Precious Time

8VAC20-780-190-A-4 Complaint related: Yes

“Program directors shall be at least 21 years of age and shall have at least a one-year early childhood certificate from a college or university that consists of at least 30 semester hours or a child development credential. The record for Staff #1, who has been employed for three weeks, did not contain documentation of qualifications to operate as a center director. Staff #1 stated they did not have the required education qualifications.”

8VAC20-780-270-C Complaint related: No

“In inside areas occupied by children, the temperature shall be maintained no lower than 68?F. During the inspection, the temperature was 66.6 degrees in Classroom #1 and 65.4 degrees in Classroom #2. Children were observed in each classroom.”

8VAC20-780-245-A

“Staff shall complete a minimum of 16 hours of training annually, appropriate to the age of children in care. Staff #4 did not obtain 16 required hours in 2023-2024 year. Staff #4 has worked at the center for over four years.”

8VAC20-780-160-C

“A tuberculosis (TB) screening is required every two years from the last screening. Staff #6 updated screening was due over seven months ago. The updated screening has not been completed.”

8VAC20-790-600-F

“The vendor did not ensure two staff annually completed the required department sponsored health and safety update training. The record for Staff #4 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed seven months ago. The record for Staff #5 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed one month ago.”

8VAC20-780-245-A

“Staff shall complete a minimum of 16 hours of training annually, appropriate to the age of children in care. Staff #4 did not obtain 16 required hours in 2023-2024 year. Staff #4 has worked at the center for over four years.”

8VAC20-780-160-C

“A tuberculosis (TB) screening is required every two years from the last screening. Staff #6 updated screening was due over seven months ago. The updated screening has not been completed.”

8VAC20-790-600-F

“The vendor did not ensure two staff annually completed the required department sponsored health and safety update training. The record for Staff #4 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed seven months ago. The record for Staff #5 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed one month ago.”

8VAC20-780-245-A

“Staff shall complete a minimum of 16 hours of training annually, appropriate to the age of children in care. Staff #4 did not obtain 16 required hours in 2023-2024 year. Staff #4 has worked at the center for over four years.”

8VAC20-780-160-C

“A tuberculosis (TB) screening is required every two years from the last screening. Staff #6 updated screening was due over seven months ago. The updated screening has not been completed.”

8VAC20-790-600-F

“The vendor did not ensure two staff annually completed the required department sponsored health and safety update training. The record for Staff #4 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed seven months ago. The record for Staff #5 contained an annual health and safety update certificate from 2023. The updated annual health and safety training was required to be completed one month ago.”

8VAC20-790-600-D-1

“Based on a review of five staff records and interviews, the vendor did not ensure one staff had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care, in which the training included an in-person competency demonstration, within 90 days of the date of employment. Evidence: The CPR certification in the record of Staff #2, employed on 04/03/23, was completed on 05/31/23, but the training did not include an in-person competency demonstration. During interview, a member of management confirmed the CPR certification on file for Staff #2 did not meet the requirements.”

8VAC20-780-510-F

“Based on a review of three medications and interviews on 05/13/24, the center did not ensure that one medication authorization was available to staff during the entire time it was effective. Evidence: A long-term prescription medication was observed for Child #1, but no written parental authorization was present at the center for this medication. During interview, a member of management acknowledged the form on file did not include parental authorization for the medication the center had on site for Child #1.”

8VAC20-780-160-B

“Based on a review of five staff records and interviews, the center did not ensure an acceptable form of documentation of tuberculosis (TB) screening was on file for one staff member. Evidence: The most recent TB screening in the record of Staff #3 (DOE: 06/01/2020) was not signed by a physician, the physician's designee or an official of the local health department. During interview, a member of management confirmed the TB screening did not contain the required information.”

8VAC20-780-160-A

“Based on a review of five staff records and interviews, the center did not ensure one staff member submitted documentation of a negative tuberculosis (TB) screening within the required timeframe. Evidence: The TB screening in the record of Staff #2 (DOE: 04/03/2023) was dated 04/05/2023. During interview, a member of management confirmed the TB screening was completed on 04/05/2023. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children.”

8VAC20-790-600-D-1

“Based on a review of five staff records and interviews, the vendor did not ensure one staff had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care, in which the training included an in-person competency demonstration, within 90 days of the date of employment. Evidence: The CPR certification in the record of Staff #2, employed on 04/03/23, was completed on 05/31/23, but the training did not include an in-person competency demonstration. During interview, a member of management confirmed the CPR certification on file for Staff #2 did not meet the requirements.”

8VAC20-780-510-F

“Based on a review of three medications and interviews on 05/13/24, the center did not ensure that one medication authorization was available to staff during the entire time it was effective. Evidence: A long-term prescription medication was observed for Child #1, but no written parental authorization was present at the center for this medication. During interview, a member of management acknowledged the form on file did not include parental authorization for the medication the center had on site for Child #1.”

8VAC20-780-160-B

“Based on a review of five staff records and interviews, the center did not ensure an acceptable form of documentation of tuberculosis (TB) screening was on file for one staff member. Evidence: The most recent TB screening in the record of Staff #3 (DOE: 06/01/2020) was not signed by a physician, the physician's designee or an official of the local health department. During interview, a member of management confirmed the TB screening did not contain the required information.”

8VAC20-780-160-A

“Based on a review of five staff records and interviews, the center did not ensure one staff member submitted documentation of a negative tuberculosis (TB) screening within the required timeframe. Evidence: The TB screening in the record of Staff #2 (DOE: 04/03/2023) was dated 04/05/2023. During interview, a member of management confirmed the TB screening was completed on 04/05/2023. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children.”

8VAC20-770-40-D-6

“Based on a review of three staff records and interview, the center did not ensure not to accept a required criminal history record report from one staff member required to obtain background checks that was dated more than 90 days prior to the date of employment. Evidence: The national fingerprint-based criminal record search in the record of Staff #1, employed on 01/22/24, was completed on 09/18/23. During interview, a member of management acknowledged the background check was completed more than 90 days prior to employment.”

22.1-289.035-B-4

“Based on a review of three staff records and interviews, the center did not obtain a required out-of-state background check from any state in which one staff member had resided in the preceding five years within the required time frame. Evidence: The record for Staff #2, employed on 01/22/24, indicated the staff had resided in another state outside of Virginia within the last five years. The record did not contain an out-of-state search for founded complaints of child abuse or neglect. The search of the child abuse and neglect registry is required to be requested within the first 30 days of employment. During interview, a member of management confirmed the required out-of-state background check was not obtained for Staff #2 within the required time frame.”

8VAC20-780-270-A

“(Repeat Violation) Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe, and operable condition. Evidence: The preschool playground had a hole in the siding with sharp edges that could snag a child’s skin.”

22.1-289.035-B-2

“(Repeat Violation) Based on a review of two staff records and interview, the center did not obtain the satisfactory results of a national fingerprint-based criminal record search for one staff prior to employment. Evidence: 1) The national fingerprint-based criminal record search in the record of Staff #1, employed on 12/07/23, was completed on 12/20/23. 2) During interview, a member of management confirmed the fingerprint-based criminal record search for Staff #1 was not completed prior to employment.”

8VAC20-780-70

“Based on a review of two staff records and interview, the center did not ensure one staff record contained the required information. Evidence: 1) The record of Staff #1, employed on 12/07/23, did not contain documentation that a second reference as to character and reputation as well as competency was checked before employment. 2) During interview, a member of management confirmed the center did not have documentation to show that a second reference for Staff #1 was obtained prior to employment.”

8VAC20-780-160-A

“(Repeat Violation) Based on a review of two staff records and interview, the center did not ensure one staff submitted documentation of a negative tuberculosis screening within the required timeframe. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department. Evidence: 1) The tuberculosis screening in the record of Staff #1, employed on 12/07/23, was completed on 09/15/22. 2) During interview, a member of management reported she was unaware that the tuberculosis screening was not acceptable if it had been completed more than 30 calendar days of the date of employment.”

8VAC20-780-410-1

“Based on a review of documentation, interviews, and video footage, the center did not ensure that staff did not use a forbidden action of rough handling a child. Evidence: Video footage of the Ladybug Room reviewed on January 18, 2024, revealed that on January 9, 2024, Staff #1 roughly handled a child in care. In the video, Staff #1 is observed grabbing Child #1 (3-year-old) under their arms and forcefully moving the child away from a group of children. During interview, Staff #2 reported Staff #1 was terminated on January 10, 2024, for rough handling Child #1.”

