Niko's Playworld

8VAC20-770-60-C-2

“The center must obtain the results of a central registry search within 30th day of employment. Staff #1, Staff #2, and Staff #3 did not have the results of their central registry search and were present at the center working with children during the time of the inspection.”

8VAC20-780-270-A

“Areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. In the infant classroom, four of the cribs were observed to have very loose-fitting crib sheets which poses as a suffocation and injury hazard.”

8VAC20-780-570-A

“When a child is placed in a high chair, the protective belt shall be fastened securely. Two infant children were eating breakfast at the feeding table without protective belts fastened securely.”

8VAC20-770-60-C-2

“The center must obtain the results of a central registry search within 30th day of employment. Staff #1, Staff #2, and Staff #3 did not have the results of their central registry search and were present at the center working with children during the time of the inspection.”

8VAC20-780-270-A

“Areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. In the infant classroom, four of the cribs were observed to have very loose-fitting crib sheets which poses as a suffocation and injury hazard.”

8VAC20-780-570-A

“When a child is placed in a high chair, the protective belt shall be fastened securely. Two infant children were eating breakfast at the feeding table without protective belts fastened securely.”

8VAC20-780-160-C

“Based on record review and interview, it was determined that the center did not ensure that at least every two years from the date of the initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. Staff #2 has an expired tuberculosis test with the most recent testing date of October 21, 2021. 2. Staff #2 confirmed that their tuberculosis test was last conducted on October 21, 2021, and that their test was expired.”

8VAC20-780-350-B-3

“Based on observation and interview, it was determined that the center did not ensure that the staff-to-children ratios of 1:8 (staff: children) for 2 year old children are required whenever children are in care. Evidence: 1. Staff #2 confirmed that on the date of the incident, December 7, 2023, they were in the classroom alone with 10 children from ages 2 years old to 3 years old. 2. The teacher assistant assigned to the classroom was not physically in the classroom at the time of the incident but was throughout the entire building serving breakfast. 3. The Injury report written on December 7, 2023, and signed by the director and parent reported that there were 10 students from the ages of 2-3 years old in the classroom and Staff #2 was the only staff member present at the time of the injury.”

8VAC20-780-340-A

“Based on observation and interview, it was determined that the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1. Staff #2 confirmed sitting in the doorway of their classroom holding a hot glue gun that was turned on and hot, while trying to console a 3 year old child from crying. While sitting in the doorway, Child #1 walked towards Staff #2 in which Child #1 obtaining an injury from the hot glue gun to their eye. 2. Staff #2 was using a hot glue gun while supervising 10 children from the ages of 2 to 3 years old alone which resulted in Child #1 walking into the hot glue gun causing the serious injury to their eye. The child was taken to the Emergency room by the parent. 3. The staff member confirmed that there were 10 children from the ages of 2 to 3 years old that were in their classroom without an assistant. The staff member confirmed that they were out of ratio as the staff to child ratio is one staff member to eight children. 4. Staff #1, the new Director, confirmed that in reviewing the evidence from the day of the incident, the class was out of ratio with one staff member and ten children from the ages of 2 years old to 3 years old. Staff #1 confirmed that this incident could have been prevented with the correct number of staff members.”

22.1-289.035-B-4

“Based on record review and interview, it was determined that the center did not ensure that they obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff #3 (date of hire 08/28/2023) reported that they lived in another state outside of Virginia in the past five years. In addition, their resume states they worked in another state outside of Virginia. Staff #3 has a copy of an identification card that was issued by another state in the past five year. No out of state background check results were completed for Staff #3. 2. Staff #4 (date of hire 08/30/2023) confirmed to the center that they lived in another state outside of Virginia in the past five years and no out of state background check results were completed for Staff #4. 3. Staff #5 (date of hire 9/11/2023) confirmed on their sworn statement disclosure that they lived outside the state of Virginia in the past five years and did not have an out of state background check result in their record. Staff #5 just recently moved from out of state to Virginia. 4. Staff #6 (date of hire 08/01/2023) has a copy of their identification card that was issued to them in the past five years from another state outside of Virginia. Staff #6 confirmed to the center that they lived outside of Virginia in the past five years and did not complete an out of state background check. 5. Staff #1 confirmed that out of state background checks were not completed for Staff #3 Staff #4, Staff #5 and Staff #6. The center responded with the following: The out of state background checks for Staff #3 Staff #4, Staff #5 and Staff #6 will be completed and sent to the licensing office within 10 business days.”

