregiver 1.”

8VAC20-800-690-D

“Based on interview, the provider failed to ensure that the diapering surface shall be cleaned after each use. Evidence: 1. The provider stated that the diapering surface was sanitized after each diaper change however, the surface was not cleaned prior to sanitizing as required.”

8VAC20-790-250-B

“Based on record review and interview, the vendor failed to ensure that within the first 90 days of employment or service all caregivers shall complete Virginia Preservice Training for Child Care Staff sponsored by the Department of Education. Evidence: 1. Caregiver 1, hire date 01/02/2023 lacks documentation of completion of Virginia Preservice Training. a. The provider confirmed that caregiver 1 had not completed this training.”

8VAC20-800-500-C

“Based on observation, the provider failed to ensure that stationary outdoor equipment be firmly anchored with ground supports. Evidence: The little tikes climber / play structure was not firmly anchored into the ground resulting in movement of the structure when pushed on.”

8VAC20-800-90-C

“Based on record review, the provider failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. Child 2, age 14 months, lacks documentation of current immunizations. a. The most recent immunizations on file were administered on 10/08/2021. 2. The provider confirmed that an updated immunization record had not been obtained for child 2.”

8VAC20-800-100-A

“Based on record review and interview, the provider failed to obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 1, enrollment date 09/06/2022, lacked documentation of a physical exam. 2. The provider confirmed that a physical exam was not on file for child 1 who was in care during the inspection.”