8VAC20-780-40-E

“Based on a review of documentation, interviews, and video footage, the center did not maintain compliance with the center’s own policies and procedures that are required by these standards. Evidence: The following was observed through video footage provided by the center on January 18, 2024: On January 9, 2024, Staff #1 grabbed Child #1 (3-year-old) by the arms and forcefully moved her away from a group of children. During interviews, Staff #2 reported that Staff #1 was terminated for using inappropriate discipline on Child #1 on January 9, 2024. It was reported that Staff #1 moved Child #1 away from the group for upsetting two children. An employee action form issued to Staff #1 on January 10, 2024 stated the following: ?A parent complaint was received on 1.9.24 indicating inappropriate discipline was used. After reviewing the video from Mon & Tus it was determined that this complaint was valid & discipline was harsh & outside of PT policy. Inappropriate discipline is grounds for immediate termination and therefore [Staff #1]?s employment will be terminated today.? The center’s discipline policy states: ?The goal of positive behavior guidance is to help the child learn self-control and build good habits. The staff shall provide opportunities for children to learn self-regulation in ways that promote their self-esteem and self-image using techniques such as: A. Setting limits that are clear, fair, consistent, appropriate and understandable B. Setting limits and patiently enforcing them C. Encouraging age appropriate behavior D. Redirecting children toward acceptable or appropriate activities and behavior E. Encouraging the use of words to express their feelings to limit and resolve conflicts F. Arranging equipment in a way that promotes desirable behavior?”

8VAC20-780-40-J Complaint related: Yes

“Based on interview, the provider failed to ensure the injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services. Evidence: The program director reported the injury prevention procedures had not been updated at least annually based on documentation of injuries and a review of the activities and services when the annual update was requested for review by the licensing inspector.”

8VAC20-780-80-B Complaint related: Yes

“Based on review of a report of child injuries, the provider failed to inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurs while the child is under the supervision of the center and requires outside medical attention. Evidence: Injury report for C1 dated 12/12/2023 documented the child while being assisted with putting on his coat complained that his arm hurt, and he was unable to raise his arm. Center staff reported that the child was taken to the hospital by a parent. The center failed to inform the department of the injury.”

8VAC20-780-500-B Complaint related: Yes

“Based on observation the provider failed to ensure that the diapering surface shall be cleaned with soap and sanitized after each use. Evidence: Licensing inspector observed a staff member in the Bunnies Room change a child’s diaper. The staff cleaned the diapering surface; however, failed to allow the disinfectant solution sprayed on the diapering surface to air dry for a minimum of two minutes. The staff reported not knowing that the disinfectant solution needed to air dry for a minimum of two minutes.”

8VAC20-780-550-P Complaint related: Yes

“Based on review of a written record of a child’s injury, the provider failed to document the required information. Evidence: The injury report dated 12/12/2023 for C1 did not document the name of the staff present when the injury occurred and any future action to prevent recurrence of the injury.”

8VAC20-780-270-A Complaint related: Yes

“(Repeat violation) Based on observation, the provider did not ensure that all areas of the center be maintained in a clean, safe, and operable condition. Evidence: The carpet in the Bunnies Room (1 year old room) was observed to be stained and dirty with food debris.”

8VAC20-780-350-B-3 Complaint related: Yes

“Based on observation and interviews, the center did not ensure compliance with ratios of staff to children as required. Evidence: Based on observation the center did not maintain the ratio of 1 staff to 8 children in the Deer Room(2 year old room). The licensing inspector observed the classroom teacher accept supervision of a 9th child at approximately 10:10 a.m. while the class was on the playground. Classroom staff acknowledged she was out of ratio at that time.”

8VAC20-780-350-B-3 Complaint related: Yes

“Based on observation and interview, the center failed to ensure the 1:10 staff-to-child ratio requirement was met for children ages 3 years old to school age. Evidence: 1. During the inspection 11 children from the Red Robin room (4 year olds) were observed being supervised outside by one staff. One additional staff was required. 2. During an interview with Staff #1, it was acknowledged that staff-to-child ratio requirements were out of compliance.”

22.1-289.035-A

“Based on review of six staff records, the center did not ensure that one staff completed a criminal history record check every 5 years. Evidence: The record for Staff #1 documented a criminal history check dated 3/30/2018, a repeat check was required no later than 3/30/2023.”

8VAC20-780-420-E-3

“Based on review of seven children's records, the center did not obtain at least annually parent confirmation that the required information in the children’s records were up to date. Evidence: 1. Child #2 (enrolled 9/19/22), Child #3 (enrolled 5/3/21) and Child #6 (enrolled 8/22/22) did not have the parent confirmation that the required information in the children’s records were up to date annually. 2. During an interview with Staff #1, it was acknowledged that parent confirmations were not obtained.”

8VAC20-780-520-C

“REPEAT Based on review of the medication authorization forms and interview, the center did not have written parental authorization to administer diaper ointment or creams for one child. Evidence: 1.Diaper ointment with Child #7?s name on it was observed in Child #7?s classroom. 2.There was no parent authorization on file for Child #7. 3.During an interview with Staff #1 it was acknowledged the diaper ointment is being administered on Child #7 and no authorization was on file.”

8VAC20-770-60-C-2

“REPEAT Based on review of six staff records, the center did not ensure one staff had central registry findings by the end of the 30th day of employment. Evidence: 1.The record for Staff #6 (date of employment: 9/19/22) did not document a central registry finding. 2. No additional information was provided.”

8VAC20-780-270-A

“REPEAT Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1.The bunny room (16 months-2 year olds) had a gap in the wall within reach of children which created a snag risk. 2.The pre-school playground had a hole in the siding with sharp edges that could snag a child’s skin. 3.The plastic base of the portable basketball goal on the pre-k playground had torn sharp edges that could snag a child’s skin. 4.The bottom siding of the building on the Pre-k playground was loose creating sharp edges that could snag a child’s skin.”

22.1-289.036-A

“Based on review of background checks for one applicant, the center did not ensure the applicant completed an out state central registry check every 5 years for the state where the applicant resides. Evidence: 1.The central registry findings for the state where the applicant resides is dated 12/5/17, a repeat out of state registry findings was required no later than 12/5/2022. 2. No additional information was provided.”

8VAC20-780-160-A

“REPEAT Based on review of six staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis screening completed at the time of employment. Evidence: The record for Staff #6 (date of employment: 9/19/22) documented a tuberculosis screening dated 11/1/22 which is beyond the date of employment.”

8VAC20-780-245-A

“REPEAT Based on review of six staff records, the center did not ensure that one staff completed annually a minimum of 16 hours of training appropriate to the age of children in care. Evidence: The record for Staff #2, (employment date: 7/13/21) documented 7.5 hours of annual training from 7/14/2022-7/13/2023.”

8VAC20-780-240-A

“REPEAT Based on a review of six staff records, the center did not ensue one staff completed the Virginia department of Education-sponsored orientation course with in 90 calendar days of employment. Evidence: 1.The record for Staff #3 (date of employment: 11/14/22) did not document completion of the Virginia department of Education-sponsored orientation course. 2. Staff #1 confirmed via an email provided on 10/4/2023 that Staff #3?s record did not document completion of the required course.”

8VAC20-790-600-F

“Based on review of six staff records, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department. Evidence: 1.The record for Staff #2 (date of employment:7/13/21) did not document completion of the Virginia Annual Health and Safety Update Course. 2. Staff #1 confirmed via email provided on 10/4/2023 that there was no documentation of Staff #2 completing the update course.”

8VAC20-790-600-D-1

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.”

8VAC20-790-600-D-2

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. 1.The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in first aid. 2.Staff #1 verified during an interview that Staff #4 has not completed certification in first aid.”

8VAC20-780-350-B-3 Complaint related: Yes

“Based on observation and interview, the center failed to ensure the 1:10 staff-to-child ratio requirement was met for children ages 3 years old to school age. Evidence: 1. During the inspection 11 children from the Red Robin room (4 year olds) were observed being supervised outside by one staff. One additional staff was required. 2. During an interview with Staff #1, it was acknowledged that staff-to-child ratio requirements were out of compliance.”