8VAC20-780-570-A

“Based on observation and interview, it was determined that the center did not ensure that when children are in the feeding tables the protective belt shall be fastened securely. Evidence: 1. In the infant room, with children under the age of 13 months, the feeding tables did not have protective belt straps where children eat and sit together. 2. Infant staff confirmed that the infants do sit in the feeding tables without protective belt straps fastened securely. 3. Staff #1, owner, confirmed there are no protective straps to the children’s chairs at the feeding tables.”

8VAC20-780-270-A

“Based on observation and interview, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. In the playground, there is a large storage bin that is unlocked and the lid is broken. This poses as an entrapment and injury hazard to the children in care. 2. Staff #1 confirmed that the large storage bin was broken and unlocked.”

22.1-289.035-B-4

“Based on record review and interview, it was determined that the center did not ensure that they obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff #3 (date of hire 08/28/2023) reported that they lived in another state outside of Virginia in the past five years. In addition, their resume states they worked in another state outside of Virginia. Staff #3 has a copy of an identification card that was issued by another state in the past five year. No out of state background check results were completed for Staff #3. 2. Staff #4 (date of hire 08/30/2023) confirmed to the center that they lived in another state outside of Virginia in the past five years and no out of state background check results were completed for Staff #4. 3. Staff #5 (date of hire 9/11/2023) confirmed on their sworn statement disclosure that they lived outside the state of Virginia in the past five years and did not have an out of state background check result in their record. Staff #5 just recently moved from out of state to Virginia. 4. Staff #6 (date of hire 08/01/2023) has a copy of their identification card that was issued to them in the past five years from another state outside of Virginia. Staff #6 confirmed to the center that they lived outside of Virginia in the past five years and did not complete an out of state background check. 5. Staff #1 confirmed that out of state background checks were not completed for Staff #3 Staff #4, Staff #5 and Staff #6. The center responded with the following: The out of state background checks for Staff #3 Staff #4, Staff #5 and Staff #6 will be completed and sent to the licensing office within 10 business days.”

8VAC20-780-570-A

“Based on observation and interview, it was determined that the center did not ensure that when children are in the feeding tables the protective belt shall be fastened securely. Evidence: 1. In the infant room, with children under the age of 13 months, the feeding tables did not have protective belt straps where children eat and sit together. 2. Infant staff confirmed that the infants do sit in the feeding tables without protective belt straps fastened securely. 3. Staff #1, owner, confirmed there are no protective straps to the children’s chairs at the feeding tables.”

8VAC20-780-270-A

“Based on observation and interview, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. In the playground, there is a large storage bin that is unlocked and the lid is broken. This poses as an entrapment and injury hazard to the children in care. 2. Staff #1 confirmed that the large storage bin was broken and unlocked.”

8VAC20-780-410-1

“Based on record review and interviews, it was determined that the center did not ensure that following actions of roughly handling a child are forbidden action. Evidence: 1. Staff #1 was observed at the center to roughly handle Child #1 while in the classroom on July 24, 2023. 2. Video footage of the classroom was observed during the time of the incident on July 24, 2023, that Staff #1 grabbed Child #1 by the right arm and roughly place them down on the floor. 3. Staff director at the time of the incident, Staff #2, confirmed that the video was Staff #1 picking up Child #1 by the right arm and roughly handling the child. Staff #2 confirmed by other staff members during the interview investigation at the center that roughly handling a child was observed in the classroom.”

