Resurrection Lutheran School

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

“The center is required to maintain areas and equipment of the center, inside and outside, in a clean, safe and operable condition. The portable handwashing sink located in Infant A was not working at all at the time of the inspection. Licensee states that for about 1 ? weeks the faucet had a fluctuating flow and that it has been completely inoperable since the previous Thursday or Friday (6/26 or 6/27/2025). The portable handwashing sink located in the Toddler classroom was not working at all at the time of the inspection. Licensee states that for about 1 ? weeks the faucet had a fluctuating flow and that it has been completely inoperable since the previous Thursday or Friday (6/26 or 6/27/2025). The portable sink in "TT's" - produced only a very thin, steady, trickle of water all at the time of the inspection.”

22.1-289.035-B-4 Complaint related: Yes

“The center is required to request an Out of State Child Abuse and Neglect Search prior to employment for any staff who has resided outside of Virginia within the last five years. Staff # 1, who resided outside of Virginia within 5 years of hire, had no documentation available to demonstrate that an out-of-state search of the abuse and neglect registry was requested. Staff #1 was employed and caring for children for over 4 months without results of an out-of-state child abuse and neglect search.”

8VAC20-780-550-E

“Shelter in place procedures shall be practiced a minimum of twice per year. Only one Shelter in Place Drill was conducted in the previous 12 month period.”

8VAC20-770-70-A

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. There were no completed references for Staff #2, #3, #5, #7, #8, #9, & #10.”

22.1-289.035-B-4 Complaint related: Yes

“The center is required to request an Out of State Child Abuse and Neglect Search prior to employment for any staff who has resided outside of Virginia within the last five years. Staff # 1, who resided outside of Virginia within 5 years of hire, had no documentation available to demonstrate that an out-of-state search of the abuse and neglect registry was requested. Staff #1 was employed and caring for children for over 4 months without results of an out-of-state child abuse and neglect search.”

8VAC20-780-550-E

“Shelter in place procedures shall be practiced a minimum of twice per year. Only one Shelter in Place Drill was conducted in the previous 12 month period.”

8VAC20-770-70-A

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. There were no completed references for Staff #2, #3, #5, #7, #8, #9, & #10.”

22.1-289.035-B-4 Complaint related: Yes

“The center is required to request an Out of State Child Abuse and Neglect Search prior to employment for any staff who has resided outside of Virginia within the last five years. Staff # 1, who resided outside of Virginia within 5 years of hire, had no documentation available to demonstrate that an out-of-state search of the abuse and neglect registry was requested. Staff #1 was employed and caring for children for over 4 months without results of an out-of-state child abuse and neglect search.”

8VAC20-780-550-E

“Shelter in place procedures shall be practiced a minimum of twice per year. Only one Shelter in Place Drill was conducted in the previous 12 month period.”

8VAC20-770-70-A

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. There were no completed references for Staff #2, #3, #5, #7, #8, #9, & #10.”

22.1-289.035-B-4 Complaint related: Yes

“The center is required to request an Out of State Child Abuse and Neglect Search prior to employment for any staff who has resided outside of Virginia within the last five years. Staff # 1, who resided outside of Virginia within 5 years of hire, had no documentation available to demonstrate that an out-of-state search of the abuse and neglect registry was requested. Staff #1 was employed and caring for children for over 4 months without results of an out-of-state child abuse and neglect search.”

8VAC20-780-550-E

“Shelter in place procedures shall be practiced a minimum of twice per year. Only one Shelter in Place Drill was conducted in the previous 12 month period.”

8VAC20-770-70-A

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. There were no completed references for Staff #2, #3, #5, #7, #8, #9, & #10.”

8VAC20-790-600-F

“Staff who work directly with children shall, annually attend the department's health and safety update course. Staff #4, who is working with children, has not completed this course which is overdue by 4 months. Staff #6, who is working with children, has not completed this course which is overdue by 4over 7 months. Staff #8, who is working with children, has not completed this course which is overdue by 3 months.”