22.1-289.035-A

“Based on review of six staff records, the center did not ensure that one staff completed a criminal history record check every 5 years. Evidence: The record for Staff #1 documented a criminal history check dated 3/30/2018, a repeat check was required no later than 3/30/2023.”

8VAC20-780-420-E-3

“Based on review of seven children's records, the center did not obtain at least annually parent confirmation that the required information in the children’s records were up to date. Evidence: 1. Child #2 (enrolled 9/19/22), Child #3 (enrolled 5/3/21) and Child #6 (enrolled 8/22/22) did not have the parent confirmation that the required information in the children’s records were up to date annually. 2. During an interview with Staff #1, it was acknowledged that parent confirmations were not obtained.”

8VAC20-780-520-C

“REPEAT Based on review of the medication authorization forms and interview, the center did not have written parental authorization to administer diaper ointment or creams for one child. Evidence: 1.Diaper ointment with Child #7?s name on it was observed in Child #7?s classroom. 2.There was no parent authorization on file for Child #7. 3.During an interview with Staff #1 it was acknowledged the diaper ointment is being administered on Child #7 and no authorization was on file.”

8VAC20-770-60-C-2

“REPEAT Based on review of six staff records, the center did not ensure one staff had central registry findings by the end of the 30th day of employment. Evidence: 1.The record for Staff #6 (date of employment: 9/19/22) did not document a central registry finding. 2. No additional information was provided.”

8VAC20-780-270-A

“REPEAT Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1.The bunny room (16 months-2 year olds) had a gap in the wall within reach of children which created a snag risk. 2.The pre-school playground had a hole in the siding with sharp edges that could snag a child’s skin. 3.The plastic base of the portable basketball goal on the pre-k playground had torn sharp edges that could snag a child’s skin. 4.The bottom siding of the building on the Pre-k playground was loose creating sharp edges that could snag a child’s skin.”

22.1-289.036-A

“Based on review of background checks for one applicant, the center did not ensure the applicant completed an out state central registry check every 5 years for the state where the applicant resides. Evidence: 1.The central registry findings for the state where the applicant resides is dated 12/5/17, a repeat out of state registry findings was required no later than 12/5/2022. 2. No additional information was provided.”

8VAC20-780-160-A

“REPEAT Based on review of six staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis screening completed at the time of employment. Evidence: The record for Staff #6 (date of employment: 9/19/22) documented a tuberculosis screening dated 11/1/22 which is beyond the date of employment.”

8VAC20-780-245-A

“REPEAT Based on review of six staff records, the center did not ensure that one staff completed annually a minimum of 16 hours of training appropriate to the age of children in care. Evidence: The record for Staff #2, (employment date: 7/13/21) documented 7.5 hours of annual training from 7/14/2022-7/13/2023.”

8VAC20-780-240-A

“REPEAT Based on a review of six staff records, the center did not ensue one staff completed the Virginia department of Education-sponsored orientation course with in 90 calendar days of employment. Evidence: 1.The record for Staff #3 (date of employment: 11/14/22) did not document completion of the Virginia department of Education-sponsored orientation course. 2. Staff #1 confirmed via an email provided on 10/4/2023 that Staff #3?s record did not document completion of the required course.”

8VAC20-790-600-F

“Based on review of six staff records, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department. Evidence: 1.The record for Staff #2 (date of employment:7/13/21) did not document completion of the Virginia Annual Health and Safety Update Course. 2. Staff #1 confirmed via email provided on 10/4/2023 that there was no documentation of Staff #2 completing the update course.”

8VAC20-790-600-D-1

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.”

8VAC20-790-600-D-2

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. 1.The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in first aid. 2.Staff #1 verified during an interview that Staff #4 has not completed certification in first aid.”

8VAC20-780-350-B-3 Complaint related: Yes

“Based on observation and interview, the center failed to ensure the 1:10 staff-to-child ratio requirement was met for children ages 3 years old to school age. Evidence: 1. During the inspection 11 children from the Red Robin room (4 year olds) were observed being supervised outside by one staff. One additional staff was required. 2. During an interview with Staff #1, it was acknowledged that staff-to-child ratio requirements were out of compliance.”

22.1-289.035-A

“Based on review of six staff records, the center did not ensure that one staff completed a criminal history record check every 5 years. Evidence: The record for Staff #1 documented a criminal history check dated 3/30/2018, a repeat check was required no later than 3/30/2023.”

8VAC20-780-420-E-3

“Based on review of seven children's records, the center did not obtain at least annually parent confirmation that the required information in the children’s records were up to date. Evidence: 1. Child #2 (enrolled 9/19/22), Child #3 (enrolled 5/3/21) and Child #6 (enrolled 8/22/22) did not have the parent confirmation that the required information in the children’s records were up to date annually. 2. During an interview with Staff #1, it was acknowledged that parent confirmations were not obtained.”

8VAC20-780-520-C

“REPEAT Based on review of the medication authorization forms and interview, the center did not have written parental authorization to administer diaper ointment or creams for one child. Evidence: 1.Diaper ointment with Child #7?s name on it was observed in Child #7?s classroom. 2.There was no parent authorization on file for Child #7. 3.During an interview with Staff #1 it was acknowledged the diaper ointment is being administered on Child #7 and no authorization was on file.”

8VAC20-770-60-C-2

“REPEAT Based on review of six staff records, the center did not ensure one staff had central registry findings by the end of the 30th day of employment. Evidence: 1.The record for Staff #6 (date of employment: 9/19/22) did not document a central registry finding. 2. No additional information was provided.”

8VAC20-780-270-A

“REPEAT Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1.The bunny room (16 months-2 year olds) had a gap in the wall within reach of children which created a snag risk. 2.The pre-school playground had a hole in the siding with sharp edges that could snag a child’s skin. 3.The plastic base of the portable basketball goal on the pre-k playground had torn sharp edges that could snag a child’s skin. 4.The bottom siding of the building on the Pre-k playground was loose creating sharp edges that could snag a child’s skin.”

22.1-289.036-A

“Based on review of background checks for one applicant, the center did not ensure the applicant completed an out state central registry check every 5 years for the state where the applicant resides. Evidence: 1.The central registry findings for the state where the applicant resides is dated 12/5/17, a repeat out of state registry findings was required no later than 12/5/2022. 2. No additional information was provided.”

8VAC20-780-160-A

“REPEAT Based on review of six staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis screening completed at the time of employment. Evidence: The record for Staff #6 (date of employment: 9/19/22) documented a tuberculosis screening dated 11/1/22 which is beyond the date of employment.”

8VAC20-780-245-A

“REPEAT Based on review of six staff records, the center did not ensure that one staff completed annually a minimum of 16 hours of training appropriate to the age of children in care. Evidence: The record for Staff #2, (employment date: 7/13/21) documented 7.5 hours of annual training from 7/14/2022-7/13/2023.”

8VAC20-780-240-A

“REPEAT Based on a review of six staff records, the center did not ensue one staff completed the Virginia department of Education-sponsored orientation course with in 90 calendar days of employment. Evidence: 1.The record for Staff #3 (date of employment: 11/14/22) did not document completion of the Virginia department of Education-sponsored orientation course. 2. Staff #1 confirmed via an email provided on 10/4/2023 that Staff #3?s record did not document completion of the required course.”

8VAC20-790-600-F

“Based on review of six staff records, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department. Evidence: 1.The record for Staff #2 (date of employment:7/13/21) did not document completion of the Virginia Annual Health and Safety Update Course. 2. Staff #1 confirmed via email provided on 10/4/2023 that there was no documentation of Staff #2 completing the update course.”

8VAC20-790-600-D-1

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.”

8VAC20-790-600-D-2

“Based on review of six staff records, the vendor did not ensure all staff who work directly with children have within 90 days of the date of employment current certification in first aid appropriate to the ages of children in care. 1.The record for Staff #4 (date of hire: 4/13/2023) did not contain documentation of certification in first aid. 2.Staff #1 verified during an interview that Staff #4 has not completed certification in first aid.”