8VAC20-780-140-A Complaint related: No

“Based on record review and interview, it was determined that the center did not ensure that each child shall have a physical examination by or under the direction of a physician: 1. Before the child's attendance; or 2. Within 30 days after the first day of attendance. Evidence: 1. Child #1 (date of enrollment 8/23/22) did not have a physical examination by or under the direction of a physician in their record. 2. Staff #1 confirmed that Child #1 did not have a physical examination in their record.”

22.1-289.035-B-4 Complaint related: No

“Based on record review and interview, it was determined that the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years are in their record. Evidence: 1. Staff #2 (date of hire 08/02/2022) has a copy of their driver’s license, from a state outside of Virginia, which was issued to Staff #2 in the past 5 years. 2. Staff #2 confirmed they lived outside of the state of Virginia in the past 5 years. 3. Staff #2 documented to their resume and job application that their place of employment was outside of the state of Virginia from 2018-2021. 4. Staff #1 confirmed that out of state background checks were not completed for Staff #2 and has been working with children since August 2, 2022.”

8VAC20-780-440-G

“Based on observation and interview, it was determined that cribs shall be used for children under 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot or mat. Evidence: 1. In the older infant room, there were two children over the age of 12 months that were sleeping an a crib. The children were 14 and 15 months of age sleeping in a crib. 2. Infant staff confirmed that both children were older than 12 months of age and are sleeping in cribs.”

8VAC20-780-140-A

“Based on record review and interview, it was determined that the center did not ensure that each child have a physical examination by or under the direction of a physician: 1. Before the child's attendance; or 2. Within 30 days after the first day of attendance. Evidence: 1. Child #1 (date of enrollment 10/13/2022) did not have documentation of a physical examination in their record. 2. Child #2 (date of enrollment 1/10/2023) did not have documentation of a physical examination in their record. 3. Staff #1, Director, confirmed that both Child #1 and Child #2 did not have documentation of physical examinations in their record.”

8VAC20-780-440-L

“Based on observation and interview, it was determined that the center did not ensure that filled comforters not be used by children under two years of age. Evidence: 1. In the younger infant room, there were two children observed to have filled comforter blankets used and both children are under the age of two years old. 2. In the older infant room, there were two children observed to have filled comforter blankets used in their cribs and both children are under the age of two years old. 3. The infant teachers in both rooms confirmed that filled comforter blankets were being used in their classrooms with children in care.”

8VAC20-780-440-N

“Based on observation and interview, it was determined that the center did not ensure that toys or objects hung over an infant in a crib and crib gyms that are strung across the crib may not be used for infants over five months of age. Evidence: 1. In the younger infant room, there was a toy that hung over an infant in a crib that was sleeping. The infant, Child #1, is seven month old. 2. The infant teacher confirmed that the child was 7 months old and that the toy was being used for that specific child’s crib.”

8VAC20-780-440-G

“Based on observation and interview, it was determined that cribs shall be used for children under 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot or mat. Evidence: 1. In the older infant room, there were two children over the age of 12 months that were sleeping an a crib. The children were 14 and 15 months of age sleeping in a crib. 2. Infant staff confirmed that both children were older than 12 months of age and are sleeping in cribs.”

8VAC20-780-140-A

“Based on record review and interview, it was determined that the center did not ensure that each child have a physical examination by or under the direction of a physician: 1. Before the child's attendance; or 2. Within 30 days after the first day of attendance. Evidence: 1. Child #1 (date of enrollment 10/13/2022) did not have documentation of a physical examination in their record. 2. Child #2 (date of enrollment 1/10/2023) did not have documentation of a physical examination in their record. 3. Staff #1, Director, confirmed that both Child #1 and Child #2 did not have documentation of physical examinations in their record.”

8VAC20-780-440-L

“Based on observation and interview, it was determined that the center did not ensure that filled comforters not be used by children under two years of age. Evidence: 1. In the younger infant room, there were two children observed to have filled comforter blankets used and both children are under the age of two years old. 2. In the older infant room, there were two children observed to have filled comforter blankets used in their cribs and both children are under the age of two years old. 3. The infant teachers in both rooms confirmed that filled comforter blankets were being used in their classrooms with children in care.”

