Ms. Sarah Cox

8VAC20-800-510-A

“Rest mats were not individually assigned to children in care.”

22.1-289.011-F

“REPEAT VIOLATION The findings from the most recent inspection, dated 9/3/2025, were not posted in a conspicuous place on the premises.”

8VAC20-800-170-A

“Providers must obtain a current tuberculosis screening from a caregiver at the time of hire and prior to coming into contact with children. There was no tuberculosis screening for Assistant #2, who has been caring for children for over two months.”

22.1-289.035-B-1

“The provider is required to obtain a completed sworn statement prior to the employee's first day of employment. There was not a sworn statement in Assistant #2's record.”

8VAC20-800-60-B

“Children's record are required to contain proof of the child's age and identity. Child #2's record did not contain proof of the child's age and identity.”

22.1-289.035-B-2

“Providers must obtain a completed national criminal background check prior to the employee's first day of employment. There was not a completed national criminal background check in Assistant #2's record.”

8VAC20-800-520-B

“Cribs shall not be used as a play space for infants. Upon arrival to the provider's home an infant was observed in a crib playing with various toys.”

22.1-289.011-F

“The license and any other documents required shall be posted in a conspicuous place on the licensed premises. The findings from the most recent inspection, dated 3/11/2025, were not posted in a conspicuous place on the premises.”

22.1-289.035-A

“Based on record review and interview, the family day home failed to ensure that all applicants for employment, employees, applicants to serve as volunteers, and volunteers shall undergo a background check in accordance with subsection B prior to employment or beginning to serve as a volunteer and every five years thereafter. Evidence: Staff #1 has a central registry background check that expired 3/19/2020. Staff #2 has a central registry background check that expired 3/23/2020 and Staff #3 has a central registry background check that expired 8/15/2020.”

8VAC20-800-280

“Based on observation, the provider failed to ensure that poisonous materials be inaccessible to children. Evidence: A bottle of pesticide, Ex-Lax and Bleach were found in unlocked cabinets in the kitchen which is adjacent to the room where children eat.”

22.1-289.058

“Based on observation, the provider did not ensure that a carbon monoxide detector was equipped in at least one room. Evidence: There was no carbon monoxide detector found in the home and the provider was unable to locate one.”

8VAC20-800-350-E

“(REPEAT VIOLATION) Based on observation, the provider failed to ensure that the hot water at taps available to children shall be maintained within a range of 105 degrees Fahrenheit to 120 degrees Fahrenheit. Evidence: The hot water measured 124.2 degrees Fahrenheit.”

8VAC20-800-530-I

“Based on observation, the provider failed to use a mattress covered in a waterproof material that can be cleaned or sanitized. Evidence: A mattress was found in a crib used for infant nap time had two cracks in it revealing a non-absorbent material.”

8VAC20-800-900-A

“Based on observation, the provider failed to serve grapes cut in small pieces to prevent choking. Evidence: The provider served whole grapes to children under four years of age.”

8VAC20-800-570-A

“Based on observation the provider failed to ensure that a caregiver does not exceed 16 points by using the point system to determine if an additional caregiver is needed. Evidence: Upon arrival to the family day home staff #1 was alone with nine children totaling 18 points. Staff #1 stated that staff #2 had gone out and she had texted staff #2 to come back. Staff #2 returned to the family day home in approximately 10 minutes.”

8VAC20-800-500-F

“Based on observation and interviews the provider failed to ensure that trampolines shall not be used during the hours children are in care. Evidence: Located outside next to the house was a small trampoline that is used by the children in care.”

8VAC20-800-500-D

“Based on observation the provider failed to ensure that outdoor play equipment shall meet the following requirements: ropes, loops, or any hanging apparatus that might entrap, close, or tighten upon a child shall not be used. The newer wooden climber has a climbing wall that has a rope attached that the children use to climb the wall.”