8VAC20-780-520-C Complaint related: No

“Based on observation, interviews, and a review of documentation, the center did not follow the requirement to obtain written parent authorization noting any known adverse reactions when diaper ointment or cream is used for three out of six children. Evidence: 1) Diaper ointment was observed on-site on 07/24/23 for Child #3, Child #5, and Child #6. The center did not have written parent authorization noting any known adverse reactions for the diaper ointment on site for each child. 2) During interview, staff reported the ointments have been applied to Child #3, Child #5, and Child #6.”

8VAC20-780-570-E Complaint related: No

“Based on observation and interviews on 07/24/23, the center did not ensure prepared infant formula was dated and labeled with the child's name. Evidence: 1) In the refrigerator in the Fish Class (Infant 1), the inspector observed 13 prepared infant bottles that were not dated and two bottles that did not have a child’s name or the date. 2) During interview, staff reported all the prepared bottles contain formula and acknowledged they were not dated and two were also missing the child’s name.”

8VAC20-780-440-G Complaint related: Yes

“Based on interviews and a review of documentation, the center did not ensure cribs shall be used for children under 12 months of age. Evidence: 1) During interviews, it was reported that on several occasions, Child #1 (6-months-old) has fallen asleep in a bouncy chair but was not transitioned to their assigned crib. When staff were asked why the child was not moved, they reported ?she was already asleep, and we didn?t want to wake her.? 2) A daily report reviewed for Child #1 dated 05/26/23 shows a picture of Child #1 asleep in a bouncy chair with a blanket. The report was labeled ?Naptime.?”

8VAC20-780-350-B-1 Complaint related: Yes

“Based on a review of documentation and interviews, the center did not maintain the required staff-child ratio for children birth up to 16 months. Evidence: 1) During an interview with a collateral witness, it was reported that on 06/14/23 at approximately 7:55am, Staff #1 and Staff #3 were the only two staff members in the Fish Class (Infant 1) with nine children. 2) A review of the center’s Rollcall Sheet for the Fish Class (Infant 1) and the Turtles Class (Infant 2) for 06/14/23 showed there were a total of nine children present by approximately 7:25am. The ages of the children ranged from 3 months to 17 months. A member of management reported the Fish Class (Infant 1) and the Turtles Class (Infant 2) are typically combined in the mornings and were combined on 06/14/23. The staff-child ratio applied to the group is one staff member to four children based on the age of the youngest child present.”

8VAC20-780-240-A Complaint related: No

“Repeat Violation Based on a review of three staff records and interview, the center did not ensure two staff members completed the Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. Evidence: 1) According to the certificate for Virginia Department of Education-sponsored orientation course in the record of Staff #2, employed on 08/01/22, the training was completed on 12/31/22. 2) The record of Staff #3, employed on 06/14/22, did not contain a training certificate for the Virginia Department of Education-sponsored orientation course. During interview, a member of management reported the center does not have documentation that Staff #3 has completed the course.”

8VAC20-780-220 Complaint related: Yes

“Based on a review of three staff records and interview, the center did not ensure one staff was at least 16 years of age. Evidence: 1) The record of Staff #3, employed on 06/14/22 as an aide, indicates the staff member is 15 years of age. Aides shall be at least 16 years of age. 2) During interview, a member of management reported she was unaware an aide had to be 16 years of age. The staff is never alone with children but has been counted in ratio in the past.”

8VAC20-780-40-E Complaint related: Yes

“Based on a review of documentation, observations, and interviews, the center did not ensure to follow the center's own policies and procedures that are required by these standards. Evidence: During the inspection on 07/24/23, the inspector observed three infants, under 12 months of age, sleeping in cribs. Two out of the three infants had blankets in the cribs. A staff member in the classroom reported she did not know infants could not have blankets in the crib. The center’s policy on safe sleeping practices state: ?Use a wearable blanket to keep baby warm without blankets in the sleep area. Make sure baby’s head and face stay uncovered during sleep.?”

8VAC20-780-160-A Complaint related: No

“Repeat Violation Based on a review of three staff records and interview, the center did not ensure one staff member submitted documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children. Evidence: 1) The TB screening in the record of Staff #3, employed on 06/14/22, was completed on 06/28/23. 2) During interview, a member of management reported this was the only TB screening on file for Staff #3.”

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

“Based on a review of a child’s record and interview, the center did not ensure one child had a physical examination by or under the direction of a physician before the child’s attendance or within 30 days of the child’s first day of attendance. Evidence: 1) The record of Child #1, date of attendance 04/17/23, did not contain documentation of a physical examination. 2) During interview, a member of management acknowledged a physical examination was not on file for Child #1.”

8VAC20-770-60-C-2 Complaint related: No

“Repeat Violation Based on a review of three staff records and interviews, the center did not have a central registry finding for one staff within 30 days of employment. Evidence: 1) The record of Staff #3, employed on 06/14/22, did not contain a central registry finding. 2) During interview, a member of management reported the center did not have a central registry finding for Staff #3.”

8VAC20-770-60-B Complaint related: No

“Based on a review of three staff records, the center did not ensure one staff had a completed sworn statement or affirmation prior to employment. Evidence: The sworn statement in the record of Staff #2, employed on 08/01/22, was completed on 08/02/22.”

22.1-289.035-B-2 Complaint related: No

“Repeat Violation Based on a review of three staff records and interview, the center did not obtain the satisfactory results of a national fingerprint-based criminal record search for one staff prior to employment. Evidence: 1) The record of Staff #3, employed on 06/14/22, did not contain the results of a national fingerprint-based criminal record search. 2) During interview, a member of management reported the center did not have a fingerprint-based criminal record search for Staff #3.”

8VAC20-780-490-C Complaint related: Yes

“Based on a review of documentation and interviews, the center did not ensure that when children at the center have been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the parents shall be notified within 24 hours or the next business day of the center's having been informed unless forbidden by law, except for life threatening diseases, which must be reported to parents immediately. Evidence: 1) During interviews, it was reported that on 07/10/23, a communicable disease was reported to the center for a child in the Fish Class (Infant 1). The parents of the children in the classroom did not receive a notification from the center to let them know their children had been exposed to a communicable disease. 2) Documentation reviewed showed the last notification sent to families regarding a communicable disease was on 05/09/23. A member of management reported a notification was not sent to families about the communicable disease reported on 07/10/23 because the information was given to another member of management that is no longer at the center.”

8VAC20-790-600-D-1

“Based on a review of seven staff records and interview, the vendor did not ensure three staff members had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of the date of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff member is certified in CPR. 2) The CPR certification in the record of Staff #2, employed on 03/14/22, was completed on 10/13/22, exceeding 90 days of the date of employment. 3) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff member is certified in CPR. 4) During interview, a member of management confirmed the CPR certification for Staff #2 was completed more than 90 days after employment and the CPR certification for Staff #1 and Staff #4 could not be located.”

8VAC20-790-600-F

“Based on a review of seven staff records and interview, the vendor did not ensure two staff members who work directly with children completed the department’s health and safety update course annually. Evidence: 1) The record of Staff #2, employed on 03/14/22, did not contain the department’s health and safety update course. The course should have been completed no later than 03/14/23. 2) The record of Staff #4, employed on 05/16/22, did not contain the department’s health and safety updated course. The course should have been completed no later than 05/16/23. 3) During interview, a member of management reported the health and safety update course could not be located for Staff #2 or Staff #4.”

8VAC20-790-600-D-2

“Based on a review of seven staff records and interview, the vendor did not ensure three staff members had current certification in first aid appropriate to the ages of children in care within 90 days of the date of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff member is certified in first aid. 2) The first aid certification in the record of Staff #2, employed on 03/14/22, was completed on 10/13/22, exceeding 90 days of the date of employment. 3) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff member is certified in first aid. 4) During interview, a member of management confirmed the first aid certification for Staff #2 was complete more than 90 days after employment and the first aid certification for Staff #1 and Staff #4 could not be located.”

8VAC20-780-60-A

“Based on a review of seven children’s records, the center did not ensure one child’s record contained the required information. Evidence: The second emergency contact in the record of Child #2, enrolled on 10/29/21, did not contain an address or phone number for the designated contact. A child’s record shall contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached.”