8VAC20-780-440-N

“Based on observation and interview, it was determined that the center did not ensure that toys or objects hung over an infant in a crib and crib gyms that are strung across the crib may not be used for infants over five months of age. Evidence: 1. In the younger infant room, there was a toy that hung over an infant in a crib that was sleeping. The infant, Child #1, is seven month old. 2. The infant teacher confirmed that the child was 7 months old and that the toy was being used for that specific child’s crib.”

8VAC20-780-440-G

“Based on observation and interview, it was determined that cribs shall be used for children under 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot or mat. Evidence: 1. In the older infant room, there were two children over the age of 12 months that were sleeping an a crib. The children were 14 and 15 months of age sleeping in a crib. 2. Infant staff confirmed that both children were older than 12 months of age and are sleeping in cribs.”

8VAC20-780-140-A

“Based on record review and interview, it was determined that the center did not ensure that each child have a physical examination by or under the direction of a physician: 1. Before the child's attendance; or 2. Within 30 days after the first day of attendance. Evidence: 1. Child #1 (date of enrollment 10/13/2022) did not have documentation of a physical examination in their record. 2. Child #2 (date of enrollment 1/10/2023) did not have documentation of a physical examination in their record. 3. Staff #1, Director, confirmed that both Child #1 and Child #2 did not have documentation of physical examinations in their record.”

8VAC20-780-440-L

“Based on observation and interview, it was determined that the center did not ensure that filled comforters not be used by children under two years of age. Evidence: 1. In the younger infant room, there were two children observed to have filled comforter blankets used and both children are under the age of two years old. 2. In the older infant room, there were two children observed to have filled comforter blankets used in their cribs and both children are under the age of two years old. 3. The infant teachers in both rooms confirmed that filled comforter blankets were being used in their classrooms with children in care.”

8VAC20-780-440-N

“Based on observation and interview, it was determined that the center did not ensure that toys or objects hung over an infant in a crib and crib gyms that are strung across the crib may not be used for infants over five months of age. Evidence: 1. In the younger infant room, there was a toy that hung over an infant in a crib that was sleeping. The infant, Child #1, is seven month old. 2. The infant teacher confirmed that the child was 7 months old and that the toy was being used for that specific child’s crib.”

8VAC20-780-440-G

“Based on observation and interview, it was determined that cribs shall be used for children under 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot or mat. Evidence: 1. In the older infant room, there were two children over the age of 12 months that were sleeping an a crib. The children were 14 and 15 months of age sleeping in a crib. 2. Infant staff confirmed that both children were older than 12 months of age and are sleeping in cribs.”

8VAC20-780-140-A

“Based on record review and interview, it was determined that the center did not ensure that each child have a physical examination by or under the direction of a physician: 1. Before the child's attendance; or 2. Within 30 days after the first day of attendance. Evidence: 1. Child #1 (date of enrollment 10/13/2022) did not have documentation of a physical examination in their record. 2. Child #2 (date of enrollment 1/10/2023) did not have documentation of a physical examination in their record. 3. Staff #1, Director, confirmed that both Child #1 and Child #2 did not have documentation of physical examinations in their record.”

8VAC20-780-440-L

“Based on observation and interview, it was determined that the center did not ensure that filled comforters not be used by children under two years of age. Evidence: 1. In the younger infant room, there were two children observed to have filled comforter blankets used and both children are under the age of two years old. 2. In the older infant room, there were two children observed to have filled comforter blankets used in their cribs and both children are under the age of two years old. 3. The infant teachers in both rooms confirmed that filled comforter blankets were being used in their classrooms with children in care.”

8VAC20-780-440-N

“Based on observation and interview, it was determined that the center did not ensure that toys or objects hung over an infant in a crib and crib gyms that are strung across the crib may not be used for infants over five months of age. Evidence: 1. In the younger infant room, there was a toy that hung over an infant in a crib that was sleeping. The infant, Child #1, is seven month old. 2. The infant teacher confirmed that the child was 7 months old and that the toy was being used for that specific child’s crib.”