8VAC20-780-240-A

“Staff are to complete the VDOE sponsored online orientation course within 90 days of hire. Staff #7, who is working with children, has not yet completed this course which is overdue by more than 1 month.”

8VAC20-780-70

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. . If a reference check is taken over the phone, documentation shall include: dates of contact, names of persons contacted, firms contacted, results; and signature of person making call. Staff #7, who has been actively working at the center for the past 2 months, did not have complete reference verifications on file. The documentation sent to the inspector following the inspection did not include the dates that the references were checked and the signature of the person taking the reference.”

8VAC20-780-160-A

“The center is required to obtain documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children. Staff #7 is currently working, had no documentation of a TB Screening and had been employed for over two months.”

8VAC20-780-240-B

“Staff are to complete a center-specific orientation appropriate to the age of children in care prior to working with children and no later than 7 days from the date of assuming job responsibilities. Reference checks taken over the phone, documentation shall include: Dates of contact, Names of persons contacted The firms contacted, Results; and Signature of person making call. Staff #7, who is working with children, did not have documentation in her record to demonstrate completion of the orientation training which is which is overdue by 2 months. Orientation documentation which was sent following the inspection did not contain the dates of contact or the signature of the person making the call.”

8VAC20-790-600-F

“Staff who work directly with children shall, annually attend the department's health and safety update course. Staff #4, who is working with children, has not completed this course which is overdue by 4 months. Staff #6, who is working with children, has not completed this course which is overdue by 4over 7 months. Staff #8, who is working with children, has not completed this course which is overdue by 3 months.”

8VAC20-780-240-A

“Staff are to complete the VDOE sponsored online orientation course within 90 days of hire. Staff #7, who is working with children, has not yet completed this course which is overdue by more than 1 month.”

8VAC20-780-70

“Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment. . If a reference check is taken over the phone, documentation shall include: dates of contact, names of persons contacted, firms contacted, results; and signature of person making call. Staff #7, who has been actively working at the center for the past 2 months, did not have complete reference verifications on file. The documentation sent to the inspector following the inspection did not include the dates that the references were checked and the signature of the person taking the reference.”

8VAC20-780-160-A

“The center is required to obtain documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children. Staff #7 is currently working, had no documentation of a TB Screening and had been employed for over two months.”

8VAC20-780-240-B

“Staff are to complete a center-specific orientation appropriate to the age of children in care prior to working with children and no later than 7 days from the date of assuming job responsibilities. Reference checks taken over the phone, documentation shall include: Dates of contact, Names of persons contacted The firms contacted, Results; and Signature of person making call. Staff #7, who is working with children, did not have documentation in her record to demonstrate completion of the orientation training which is which is overdue by 2 months. Orientation documentation which was sent following the inspection did not contain the dates of contact or the signature of the person making the call.”

8VAC20-780-150-B

“Based on record review and provider interview, the licensee did not ensure the physical examination and dates of immunizations shall include the signature of a physician, his designee, or an official of a local health department Evidence: The immunization and physical for Child #7 did not include a physicians or designated individual’s signature.”

8VAC20-780-550-E

“Based on staff interviews and review of documentation, the licensee did not ensure to practice a minimum of twice a year a shelter in place procedure. Evidence: Center Director confirmed they did not have documentation of two shelter in place drills in 2023”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure diapering requirements were followed. Evidence: In room C109 The diaper pad had a tear and was no longer nonabsorbent”

8VAC20-780-40-M

“Based on observation and staff interviews, the licensee did not ensure the center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. Evidence: Child #3, has a diagnosed food allergy (nuts) and was observed in room C108 and there was not an allergy list available for review in the room.”

8VAC20-780-60-A

“Based on review of children’s records and staff interviews, the licensee did not ensure to maintain and keep at the center a separate record for each child enrolled which contained the required information. Evidence: The following information is missing from 5 out of 8 of the records reviewed. 1.Child #2 did not have the home address for the 2 required emergency contacts listed. 2. Child #4 did not have the home zip code for 1 of the required emergency contacts listed, information related to any programs/schools the child concurrently attends or information related to persons who are authorized pick up the child from the center 3.Child #6 and Child #8 did not have the parent’s employment phone number or information related to persons who are authorized pick up the children from the center.”