8VAC20-780-160-A

“Based on a review of seven staff records and interview, the center did not ensure three staff submitted documentation of a negative tuberculosis screening within the required timeframe. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain documentation of a negative tuberculosis screening. 2) The record of Staff #5, employed on 03/08/23, did not contain documentation of a negative tuberculosis screening. 3) The record of Staff #6, employed on 05/15/23, did not contain documentation of a negative tuberculosis screening. 4) During interview, a member of management reported the tuberculosis screening for Staff #4, Staff #5, and Staff #6, could not be located and was unaware if they were completed prior to the staff beginning employment. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.”

8VAC20-770-60-C-2

“Based on a review of seven staff records and interview, the center did not ensure two staff members had a central registry finding within 30 days of employment. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain a central registry finding within 30 days of employment. 2) The record of Staff #5, employed on 03/08/23, did not contain a central registry finding within 30 days of employment. 3) During interview, a member of management confirmed the results of the central registry finding for Staff #4 and Staff #5 could not be located. The center did not have documentation of following up with the Office of Background Investigation within 30 days of employment.”

8VAC20-770-60-B

“Based on a review of seven staff records and interview, the center did not ensure two staff had a completed sworn statement or affirmation prior to employment. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain documentation of a sworn statement or affirmation. 2) The record of Staff #5, employed on 03/08/23, did not contain documentation of a sworn statement or affirmation. 3) During interview, a member of management reported the sworn statement or affirmation for Staff #4 and Staff #5 could not be located.”

22.1-289.035-B-4

“Based on a review of seven staff records and interview, the center did not obtain two required out-of-state background checks from any state in which one staff had resided in the preceding five years within the required timeframes. Evidence: 1) The record for Staff #3, employed on 01/19/23, indicated the staff had resided in another state outside of Virginia within the last five years. The record did not contain the results of the child abuse and neglect registry from that state. The out-of-state search for founded complaints of child abuse or neglect is required to be requested within the first 30 days of employment. The out-of-state sex offender registry check was obtained on 01/23/23. The out-of-state sex offender registry check is required to be obtained prior to employment. 2) During interview, a member of management reported the out-of-state results of the child abuse and neglect registry could not be located.”

22.1-289.035-B-2

“Based on a review of seven staff records and interview, the center did not obtain the satisfactory results of a national fingerprint-based criminal record search for three staff within the required timeframe. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain the results of a national fingerprint-based criminal record search. 2) The record of Staff #5, employed on 03/08/23, did not contain the results of a national fingerprint-based criminal record search. 3) The record of Staff #7, employed on 05/10/23, contained the results of a national fingerprint-based criminal record search that were completed on 05/11/23. 4) During interview, a member of management reported the fingerprint-based criminal record search for Staff #4 and Staff #5 could not be located.”

8VAC20-780-550-D

“Based on a review of documents and interview, the center did not implement a monthly practice evacuation drill. Evidence: 1) The licensing inspector reviewed the emergency drill log for the year 2023. The last practice evacuation drill was documented on 03/08/2023. 2) During interview, a member of management reported a monthly evacuation drill was not practiced in April 2023.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe, and operable condition. Evidence: During the inspection of the physical plant on 05/31/23, the inspector observed the following: 1. There was a water hose several feet long, sitting on the playground outside of the three-year-old classroom presenting an entanglement and tripping hazard. 2. The following playground structures and equipment had several rusted areas within the reach of children in care: swing chains and seat connectors. 3. There were several nails protruding from the plastic boards around the playground structures.”

8VAC20-780-245-A

“Based on a review of seven staff records and interview, the center did not ensure two staff completed annually a minimum of 16 hours of training appropriate to the age of children in care. Evidence: 1) The record of Staff #2, employed on 03/14/22, contained a total of 14.5 hours of annual training from 03/2022 - 03/2023. 2) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff completed annual training from 05/2022 ? 05/2023. 3) During interview, a member of management reported there was no additional training for Staff #2 from 03/2022 ? 03/2023. The record of Staff #4 could not be located.”

8VAC20-780-240-E

“Based on a review of seven staff records and interview, the center did not ensure two staff completed orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, within 30 days of the first day of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, and the record of Staff #2, employed on 03/14/22, did not contain documentation that the staff completed first and CPR orientation within 30 days of employment. 2) During interview, a member of management reported the center did not have additional documentation that the staff completed additional orientation in first aid and CPR within the required timeframe.”

8VAC20-780-240-C

“Based on a review of records and interview, the center did not ensure that orientation training included all the required topics. Evidence: 1) The record of Staff #2, employed 03/14/22, had documentation of an orientation training that did not include the topics on the prevention of sudden infant death syndrome and use of safe sleep practices; prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children; and prevention of and response to emergencies due to food and other allergic reactions. 2) During interview, a member of management reported the center did not have additional documentation that the staff received orientation on those topics.”

8VAC20-780-240-A

“Based on a review of seven staff records and interview, the center did not ensure four staff completed the Virginia Department of Education-sponsored (VDOE) orientation course within 90 calendar days of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff completed the VDOE orientation course. 2) The record of Staff #2, employed on 03/14/22, did not contain documentation that the staff completed the VDOE orientation course. 3) The record of Staff #3, employed on 01/19/23, did not contain documentation that the staff completed the VDOE orientation course. 4) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff completed the VDOE orientation course. 5) During interview, a member of management reported the VDOE orientation course for the staff could not be located.”

8VAC20-780-70

“Based on a review of seven staff records and interview, the center did not ensure four staff records contained the required information. Evidence: 1) The records of Staff #4 (DOE: 05/16/22), Staff #5 (DOE: 03/08/23), Staff #6 (DOE: 05/15/23), and Staff #7 (DOE: 05/10/23) could not be located. 2) During interview, a member of management reported the staff records could not be located. The following information was missing for each staff record: address, verification of age requirement, job title; name, address, and telephone number of a person to be notified in an emergency; documentation that two or more references as to character and reputation as well as competency were checked before employment or volunteering; documentation to demonstrate that the individual possesses the education, certification, and experience required by the job position, and orientation and training as required in 8VAC20-780-240 and 8VAC20-780-245; and information about any health problems that may interfere with fulfilling the job responsibilities.”

8VAC20-780-550-P

“Based on a review of documentation, the center did not ensure that written injury records contained the required information. Evidence: Three out of four injury records reviewed did not contain documentation of the date and time the parents were notified of the injuries. The center should maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include the following: date and time of injury; name of injured child; type and circumstance of the injury; staff present and treatment; date and time when parents were notified; any future action to prevent reoccurrence of the injury; staff and parent signatures or two staff signatures; and documentation on how parent was notified.”

8VAC20-790-600-D-1

“Based on a review of seven staff records and interview, the vendor did not ensure three staff members had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of the date of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff member is certified in CPR. 2) The CPR certification in the record of Staff #2, employed on 03/14/22, was completed on 10/13/22, exceeding 90 days of the date of employment. 3) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff member is certified in CPR. 4) During interview, a member of management confirmed the CPR certification for Staff #2 was completed more than 90 days after employment and the CPR certification for Staff #1 and Staff #4 could not be located.”

8VAC20-790-600-F

“Based on a review of seven staff records and interview, the vendor did not ensure two staff members who work directly with children completed the department’s health and safety update course annually. Evidence: 1) The record of Staff #2, employed on 03/14/22, did not contain the department’s health and safety update course. The course should have been completed no later than 03/14/23. 2) The record of Staff #4, employed on 05/16/22, did not contain the department’s health and safety updated course. The course should have been completed no later than 05/16/23. 3) During interview, a member of management reported the health and safety update course could not be located for Staff #2 or Staff #4.”

8VAC20-790-600-D-2

“Based on a review of seven staff records and interview, the vendor did not ensure three staff members had current certification in first aid appropriate to the ages of children in care within 90 days of the date of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff member is certified in first aid. 2) The first aid certification in the record of Staff #2, employed on 03/14/22, was completed on 10/13/22, exceeding 90 days of the date of employment. 3) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff member is certified in first aid. 4) During interview, a member of management confirmed the first aid certification for Staff #2 was complete more than 90 days after employment and the first aid certification for Staff #1 and Staff #4 could not be located.”

8VAC20-780-60-A

“Based on a review of seven children’s records, the center did not ensure one child’s record contained the required information. Evidence: The second emergency contact in the record of Child #2, enrolled on 10/29/21, did not contain an address or phone number for the designated contact. A child’s record shall contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached.”