8VAC20-780-350-B-1 Complaint related: No

“Based on staff interviews, it was determined that the center did not ensure that the staff-to-children ratio in the birth up to 16 months infant room is one staff member to four children. Evidence: 1. Staff #3 reported that there is a ratio of one staff member to five children in the morning for about 15-20 minutes when staff members are running late. 2. Staff #4 confirmed that there are times during the day where there are more that four children to one staff ratio for about 10 minutes at a time when other staff have to get bottles, get laundry, and when parents step in to get their children. When out of ratio, the children are awake usually on tummy time, in the play saucers, or being fed.”

8VAC20-790-600-D-1

“Based on record review and interview, it was determined that the vendor did not ensure that staff have a current certification of CPR and First Aid. Evidence: 1. Staff #2 (hire date of 06/30/2022) does not have a certification of first aid and CPR completed. 2. Staff #3 (date of hire 06/23/2022) does not have a certification of first aid and CPR completed. 3. Staff #1, the Director, confirmed that Staff #2 and Staff #3 have not completed first aid and CPR class.”

8VAC20-780-60-A

“Based on observation and interview, it was determined that the center did not ensure that each center shall maintain and keep a separate record for each child enrolled which shall contain the work phone number of each parent who has custody. Evidence: 1. Child #1 (date of enrollment 6/14/22) does not have their father’s work number in the record. 2. Child #2 (date of enrollment 8/29/22) does not have their father’s work number in the record. 3. Child #3 (date of enrollment 6/06/22) does not have both parents? work number in their record. 4. Staff #1 confirmed that Child #1, Child #2, and Child #3 do not have work phone numbers of their custodial parents in their record.”

8VAC20-780-520-C

“Based on observation and interview, it was determined that the center did not ensure that if diaper ointment or cream is used, the following requirements shall be met: these products shall be in the original container and labeled with the child's name. Evidence: 1. In the 16 month to 24 month classroom, there was an unlabeled tube of diaper cream on the diaper changing table. 2. The classroom teacher confirmed that the diaper cream tube was unlabeled.”

8VAC20-780-270-A

“Based on observation and interview, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. In the playground, there was an empty storage shed that had sharp plastic pieces coming off the handle.This is in reach of children. This poses a pinching and injury hazard. 2. The storage shed in the playground is approximately 2 to 3 feet high in which children can open the shed and fall inside the shed or harm themselves. The lid of the storage shed automatically closes when the top of the shed is lifted. This storage shed is an injury and trapping hazard for children. 3. In the young infant classroom, the crib sheet for Child #4 was loose and not fitted to the mattress. This is a suffocation hazard. 4. Staff #1 confirmed that the empty storage was a trapping and injury hazard and will move it immediately so that it is not accessible to children. 5. Staff #1 and Staff #2 confirmed that the crib sheet for Child #4 is loose and poses as a suffocation hazard.”

8VAC20-780-280-B

“Based on observation, it was determined that the center did not ensure that hazardous substances such as cleaning materials be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In the 3 year old classroom with 7 children present, the cabinet above the sink contains bottles of disinfectant cleaners that are unlocked and accessible to children. 2. In the 16 month to 24 month classroom with 5 children present, there is a bottle of yellow disinfectant on a shelf that was unlocked.”

8VAC20-790-600-D-1

“Based on record review and interview, it was determined that the vendor did not ensure that staff have a current certification of CPR and First Aid. Evidence: 1. Staff #2 (hire date of 06/30/2022) does not have a certification of first aid and CPR completed. 2. Staff #3 (date of hire 06/23/2022) does not have a certification of first aid and CPR completed. 3. Staff #1, the Director, confirmed that Staff #2 and Staff #3 have not completed first aid and CPR class.”