8VAC20-780-270-A

“Based on observation and staff interviews, the licensee did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: The following equipment was observed and determined to inadequately meet safety standards. 1.In room B106, there was peeling wallpaper accessible to children 2.In room D104 there is a sink countertop that is not attached to the sink cabinet. The countertop moves when touched and could be a tipping hazard. The countertop is also is a pinch point as there is space between the countertop and where it should be attached to the cabinet. 3 The playground composite piece has a platform with steps and there is a plastic mat on the platform; the plastic mat is peeling away from the platform and is a tripping hazard. 4.On the playground there is a plastic caterpillar that has broken sharp edges/ points. 5.On the toddler playground there water drain/ grate in the ground with a hole that was a tripping hazard.”

8VAC20-780-330-B

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: On the playground the following inadequate resilient surfacing and fall zones were observed. 1. The large composite piece with a slide that did not have measurable resilient surfacing at the base of the slide chute as there was a visible tree root and no resilient surfacing covering the root. 2. There was a grey climbing tower and there is only only 4 `8? of fall zone and a minimum of 6 feet is required.”

8VAC20-780-280-B

“Repeat Violation Based on observation, the licensee did not ensure hazardous substances and other harmful agents such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In the pantry across from the room #106, (pre-k 3), there was an unlocked closet and, on the floor, there were containers of detergent /cleaner. The containers were observed stored in an unlocked manner and were accessible to children. The hazardous chemicals were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning".”

8VAC20-780-160-A

“Based on record review and staff interviews, the licensee did not ensure each staff member shall submit documentation of a negative tuberculosis screening (TB) prior to employment. Evidence: Staff #5?s TB screening was dated 2-12-2023 and first day of employment was 1-16-2024.”

8VAC20-780-150-B

“Based on record review and provider interview, the licensee did not ensure the physical examination and dates of immunizations shall include the signature of a physician, his designee, or an official of a local health department Evidence: The immunization and physical for Child #7 did not include a physicians or designated individual’s signature.”

8VAC20-780-550-E

“Based on staff interviews and review of documentation, the licensee did not ensure to practice a minimum of twice a year a shelter in place procedure. Evidence: Center Director confirmed they did not have documentation of two shelter in place drills in 2023”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure diapering requirements were followed. Evidence: In room C109 The diaper pad had a tear and was no longer nonabsorbent”

8VAC20-780-40-M

“Based on observation and staff interviews, the licensee did not ensure the center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. Evidence: Child #3, has a diagnosed food allergy (nuts) and was observed in room C108 and there was not an allergy list available for review in the room.”

8VAC20-780-60-A

“Based on review of children’s records and staff interviews, the licensee did not ensure to maintain and keep at the center a separate record for each child enrolled which contained the required information. Evidence: The following information is missing from 5 out of 8 of the records reviewed. 1.Child #2 did not have the home address for the 2 required emergency contacts listed. 2. Child #4 did not have the home zip code for 1 of the required emergency contacts listed, information related to any programs/schools the child concurrently attends or information related to persons who are authorized pick up the child from the center 3.Child #6 and Child #8 did not have the parent’s employment phone number or information related to persons who are authorized pick up the children from the center.”

8VAC20-780-270-A

“Based on observation and staff interviews, the licensee did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: The following equipment was observed and determined to inadequately meet safety standards. 1.In room B106, there was peeling wallpaper accessible to children 2.In room D104 there is a sink countertop that is not attached to the sink cabinet. The countertop moves when touched and could be a tipping hazard. The countertop is also is a pinch point as there is space between the countertop and where it should be attached to the cabinet. 3 The playground composite piece has a platform with steps and there is a plastic mat on the platform; the plastic mat is peeling away from the platform and is a tripping hazard. 4.On the playground there is a plastic caterpillar that has broken sharp edges/ points. 5.On the toddler playground there water drain/ grate in the ground with a hole that was a tripping hazard.”