8VAC20-780-160-A

“Based on a review of seven staff records and interview, the center did not ensure three staff submitted documentation of a negative tuberculosis screening within the required timeframe. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain documentation of a negative tuberculosis screening. 2) The record of Staff #5, employed on 03/08/23, did not contain documentation of a negative tuberculosis screening. 3) The record of Staff #6, employed on 05/15/23, did not contain documentation of a negative tuberculosis screening. 4) During interview, a member of management reported the tuberculosis screening for Staff #4, Staff #5, and Staff #6, could not be located and was unaware if they were completed prior to the staff beginning employment. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.”

8VAC20-770-60-C-2

“Based on a review of seven staff records and interview, the center did not ensure two staff members had a central registry finding within 30 days of employment. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain a central registry finding within 30 days of employment. 2) The record of Staff #5, employed on 03/08/23, did not contain a central registry finding within 30 days of employment. 3) During interview, a member of management confirmed the results of the central registry finding for Staff #4 and Staff #5 could not be located. The center did not have documentation of following up with the Office of Background Investigation within 30 days of employment.”

8VAC20-770-60-B

“Based on a review of seven staff records and interview, the center did not ensure two staff had a completed sworn statement or affirmation prior to employment. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain documentation of a sworn statement or affirmation. 2) The record of Staff #5, employed on 03/08/23, did not contain documentation of a sworn statement or affirmation. 3) During interview, a member of management reported the sworn statement or affirmation for Staff #4 and Staff #5 could not be located.”

22.1-289.035-B-4

“Based on a review of seven staff records and interview, the center did not obtain two required out-of-state background checks from any state in which one staff had resided in the preceding five years within the required timeframes. Evidence: 1) The record for Staff #3, employed on 01/19/23, indicated the staff had resided in another state outside of Virginia within the last five years. The record did not contain the results of the child abuse and neglect registry from that state. The out-of-state search for founded complaints of child abuse or neglect is required to be requested within the first 30 days of employment. The out-of-state sex offender registry check was obtained on 01/23/23. The out-of-state sex offender registry check is required to be obtained prior to employment. 2) During interview, a member of management reported the out-of-state results of the child abuse and neglect registry could not be located.”

22.1-289.035-B-2

“Based on a review of seven staff records and interview, the center did not obtain the satisfactory results of a national fingerprint-based criminal record search for three staff within the required timeframe. Evidence: 1) The record of Staff #4, employed on 05/16/22, did not contain the results of a national fingerprint-based criminal record search. 2) The record of Staff #5, employed on 03/08/23, did not contain the results of a national fingerprint-based criminal record search. 3) The record of Staff #7, employed on 05/10/23, contained the results of a national fingerprint-based criminal record search that were completed on 05/11/23. 4) During interview, a member of management reported the fingerprint-based criminal record search for Staff #4 and Staff #5 could not be located.”

8VAC20-780-550-D

“Based on a review of documents and interview, the center did not implement a monthly practice evacuation drill. Evidence: 1) The licensing inspector reviewed the emergency drill log for the year 2023. The last practice evacuation drill was documented on 03/08/2023. 2) During interview, a member of management reported a monthly evacuation drill was not practiced in April 2023.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe, and operable condition. Evidence: During the inspection of the physical plant on 05/31/23, the inspector observed the following: 1. There was a water hose several feet long, sitting on the playground outside of the three-year-old classroom presenting an entanglement and tripping hazard. 2. The following playground structures and equipment had several rusted areas within the reach of children in care: swing chains and seat connectors. 3. There were several nails protruding from the plastic boards around the playground structures.”

8VAC20-780-245-A

“Based on a review of seven staff records and interview, the center did not ensure two staff completed annually a minimum of 16 hours of training appropriate to the age of children in care. Evidence: 1) The record of Staff #2, employed on 03/14/22, contained a total of 14.5 hours of annual training from 03/2022 - 03/2023. 2) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff completed annual training from 05/2022 ? 05/2023. 3) During interview, a member of management reported there was no additional training for Staff #2 from 03/2022 ? 03/2023. The record of Staff #4 could not be located.”

8VAC20-780-240-E

“Based on a review of seven staff records and interview, the center did not ensure two staff completed orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, within 30 days of the first day of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, and the record of Staff #2, employed on 03/14/22, did not contain documentation that the staff completed first and CPR orientation within 30 days of employment. 2) During interview, a member of management reported the center did not have additional documentation that the staff completed additional orientation in first aid and CPR within the required timeframe.”

8VAC20-780-240-C

“Based on a review of records and interview, the center did not ensure that orientation training included all the required topics. Evidence: 1) The record of Staff #2, employed 03/14/22, had documentation of an orientation training that did not include the topics on the prevention of sudden infant death syndrome and use of safe sleep practices; prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children; and prevention of and response to emergencies due to food and other allergic reactions. 2) During interview, a member of management reported the center did not have additional documentation that the staff received orientation on those topics.”

8VAC20-780-240-A

“Based on a review of seven staff records and interview, the center did not ensure four staff completed the Virginia Department of Education-sponsored (VDOE) orientation course within 90 calendar days of employment. Evidence: 1) The record of Staff #1, employed on 12/26/22, did not contain documentation that the staff completed the VDOE orientation course. 2) The record of Staff #2, employed on 03/14/22, did not contain documentation that the staff completed the VDOE orientation course. 3) The record of Staff #3, employed on 01/19/23, did not contain documentation that the staff completed the VDOE orientation course. 4) The record of Staff #4, employed on 05/16/22, did not contain documentation that the staff completed the VDOE orientation course. 5) During interview, a member of management reported the VDOE orientation course for the staff could not be located.”

8VAC20-780-70

“Based on a review of seven staff records and interview, the center did not ensure four staff records contained the required information. Evidence: 1) The records of Staff #4 (DOE: 05/16/22), Staff #5 (DOE: 03/08/23), Staff #6 (DOE: 05/15/23), and Staff #7 (DOE: 05/10/23) could not be located. 2) During interview, a member of management reported the staff records could not be located. The following information was missing for each staff record: address, verification of age requirement, job title; name, address, and telephone number of a person to be notified in an emergency; documentation that two or more references as to character and reputation as well as competency were checked before employment or volunteering; documentation to demonstrate that the individual possesses the education, certification, and experience required by the job position, and orientation and training as required in 8VAC20-780-240 and 8VAC20-780-245; and information about any health problems that may interfere with fulfilling the job responsibilities.”

8VAC20-780-550-P

“Based on a review of documentation, the center did not ensure that written injury records contained the required information. Evidence: Three out of four injury records reviewed did not contain documentation of the date and time the parents were notified of the injuries. The center should maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include the following: date and time of injury; name of injured child; type and circumstance of the injury; staff present and treatment; date and time when parents were notified; any future action to prevent reoccurrence of the injury; staff and parent signatures or two staff signatures; and documentation on how parent was notified.”

8VAC20-780-60-A-7

“Based on record review, the center did not ensure to obtain documentation of a written allergy care plan for each child with a diagnosed food allergy. Evidence: 1. The record of child # 1 (enrollment date: 7/1/2019) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 2. The record of child # 2 (enrollment date: 4/6/2020) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 3. The record of child # 3 (enrollment date: 5/30/2022) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 4. The record of child # 5 (enrollment date: 6/6/2022) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 5. The record of child # 6 (enrollment date: 2/8/2021) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy.”

8VAC20-780-240-C

“Based on record review, the center did not ensure that the orientation training included all required topics. Evidence: 1. The record of staff #1 (employment date: 11/14/2022) had documentation of an orientation training that did not include all of the required topics. 2. The record of staff #2 (employment date: 8/1/2022) had documentation of an orientation training that did not include all of the required topics. 3. The record of staff #4 (employment date: 5/9/2022) had documentation of an orientation training that did not include all of the required topics. 4. The record of staff #5 (employment date: 4/11/2022) had documentation of an orientation training that did not include all of the required topics.”

8VAC20-780-580-B

“Based on record review, the center did not ensure to maintain all required emergency information documentation as specified in 8VAC20-780-550-I and K. Evidence: Bus #3 did not have documentation of the following: 911 or local dial number for police, fire and emergency medical services, the number of the regional poison control, potential shelters, hospitals, evacuation routes that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools.”