8VAC20-780-60-A

“Based on observation and interview, it was determined that the center did not ensure that each center shall maintain and keep a separate record for each child enrolled which shall contain the work phone number of each parent who has custody. Evidence: 1. Child #1 (date of enrollment 6/14/22) does not have their father’s work number in the record. 2. Child #2 (date of enrollment 8/29/22) does not have their father’s work number in the record. 3. Child #3 (date of enrollment 6/06/22) does not have both parents? work number in their record. 4. Staff #1 confirmed that Child #1, Child #2, and Child #3 do not have work phone numbers of their custodial parents in their record.”

8VAC20-780-520-C

“Based on observation and interview, it was determined that the center did not ensure that if diaper ointment or cream is used, the following requirements shall be met: these products shall be in the original container and labeled with the child's name. Evidence: 1. In the 16 month to 24 month classroom, there was an unlabeled tube of diaper cream on the diaper changing table. 2. The classroom teacher confirmed that the diaper cream tube was unlabeled.”

8VAC20-780-270-A

“Based on observation and interview, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. In the playground, there was an empty storage shed that had sharp plastic pieces coming off the handle.This is in reach of children. This poses a pinching and injury hazard. 2. The storage shed in the playground is approximately 2 to 3 feet high in which children can open the shed and fall inside the shed or harm themselves. The lid of the storage shed automatically closes when the top of the shed is lifted. This storage shed is an injury and trapping hazard for children. 3. In the young infant classroom, the crib sheet for Child #4 was loose and not fitted to the mattress. This is a suffocation hazard. 4. Staff #1 confirmed that the empty storage was a trapping and injury hazard and will move it immediately so that it is not accessible to children. 5. Staff #1 and Staff #2 confirmed that the crib sheet for Child #4 is loose and poses as a suffocation hazard.”

8VAC20-780-280-B

“Based on observation, it was determined that the center did not ensure that hazardous substances such as cleaning materials be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In the 3 year old classroom with 7 children present, the cabinet above the sink contains bottles of disinfectant cleaners that are unlocked and accessible to children. 2. In the 16 month to 24 month classroom with 5 children present, there is a bottle of yellow disinfectant on a shelf that was unlocked.”

8VAC20-780-440-J

“Based on observation and interview, it was determined that the center did not ensure that there is at least thirty inches of space between the service sides of occupied cribs and other furniture where the space is the walkway for staff to gain access to any occupied crib. Evidence. 1. In the infant room there were three occupied cribs with children under the age of 12 months that did not have at least thirty inches of space between the service sides of their crib. 2. Staff #3 confirmed that there was not thirty inches of space between the service sides of the cribs for the three children.”

8VAC20-780-500-A

“8VAC20-780-500.A.3.d Based on observation and interview, it was determined that the center did not ensure that staff wash their hands with soap and running water after any contact with body fluids. Evidence: 1. In the 3 year old classroom, a staff member wiped the mucus off a child’s nose and did not wash their hands. 2. Staff in the 3 year old classroom confirmed they did not wash their hands after contact with body fluids.”

8VAC20-780-500-A

“Based on observation and interview, it was determined that the center did not ensure that children’s hands are washed with soap and running water after toileting. Evidence: 1. Staff #4 did not wash the hands of Child #1 after diapering. 2. Staff #4 confirmed they did not wash the hands of Child #1 after diapering.”

22VAC40-185-350-A

“Based on observation and interview, it was determined that the center did not ensure that the staff-to-children ratio be followed when children are in care. Evidence: 1. The infant classroom had a ratio of nine infant children to two staff members when the staff-to-ration is four children to one staff. 2. Staff # 1, Staff #2, and Staff #3 confirmed the infant room was out of ratio.”

8VAC20-780-570-A

“8VAC20-780-570.A.2 Based on observation and interview, it was determined that when a child is placed in a high chair or feeding chair, the protective belt be fastened securely. Evidence: 1. In the infant room, there were three children, age 12 months and younger, that were in a feeding chair without a protective belt securely fastened. 2. Staff #5 confirmed that the three infant children were not strapped in their feeding chair.”

8VAC20-780-570-B

“Based on observation and interview, it was determined that the center did not ensure that bottle fed infants not use their bottles while in their designate sleeping location. Evidence: 1. Child #1 was observed in their crib with a bottle of milk. 2. Staff #3 confirmed there was a bottle in Child #1?s crib.”