8VAC20-780-330-B

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: On the playground the following inadequate resilient surfacing and fall zones were observed. 1. The large composite piece with a slide that did not have measurable resilient surfacing at the base of the slide chute as there was a visible tree root and no resilient surfacing covering the root. 2. There was a grey climbing tower and there is only only 4 `8? of fall zone and a minimum of 6 feet is required.”

8VAC20-780-280-B

“Repeat Violation Based on observation, the licensee did not ensure hazardous substances and other harmful agents such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In the pantry across from the room #106, (pre-k 3), there was an unlocked closet and, on the floor, there were containers of detergent /cleaner. The containers were observed stored in an unlocked manner and were accessible to children. The hazardous chemicals were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning".”

8VAC20-780-160-A

“Based on record review and staff interviews, the licensee did not ensure each staff member shall submit documentation of a negative tuberculosis screening (TB) prior to employment. Evidence: Staff #5?s TB screening was dated 2-12-2023 and first day of employment was 1-16-2024.”

8VAC20-770-60-B

“Based on record review and staff interviews, the licensee did not ensure each staff member had a Sworn Statement completed prior to 1st day of employment. Evidence: Staff #1?s Sworn Statement was dated 12-15-2023 which is after the 1st date of employment on 11-20-2023.”

8VAC20-780-280-B

“Repeat Violation Based on observation, the licensee did not ensure hazardous substances and other harmful agents such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The following items were observed stored in an unlocked manner and were accessible to children. The hazardous chemicals were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning". 1. In the pantry closet across from the room #106, (pre-k 3), there was an unlocked closet and on the floor, there were 10 containers of dish detergent, 4 containers of disinfectant and 2 containers of floor cleaner. 2. In room #106 B, in an unlocked cabinet, 1 container of disinfectant and 2 mops with attached containers of disinfectant/cleaner were sitting in the corners of the room. 3. In room #108 B, in an unlocked cabinet, 2 containers of disinfectant, 2 containers of hand sanitizer were sitting on the counter and 1 container of hand soap near the sink. 4. In room #110 B, in 1 mop with attached containers of disinfectant/cleaner was sitting in the corner of the room. 5. In room #103 D, 1 mop with attached container of disinfectant/cleaner was sitting in the corner of the room, 1 container of hand sanitizer and 1 container of hand soap were near the sink.”

8VAC20-780-530-A

“Based on record review and staff interviews, the licensee did not ensure there was at least one staff in each classroom or area where children are present had obtained a current certification in cardiopulmonary resuscitation (CPR) and First Aid as appropriate to the age of the children in care Evidence: Staff #4 and Staff #19 were the only staff observed supervising 8 infants and Staff #4 and #19 did not have a certification in CPR and First Aid.”

22.1-289.035-B-4

“Repeat Violation Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment for any state where they lived within the last five years from date of hire (DOH). Evidence: Staff #10's record did not include an out of state CPS for North Carolina (DOH 10-30-2023). Staff #17's record did not include an out of state CPS for North Carolina (DOH 7-31-2023). Staff #19?s record did not include an out of state CRC for South Carolina prior to first day of employment (DHO 1-8-2024). South Carolina CRC results were dated 1-9-2024.”

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

“Based on observation and staff interviews, the licensee did not ensure prepared infant formula shall be refrigerated, dated and labeled with the child's name.. Evidence: During the inspection on 11-20-2023, 5 bottles with formula were observed 3 did not include the date.”

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

“Based on observation and staff interviews, the licensee did not ensure the record of each child on formula shall contain the brand of formula and the child's feeding schedule. Evidence: During the inspection on 11-20-2023, 8 infants on formula were observed and their record did not include the brand of formula they were using. This was confirmed by the Center Director.”