8VAC20-780-330-B

“Based on observation, the center did not ensure that where play equipment is provided, resilient surfacing complied with minimum safety standards described in the American Society for Testing and Materials. Evidence: 1. The slides located on the center's toddler playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least six inches of resilient surfacing throughout the fall zone. The center had about 2-4 inches of wooden mulch and decomposed mulch/dirt in the fall zone. 2. The yellow slide located on the center's school age playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least nine inches of resilient surfacing throughout the fall zone. The center had about 5-6 inches of wooden mulch and decomposed mulch/dirt in the fall zone.”

8VAC20-780-510-B

“Based on observation and record review, the center did not ensure to obtain written parent permission for prescription medication given to a child. Evidence: The record of child number seven (enrollment date: 9/20/2021) did not have documentation of written parent permission to administer medication. The center’s medication log indicated that the child was given the medication on several occasions.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, save and operable condition. Evidence: 1. There was a water hose several feet long, sitting on the playground outside of the three year old classroom presenting an entanglement and tripping hazard. 2. The following playground structures and equipment had several rusted areas within the reach of children in care: playground fence, rake, stationary car, swing chains and seat connectors. 3. Four of the five plastic seats on the red merry-go-cycle were cracked in several places presenting a pinching hazard. 4. There was a rake laying on the ground near the backdoor of the three’s classroom presenting a tripping hazard. 5. There were two corn-hole games located on the playground with chipped paint and splintering wood within the reach of children in care. 6. There were two vinyl mats located on the playground, under the mats was several areas with mold growing on the ground. 7. Several ceiling tiles throughout the center had layers of dust built up around the vents and the wall vent located in the three and four year old classroom had several layers of dust which could affect air quality in the classrooms.”

8VAC20-780-500-A

“Based on observation, the center did not ensure staff wash their hands with soap and running water before and after a diaper change. Evidence: 1. Infant teacher #1 did not wash their hands before diapering a child. Additionally, the infant teacher stated that they do not normally wash their hands before diapering. 2. Infant teacher #2 stated that they do not regularly wash their hands before diapering.”

8VAC20-770-60-C-2

“Based on record review, the provider did not ensure four of six staff records had documentation of central registry results within 30 days of employment. Evidence: 1. The record of staff #2 (employment date: 8/1/22) did not have documentation of central registry results. 2. The record of staff #4 (employment date: 5/9/22) did not have documentation of central registry results. 3. The record of staff #5 (employment date: 4/11/22) had documentation of central registry results dated 6/17/22. 4. The record of staff #6 (employment date: 8/20/19) had documentation of central registry results dated 9/30/2019.”

8VAC20-780-160-A

“Based on record review, the center did not ensure four of six staff records contained documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children. Evidence: 1. The record of staff #1 (employment date: 11/14/22) did not have documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children. 2. The record of staff #2 (employment date: 8/1/22) did not have documentation of tuberculosis screening at the time of employment and prior to coming in contact with children. 3. The record of staff #4 (employment date: 5/9/22) had documentation of a negative tuberculosis screening dated 9/15/2022. 4. The record of staff #5 (employment date: 4/11/22) had documentation of a negative tuberculosis screening dated 6/8/2022.”

8VAC20-780-60-A-7

“Based on record review, the center did not ensure to obtain documentation of a written allergy care plan for each child with a diagnosed food allergy. Evidence: 1. The record of child # 1 (enrollment date: 7/1/2019) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 2. The record of child # 2 (enrollment date: 4/6/2020) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 3. The record of child # 3 (enrollment date: 5/30/2022) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 4. The record of child # 5 (enrollment date: 6/6/2022) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy. 5. The record of child # 6 (enrollment date: 2/8/2021) did not have documentation of a written allergy care plan. The child’s record and the center’s allergy list both indicated that the child had a diagnosed food allergy.”

8VAC20-780-240-C

“Based on record review, the center did not ensure that the orientation training included all required topics. Evidence: 1. The record of staff #1 (employment date: 11/14/2022) had documentation of an orientation training that did not include all of the required topics. 2. The record of staff #2 (employment date: 8/1/2022) had documentation of an orientation training that did not include all of the required topics. 3. The record of staff #4 (employment date: 5/9/2022) had documentation of an orientation training that did not include all of the required topics. 4. The record of staff #5 (employment date: 4/11/2022) had documentation of an orientation training that did not include all of the required topics.”

8VAC20-780-580-B

“Based on record review, the center did not ensure to maintain all required emergency information documentation as specified in 8VAC20-780-550-I and K. Evidence: Bus #3 did not have documentation of the following: 911 or local dial number for police, fire and emergency medical services, the number of the regional poison control, potential shelters, hospitals, evacuation routes that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools.”

8VAC20-780-330-B

“Based on observation, the center did not ensure that where play equipment is provided, resilient surfacing complied with minimum safety standards described in the American Society for Testing and Materials. Evidence: 1. The slides located on the center's toddler playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least six inches of resilient surfacing throughout the fall zone. The center had about 2-4 inches of wooden mulch and decomposed mulch/dirt in the fall zone. 2. The yellow slide located on the center's school age playground did not have enough resilient surfacing throughout the entire fall zone. There must be at least nine inches of resilient surfacing throughout the fall zone. The center had about 5-6 inches of wooden mulch and decomposed mulch/dirt in the fall zone.”

8VAC20-780-510-B

“Based on observation and record review, the center did not ensure to obtain written parent permission for prescription medication given to a child. Evidence: The record of child number seven (enrollment date: 9/20/2021) did not have documentation of written parent permission to administer medication. The center’s medication log indicated that the child was given the medication on several occasions.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, save and operable condition. Evidence: 1. There was a water hose several feet long, sitting on the playground outside of the three year old classroom presenting an entanglement and tripping hazard. 2. The following playground structures and equipment had several rusted areas within the reach of children in care: playground fence, rake, stationary car, swing chains and seat connectors. 3. Four of the five plastic seats on the red merry-go-cycle were cracked in several places presenting a pinching hazard. 4. There was a rake laying on the ground near the backdoor of the three’s classroom presenting a tripping hazard. 5. There were two corn-hole games located on the playground with chipped paint and splintering wood within the reach of children in care. 6. There were two vinyl mats located on the playground, under the mats was several areas with mold growing on the ground. 7. Several ceiling tiles throughout the center had layers of dust built up around the vents and the wall vent located in the three and four year old classroom had several layers of dust which could affect air quality in the classrooms.”

8VAC20-780-500-A

“Based on observation, the center did not ensure staff wash their hands with soap and running water before and after a diaper change. Evidence: 1. Infant teacher #1 did not wash their hands before diapering a child. Additionally, the infant teacher stated that they do not normally wash their hands before diapering. 2. Infant teacher #2 stated that they do not regularly wash their hands before diapering.”

8VAC20-770-60-C-2

“Based on record review, the provider did not ensure four of six staff records had documentation of central registry results within 30 days of employment. Evidence: 1. The record of staff #2 (employment date: 8/1/22) did not have documentation of central registry results. 2. The record of staff #4 (employment date: 5/9/22) did not have documentation of central registry results. 3. The record of staff #5 (employment date: 4/11/22) had documentation of central registry results dated 6/17/22. 4. The record of staff #6 (employment date: 8/20/19) had documentation of central registry results dated 9/30/2019.”

8VAC20-780-160-A

“Based on record review, the center did not ensure four of six staff records contained documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children. Evidence: 1. The record of staff #1 (employment date: 11/14/22) did not have documentation of a negative tuberculosis screening at the time of employment and prior to coming in contact with children. 2. The record of staff #2 (employment date: 8/1/22) did not have documentation of tuberculosis screening at the time of employment and prior to coming in contact with children. 3. The record of staff #4 (employment date: 5/9/22) had documentation of a negative tuberculosis screening dated 9/15/2022. 4. The record of staff #5 (employment date: 4/11/22) had documentation of a negative tuberculosis screening dated 6/8/2022.”