8VAC20-780-570-E

“Based on observation and interview, it was determined that the center did not ensure that prepared infant formula be dated and labeled with the child’s name. Evidence: 1. In the infant room with nine children present, all bottles did not have a date. Five of the eight bottles did not have a name. 2. Staff #3, Staff #4, and Staff #5 confirmed there were no dates and names to the children’s bottles. 3. In the refrigerator, there were two bags of breastmilk that had no date and label of the child’s name. 4. Staff #3 and Staff #5 confirmed there was no name to the two bags of breastmilk.”

8VAC20-780-270-A

“Based on observation, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, be maintained in a safe condition. Evidence: 1. In the infant room, there are two cribs with oversized and loose fitting crib sheets on the crib sized mattress. The cribs are assigned to children in care. The loose fitting sheet poses as a suffocation hazard.”

8VAC20-780-440-J

“Based on observation and interview, it was determined that the center did not ensure that there is at least thirty inches of space between the service sides of occupied cribs and other furniture where the space is the walkway for staff to gain access to any occupied crib. Evidence. 1. In the infant room there were three occupied cribs with children under the age of 12 months that did not have at least thirty inches of space between the service sides of their crib. 2. Staff #3 confirmed that there was not thirty inches of space between the service sides of the cribs for the three children.”

8VAC20-780-500-A

“8VAC20-780-500.A.3.d Based on observation and interview, it was determined that the center did not ensure that staff wash their hands with soap and running water after any contact with body fluids. Evidence: 1. In the 3 year old classroom, a staff member wiped the mucus off a child’s nose and did not wash their hands. 2. Staff in the 3 year old classroom confirmed they did not wash their hands after contact with body fluids.”

8VAC20-780-500-A

“Based on observation and interview, it was determined that the center did not ensure that children’s hands are washed with soap and running water after toileting. Evidence: 1. Staff #4 did not wash the hands of Child #1 after diapering. 2. Staff #4 confirmed they did not wash the hands of Child #1 after diapering.”

22VAC40-185-350-A

“Based on observation and interview, it was determined that the center did not ensure that the staff-to-children ratio be followed when children are in care. Evidence: 1. The infant classroom had a ratio of nine infant children to two staff members when the staff-to-ration is four children to one staff. 2. Staff # 1, Staff #2, and Staff #3 confirmed the infant room was out of ratio.”

8VAC20-780-570-A

“8VAC20-780-570.A.2 Based on observation and interview, it was determined that when a child is placed in a high chair or feeding chair, the protective belt be fastened securely. Evidence: 1. In the infant room, there were three children, age 12 months and younger, that were in a feeding chair without a protective belt securely fastened. 2. Staff #5 confirmed that the three infant children were not strapped in their feeding chair.”

8VAC20-780-570-B

“Based on observation and interview, it was determined that the center did not ensure that bottle fed infants not use their bottles while in their designate sleeping location. Evidence: 1. Child #1 was observed in their crib with a bottle of milk. 2. Staff #3 confirmed there was a bottle in Child #1?s crib.”

8VAC20-780-570-E

“Based on observation and interview, it was determined that the center did not ensure that prepared infant formula be dated and labeled with the child’s name. Evidence: 1. In the infant room with nine children present, all bottles did not have a date. Five of the eight bottles did not have a name. 2. Staff #3, Staff #4, and Staff #5 confirmed there were no dates and names to the children’s bottles. 3. In the refrigerator, there were two bags of breastmilk that had no date and label of the child’s name. 4. Staff #3 and Staff #5 confirmed there was no name to the two bags of breastmilk.”

8VAC20-780-270-A

“Based on observation, it was determined that the center did not ensure that areas and equipment of the center, inside and outside, be maintained in a safe condition. Evidence: 1. In the infant room, there are two cribs with oversized and loose fitting crib sheets on the crib sized mattress. The cribs are assigned to children in care. The loose fitting sheet poses as a suffocation hazard.”