8VAC20-780-40-E

“Based on observation, staff interviews and review of center documentation, the licensee did not ensure they followed the operational responsibilities of the licensee to include ensuring that the center's activities, services, and facilities are maintained in compliance with these standards, the center's own policies and procedures that are required by these standards, and the terms of the current license issued by the department. Evidence: The center did not follow their own safe sleep policy/procedure as their policy states that "A firm surface, such as a mattress will be used for infant sleeping. The mattress will fit snugly to the crib and will be covered with a fitted sheet". Two infants observed each sleeping in a crib and their sheets were not fitted to the mattress and had come loose and were bunched up under and around the infants in the crib. wer not fitted to the materess s chidlnre wer observed sleeping in cribs Teh.the lic yrelatedto safe sleep practicves as theyir poicy”

8VAC20-780-500-B

“Repeat Violation Based on observation and staff interviews, the licensee did not ensure the diapering area had all required items and staff followed diapering procedures for handwashing. Evidence: Staff #1 was observed conducting diaper change for a two year old in the fellowship hall and the diaper pad was not sanitized as required. Staff #1 completed their diaper change, they spayed the diaper pad with a sanitizing solution and then immediately wiped down the diaper pad. The diaper pad was not sanitized as it was not allowed to air dry or be wiped down only after 2 minutes.”

8VAC20-780-280-B

“Based on observation and staff interviews, the licensee did not ensure hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In the following areas hazardous chemicals were observed, and they were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning" 1.In the Infant 2 room, #109, there was an unlocked cabinet with containers of air freshener, hand sanitizers and disinfectant spray. 2.In the hallway near the fellowship hall and the children restroom, the pantry door was open and the floor there were gallon jugs of cleaner 3. The centers kitchen window/ counter was open and accessible to children as it was directly across from the two year old’s diapering station and there were spray bottles with disinfectant and fresher sitting on the counter.”

8VAC20-780-40-E

“Based on observation, staff interviews and review of center documentation, the licensee did not ensure they followed the operational responsibilities of the licensee to include ensuring that the center's activities, services, and facilities are maintained in compliance with these standards, the center's own policies and procedures that are required by these standards, and the terms of the current license issued by the department. Evidence: The center did not follow their own safe sleep policy/procedure as their policy states that "A firm surface, such as a mattress will be used for infant sleeping. The mattress will fit snugly to the crib and will be covered with a fitted sheet". Two infants observed each sleeping in a crib and their sheets were not fitted to the mattress and had come loose and were bunched up under and around the infants in the crib. wer not fitted to the materess s chidlnre wer observed sleeping in cribs Teh.the lic yrelatedto safe sleep practicves as theyir poicy”

8VAC20-780-500-B

“Repeat Violation Based on observation and staff interviews, the licensee did not ensure the diapering area had all required items and staff followed diapering procedures for handwashing. Evidence: Staff #1 was observed conducting diaper change for a two year old in the fellowship hall and the diaper pad was not sanitized as required. Staff #1 completed their diaper change, they spayed the diaper pad with a sanitizing solution and then immediately wiped down the diaper pad. The diaper pad was not sanitized as it was not allowed to air dry or be wiped down only after 2 minutes.”

8VAC20-780-280-B

“Based on observation and staff interviews, the licensee did not ensure hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: In the following areas hazardous chemicals were observed, and they were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning" 1.In the Infant 2 room, #109, there was an unlocked cabinet with containers of air freshener, hand sanitizers and disinfectant spray. 2.In the hallway near the fellowship hall and the children restroom, the pantry door was open and the floor there were gallon jugs of cleaner 3. The centers kitchen window/ counter was open and accessible to children as it was directly across from the two year old’s diapering station and there were spray bottles with disinfectant and fresher sitting on the counter.”