22.1-289.035-B-4 Complaint related: No

“Based on record review, the center did not ensure one of four staff records contained documentation of criminal history record results, sex offender registry check results and a child abuse and neglect search request from any state in which the individual has resided in the past five years. Evidence: 1. The record of staff #2 (start date: 5/3/2021) did not have documentation of criminal history record results, sex offender registry check results from any state in which the individual has resided in the past five years. 2. The record of staff #3 (start date: 7/13/2020) did not have documentation of criminal history record results, sex offender registry check results and a child abuse and neglect search request follow up from any state in which the individual has resided in the past five years. 3. The Sworn Statement or Affirmation for staff #2 and staff #3 indicated that each staff has lived in one other state within the past five years.”

8VAC20-780-350-B

“Based on observation, the center did not ensure to comply with the ratio requirements for toddler children ages 16 months to 24 months. Evidence: During the inspection, the toddler classroom had 9 children present and 1 staff supervising.”

8VAC20-780-160-A-1

“Based on record review, the center did not ensure two of three staff records had documentation of a negative tuberculosis screening submitted at the time of employment and prior to coming into contact with children. Evidence: 1. The record of staff #1 (start date: 1/10/2022) had documentation of a negative tuberculosis screening dated 2/2/2022. 2. The record of staff #3 (start date: 12/30/2019) did not have documentation of a negative tuberculosis screening.”

8VAC20-770-60-C-2

“Based on record review, the center did not ensure three of three staff records contained documentation of central registry findings within 30 days of employment. Evidence: 1. The record of staff #1 (start date: 1/10/22) did not have documentation of central registry finding. 2. The record of staff #2 (start date: 10/13/21) had documentation of central registry findings dated 12/18/21. 3. The record of staff #3 (start date: 12/30/19) had documentation of central registry findings dated 2/4/20.”

22.1-289.058

“Based on observation, the center did not ensure that the building was equipped with at least one carbon monoxide detector. Evidence: The center was not equipped with at least one carbon monoxide detector.”

8VAC20-780-70

“Based on record review, the center did not ensure one of three staff records had documentation to demonstrate that the individual possesses the education and experience required by the job description. Evidence: The record of staff #2 (start date: 10/13/21) did not have documentation of the staff's education and experience as required for a program leader. The center representative stated that staff #2 is a program leader and is alone with assigned children throughout the day.”

8VAC20-780-350-B

“Based on observation, the center did not ensure to comply with the ratio requirements for toddler children ages 16 months to 24 months. Evidence: During the inspection, the toddler classroom had 9 children present and 1 staff supervising.”

8VAC20-780-160-A-1

“Based on record review, the center did not ensure two of three staff records had documentation of a negative tuberculosis screening submitted at the time of employment and prior to coming into contact with children. Evidence: 1. The record of staff #1 (start date: 1/10/2022) had documentation of a negative tuberculosis screening dated 2/2/2022. 2. The record of staff #3 (start date: 12/30/2019) did not have documentation of a negative tuberculosis screening.”

8VAC20-770-60-C-2

“Based on record review, the center did not ensure three of three staff records contained documentation of central registry findings within 30 days of employment. Evidence: 1. The record of staff #1 (start date: 1/10/22) did not have documentation of central registry finding. 2. The record of staff #2 (start date: 10/13/21) had documentation of central registry findings dated 12/18/21. 3. The record of staff #3 (start date: 12/30/19) had documentation of central registry findings dated 2/4/20.”

22.1-289.058

“Based on observation, the center did not ensure that the building was equipped with at least one carbon monoxide detector. Evidence: The center was not equipped with at least one carbon monoxide detector.”

8VAC20-780-70

“Based on record review, the center did not ensure one of three staff records had documentation to demonstrate that the individual possesses the education and experience required by the job description. Evidence: The record of staff #2 (start date: 10/13/21) did not have documentation of the staff's education and experience as required for a program leader. The center representative stated that staff #2 is a program leader and is alone with assigned children throughout the day.”

8VAC20-790-600-D-1

“Based on record review, the center did not ensure one of four staff records contained documentation of current certification in CPR within 90 days of the date of employment. Evidence: 1. The record of staff #2 (start date: 7/13/2021) did not have documentation of current certification in CPR. 2. The record of staff #3 (start date: 10/19/2021) had documentation of certification in CPR dated 2/15/2021.”

8VAC20-790-600-D-2

“Based on record review, the center did not ensure one of four staff records contained documentation of current certification in first aid within 90 days of the date of employment. Evidence: 1. The record of staff #2 (start date: 7/13/2021) did not have documentation of current certification in first aid. 2. The record of staff #3 (start date: 10/19/2021) had documentation of certification in first aid dated 2/15/2021.”

22.1-289-036-B-4

“Based on record review, the applicant did not ensure that the applicant’s record contained documentation of criminal history record results and sex offender registry check results from any state in which the individual has resided in the past five years. Evidence: 1. The record of the applicant did not have documentation of criminal history record results and sex offender registry check results from any state in which the individual has resided in the past five years. 2. The applicant’s record indicates that the applicant has lived in one other state within the past five years.”

8VAC20-780-350-B

“Based on observation, the center did not ensure to maintain the required 1:4 staff-to-children ratio in the infant classroom and the required 1:5 staff-to-children ratio in the toddler classroom. Evidence: 1. There was 1 teacher supervising 5 younger infant children in the Fish classroom. 2. There was 1 teacher supervising 5 older infant children in the Turtles classroom. 3. There were 2 teachers supervising 12 toddler children in the Bunnies classroom. 4. The center representative stated that the center was operating under a ratio waiver that allowed an additional child per teacher. However, the center failed to properly apply for the waiver or provide proof that parents were notified.”

8VAC20-790-600-D-1

“Based on record review, the center did not ensure one of four staff records contained documentation of current certification in CPR within 90 days of the date of employment. Evidence: 1. The record of staff #2 (start date: 7/13/2021) did not have documentation of current certification in CPR. 2. The record of staff #3 (start date: 10/19/2021) had documentation of certification in CPR dated 2/15/2021.”

8VAC20-790-600-D-2

“Based on record review, the center did not ensure one of four staff records contained documentation of current certification in first aid within 90 days of the date of employment. Evidence: 1. The record of staff #2 (start date: 7/13/2021) did not have documentation of current certification in first aid. 2. The record of staff #3 (start date: 10/19/2021) had documentation of certification in first aid dated 2/15/2021.”

22.1-289-036-B-4

“Based on record review, the applicant did not ensure that the applicant’s record contained documentation of criminal history record results and sex offender registry check results from any state in which the individual has resided in the past five years. Evidence: 1. The record of the applicant did not have documentation of criminal history record results and sex offender registry check results from any state in which the individual has resided in the past five years. 2. The applicant’s record indicates that the applicant has lived in one other state within the past five years.”

8VAC20-780-350-B

“Based on observation, the center did not ensure to maintain the required 1:4 staff-to-children ratio in the infant classroom and the required 1:5 staff-to-children ratio in the toddler classroom. Evidence: 1. There was 1 teacher supervising 5 younger infant children in the Fish classroom. 2. There was 1 teacher supervising 5 older infant children in the Turtles classroom. 3. There were 2 teachers supervising 12 toddler children in the Bunnies classroom. 4. The center representative stated that the center was operating under a ratio waiver that allowed an additional child per teacher. However, the center failed to properly apply for the waiver or provide proof that parents were notified.”

22VAC40-185-400-B Complaint related: Yes

“Based on interviews and review of video footage, the facility did not ensure behavioral guidance was constructive in nature and age and stage appropriate. Evidence: 1. Video footage of the Ladybug classroom revealed that around 10:50am to 11:05am on 9/1/21, child #1 (Age: 3 years) was visibly crying and upset. While child #1 was near the classroom’s restroom, Staff #1 seemed to try to console and redirect child #1 from the restroom area to the reading corner. The child continued to cry and resist staff #1?s redirection attempts. Child #1 stopped walking and began to push back against staff #1 who was in turn pushing forward against the child while holding the upper area of both arms of the child. While continuing to hold the child’s upper arms staff #1 picked the child up off of the ground and carried the child about 2-3 feet onto the carpet in the reading area of the classroom. The child landed on their feet and immediately dropped to the floor. 2. The Child Protective Services Representative, assigned to the case, informed the inspector that child #1 was taken to get the child’s upper arm medically evaluated. It was determined that the marks on child #1?s arm were from another person grabbing the child. 3. This use of behavioral guidance in the above described incident does not meet the requirements of being constructive in nature, age and stage appropriate, nor being used to redirect the child to appropriate behavior.”