8VAC20-800-460-C

“(REPEAT VIOLATION)Based on record reviews the provider failed to ensure that dogs or cats, where allowed, shall be vaccinated for rabies and shall be treated for fleas, ticks, or worms as needed. Evidence: the rabies vaccination for pet 31 expired 7/2022.”

8VAC20-800-350-E

“Based on observation the provider failed to ensure that the Hot water at taps available to children shall be maintained within a range of 105?F to 120?F. Evidence: The hot water measured 136 degrees F, exceeding 120 F.”

8VAC20-800-90-A

“Based on record review the provider failed to ensure that before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations. Evidence: Child #5 does not have an immunization record on file. Child began care 10/22.”

8VAC20-800-100-A

“(REPEAT VIOLATION) Based on record reviews 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: Child #5 does not have a physical examination on file. Began care 10/22.”

8VAC20-800-780-B

“Based on record reviews the provider failed to ensure that annually a review with the parent the emergency contact information to ensure the information is correct, and obtain the parent's signed acknowledgment of the review. Evidence: Child records 1-5 have been in care more than a year and there is no documentation that an annually review has been conducted with the parents.”

8VAC20-800-730-D

“Based on observation the provider did not ensure that medication, except for those prescriptions designated otherwise by a written physician's order, including refrigerated medication and medications for caregivers and household members, shall be kept in a locked place using a safe locking method that prevents access by children. Located on the wooden rail as you enter the child care room was a bottle of soothing tablets, not locked.”

8VAC20-800-140-B-3

“Based on record review the provider failed to ensure that a caregiver was present with current cardiopulmonary resuscitation (CPR). Evidence: Staff #1 & 2 have CPR and first aid certification that expired 9/2022.”

8VAC20-800-140-B-4

“Based on record review the provider failed to ensure that a caregiver was present with current certification in first aid Evidence: Staff #1 & 2 have CPR and first aid certification that expired 9/2022.”

8VAC20-820-120-E-2

“Based on observation and interviews the provider failed to ensure that certain documents related to the terms of the license are required to be posted on the premises of each facility. These are: the finding of the most recent inspection of the facility. Evidence: The findings from the most recent inspection dated 8/23/22 were not posted at the family day home.”

8VAC20-800-100-A

“Based on record reviews 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. Child #1 began care 8/24/22. There is no documentation of a physical on file.”

8VAC20-800-460-C

“Based on record reviews the provider failed to ensure that Dogs or cats, where allowed, shall be vaccinated for rabies and shall be treated for fleas, ticks, or worms as needed. Evidence: The rabies vaccination for pet #2 expired 7/22.”

8VAC20-800-210-A

“Based on record reviews the provider failed to ensure that all staff obtain a minimum of 16 clock hours of annual training in areas relevant to their job responsibilities. Evidence: 1. Staff # 1-3 records did not contain annual training hours.”

22.1-289.035-B-2

“Based on record reviews, the provider failed to have a staff obtain a fingerprint based criminal history check prior to employment. Evidence: Staff #4 (hire date 6/27/2022) does not have a fingerprint base criminal history check.”

8VAC20-770-60-B

“Based on record reviews, the provider failed to obtain a completed sworn statement or affirmation from the assistant before beginning work. Staff #4 (hire date ) does not have a sworn statement on file.”

8VAC20-770-60-C-2

“Based on record review, the provider failed to obtain a search of the central registry for a staff member within 30 days of employment. Evidence: Staff record #4 (hire date 6/27/2022) did not have a central registry check within 30 days of employment.”

8VAC20-800-120-B

“Based on record reviews the provider failed to ensure that the assistants record contained all the required information. Evidence: 1. Staff #4 did not have an emergency contact listed. 2. Staff #4 did not have two references on file.”

8VAC20-800-200-A

“Based on record review the provider failed to provide orientation to the assistant by the end of their first week of assuming job responsibilities. Evidence: Staff #4 (hire date ) was not provided orientation by the end of their first week.”