8VAC20-780-70

“Repeat Based on record review and staff interviews, the licensee did not ensure staff records contained all required documentation. Evidence: 1.There were no references available for review for Staff #1, Staff #4, Staff #5, and Staff #6. 2.The references for Staff #2 and Staff #7 did not include the signature of the person conducting the reference check. 3.There was not documentation to demonstrate Staff #1 and Staff #2, designated program leads have the experience required for the position”

8VAC20-780-40-M

“Based on observation and staff interviews, the licensee did not ensure the center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. Evidence: Child #4 has an allergy to a medication (amoxicillin), and it was not listed on the allergy list.”

8VAC20-780-520-A

“Based on observation the licensee did not ensure that all nonprescription drugs and over-the- counter skin products shall be used in accordance with the manufacturer's recommendations. Nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Evidence: In the toddler room, 2 out of 5 of diaper creams observed had expired, (Desitin expired 6-2023 and Boudreaux Butt Paste expired 4-2023).”

22.1-289.035-B-4

“Repeat Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment for any state where they lived within the last five years from date of hire. (DOH) Evidence: 1.Staff #3's record did not include an out of state CRC for Alaska (DOH 9-1-2023). 2.Staff #15?s record did not include an out of state CRC for Pennsylvania (DOH 9-18-23) . 3.Staff #6 record did not include and out of State CRC and CPS for South Carolina (DOH 7-3-2023).”

8VAC20-780-70

“Repeat Based on record review and staff interviews, the licensee did not ensure staff records contained all required documentation. Evidence: 1.There were no references available for review for Staff #1, Staff #4, Staff #5, and Staff #6. 2.The references for Staff #2 and Staff #7 did not include the signature of the person conducting the reference check. 3.There was not documentation to demonstrate Staff #1 and Staff #2, designated program leads have the experience required for the position”

8VAC20-780-40-M

“Based on observation and staff interviews, the licensee did not ensure the center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. Evidence: Child #4 has an allergy to a medication (amoxicillin), and it was not listed on the allergy list.”

8VAC20-780-520-A

“Based on observation the licensee did not ensure that all nonprescription drugs and over-the- counter skin products shall be used in accordance with the manufacturer's recommendations. Nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Evidence: In the toddler room, 2 out of 5 of diaper creams observed had expired, (Desitin expired 6-2023 and Boudreaux Butt Paste expired 4-2023).”

22.1-289.035-B-4

“Repeat Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment for any state where they lived within the last five years from date of hire. (DOH) Evidence: 1.Staff #3's record did not include an out of state CRC for Alaska (DOH 9-1-2023). 2.Staff #15?s record did not include an out of state CRC for Pennsylvania (DOH 9-18-23) . 3.Staff #6 record did not include and out of State CRC and CPS for South Carolina (DOH 7-3-2023).”

8VAC20-780-350-B-4 Complaint related: Yes

“Based on observation, staff interviews and documentation review, the licensee did not ensure to follow the required ratio of 1 staff for every 10 children ages 3 years old up to school age eligible. Evidence: On 10-2-2023 at approximately 5:05 PM, in the fellowship hall 12 children ages 3 and 4 were observed with only 1 staff (Staff #3), this exceeds the required ratio of 1:10.”

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

“Basse on observation, staff interviews and documentation review, the licensee did not ensure to follow the required ratio of 1 staff for every 4 infants in care. Evidence: On 10-2-2023 at approximately 5:05 PM, in the fellowship hall 9 children age range 14 months (Child #1) to age 2 were observed with only 2 staff (Staff #1 and Staff #2), this exceeds the required ratio of 1:4.”

8VAC20-780-510-P Complaint related: Yes

“Based on review of documentation and staff interviews, the licensee did not ensure when an authorization for medication expires, the parent shall be notified the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet. Evidence: Child #1 has a medication (acetaminophen) and with an expired authorization. The medication was required to be disposed or returned by 7-29-2023.”

8VAC20-780-340-F Complaint related: Yes

“Based on interviews and documentation review, the licensee did not ensure all children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: Center Staff and video recording of June 28, 2023 confirmed during a fire evacuation drill on June 28, 2023, at approximately 8:23 AM, an infant, Child #5 was left in the Infant Room without supervision of center staff for approximately less than 1 minute. Center staff confirmed 2 staff had evacuated the infant room with 6 infants and then realized they had left Child #5 asleep in a bouncer seat.”

8VAC20-780-410-1 Complaint related: No

“Repeat Violation Based on video recording observation and staff interviews, staff engaged in forbidden action. Evidence: Video recording of June 28, 2023, in the Toddler Room, showed at approximately 11:37 AM, Staff #2 picked up Child # 4, (15 months old) by his upper right arm (between his shoulder and his elbow) and moved him from one cot to another cot. Child #4?s feet were not touching the ground when Staff #2 moved him by his arm.”

8VAC20-780-570-B Complaint related: Yes

“Based on video recording and staff interviews, the licensee did not ensure that bottles shall not be used while the child is in his designated sleeping location. Evidence: Video recording from June 28, 2023, in the Transitional Toddler Room, shows the following children are put in their cribs during their designated rest period with sippy cups or bottles 1.Child #1 and Child #2 had a sippy cup with milk 2.Child #3 had a bottle with milk Staff #1 confirmed Child #1, Child #2 and Child #3 were given sippy cups/ bottles with milk while they were in their cribs.”

8VAC20-780-500-B Complaint related: No

“Repeat Violation Systemic Violation Based on video recording observation and staff interviews, staff did not ensure requirements for diapering were followed Evidence: Video recording of June 28, 2023, in the Toddler room, showed the following, 1.Staff #2 conducted a diaper change for Child #6 and for Child #7 and did not clean the diaper pad with soap and at least room temperature water and sanitized after each use. 2.Staff #2 conducted a diaper change for Child #7 and she lifted the trashcan lid with her hand and disposed of the soiled diaper. Staff #2 failed to dispose of the soiled diaper in a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal.”

8VAC20-780-410-1 Complaint related: Yes

“Based on video recording observation and staff interviews, staff engaged in forbidden action. Evidence: Video recording of June 28, 2023, in the Toddler Room, showed Staff #3 engaged in forbidden action by restricting movement through binding or tying. Staff #3 was observed covering children’s entire bodies with their top blanket then tucking the blanket underneath the supporting legs of the cot. Staff #3 said this is ?to keep them from getting up because they wander around to the other kids?. The video showed the entire bodies, to include the heads of Child #6, (15 months) and Child #2, (19 months) were covered with a blanket.”

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

“Repeat Systemic Based on observation, video recording and staff interviews, the licensee did not ensure staff and children shall wash their hands with soap and running water when required. Evidence: Staff and children did not wash their hands with soap and running water as required before and after a diaper change; after any contact with body fluids; before feeding or helping children with feeding; and before preparing or serving food or beverages. 1. On June 15, 2023, in the Transitional Toddler Room, Staff #2 was observed conducting a diaper change for Child #1. After the diaper change Staff #2 did not wash their hands and did not wash Child #1?s hands. 2. Video recording of June 28, 2023, in the Transitional Toddler Room, showed Staff #4 changed Child #4?s diaper and then immediately changed Child #5?s diaper. Staff #4 did not wash their hands after each diaper change and did not ensure Child #4?s or Child #5?s hands were washed after the diaper change. 3. Video recording of June 28, 2023, in the Transitional Toddler Room, showed children preparing for and eating lunch and they did not wash their hands with soap and running water or use disposable wipes prior to eating. 4. Video recording of June 28, 2023, in the Transitional Toddler Room, showed Staff #4 serving lunch to children and she did not wash her hands prior to serving lunch. 5. Video recording of June 28, 2023, in the Transitional Toddler Room, showed Staff #5 feeding a bottle to Child #4 and Staff #5 did not wash their hands prior to the feeding. 6. Video recording of June 28, 2023, in the Toddler room, showed Staff #3 wiping the noses of Child #2 and Child #3 with a tissue and the staff member did not wash their hands after contact with body fluids. 7. Video recording of June 28, 2023, in the Toddler room, showed Staff #3 changed Child #3?s diaper. After the diaper change Staff #3 did not wash their hands and they did not wash Child #3?s hands. 8. Video recording of June 28, 2023, in the Toddler room, showed Staff #3 and Staff # 6 did not wash their hands prior to serving (lunch) food or beverages to the children.”

8VAC20-780-340-D

“Based on staff record review, observation and staff interviews, the licensee did not ensure there shall be in each grouping of children at least one staff member who meets the qualifications of a program leader or program director. Evidence: Staff #8 and Staff #9 were observed working in the toddler room with 8 toddlers. Center Director confirmed through video footage and interviews that the Toddler room did not have a qualified program lead teacher on the day of the inspection from approximately 8:30 AM until 11:30 AM as required. Center Director verified there was not documentation indicating program lead qualifications for Staff #8 or Staff #9.”

8VAC20-780-560-F

“Based on observation and staff interviews, when centers choose to provide meals or snacks, they shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: Center director confirmed the most recent, age-appropriate nutritional requirements of the (USDA) were not followed for serving lunch in Pre-K rooms #B106 and #C106, age range of children 3-5. Pancakes, sausage, yogurt and milk were the only items observed served for lunch. The USDA requires at a minimum ? cup of fruit and ? of vegetables to be included in the items served for lunch.”

8VAC20-780-330-A

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: The following inadequate fall zones were observed on the playgrounds. 1. On the playground the climbing wall closest to the building does not have the required fall zone as the following items are within the 6 feet of the climbing wall. a) There is a plastic caterpillar is 3?10? from the climbing wall b) The plastic playground boarder is 3? 6? form the climbing wall c) The metal fence is 4? 6? from the climbing wall. 2. On the playground the climbing wall closest to the woods does not have the required 6 feet of fall zone because there is a plastic caterpillar that is 3?4? from the corner of the climbing wall.”

8VAC20-780-260-B

“Based on documentation review and staff interviews, the licensee did not ensure to obtain an annual approval from the health department. Evidence: Center Director confirmed the most recent copy of the health inspection available for review was dated 5-16-2022.”

8VAC20-780-340-D

“Based on staff record review, observation and staff interviews, the licensee did not ensure there shall be in each grouping of children at least one staff member who meets the qualifications of a program leader or program director. Evidence: Staff #8 and Staff #9 were observed working in the toddler room with 8 toddlers. Center Director confirmed through video footage and interviews that the Toddler room did not have a qualified program lead teacher on the day of the inspection from approximately 8:30 AM until 11:30 AM as required. Center Director verified there was not documentation indicating program lead qualifications for Staff #8 or Staff #9.”

8VAC20-780-560-F

“Based on observation and staff interviews, when centers choose to provide meals or snacks, they shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: Center director confirmed the most recent, age-appropriate nutritional requirements of the (USDA) were not followed for serving lunch in Pre-K rooms #B106 and #C106, age range of children 3-5. Pancakes, sausage, yogurt and milk were the only items observed served for lunch. The USDA requires at a minimum ? cup of fruit and ? of vegetables to be included in the items served for lunch.”

8VAC20-780-330-A

“Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Evidence: The following inadequate fall zones were observed on the playgrounds. 1. On the playground the climbing wall closest to the building does not have the required fall zone as the following items are within the 6 feet of the climbing wall. a) There is a plastic caterpillar is 3?10? from the climbing wall b) The plastic playground boarder is 3? 6? form the climbing wall c) The metal fence is 4? 6? from the climbing wall. 2. On the playground the climbing wall closest to the woods does not have the required 6 feet of fall zone because there is a plastic caterpillar that is 3?4? from the corner of the climbing wall.”

8VAC20-780-260-B

“Based on documentation review and staff interviews, the licensee did not ensure to obtain an annual approval from the health department. Evidence: Center Director confirmed the most recent copy of the health inspection available for review was dated 5-16-2022.”

8VAC20-790-600-F

“Based on record review and staff interview the vendor did not ensure Staff who work directly with children shall, in addition to preservice and orientation training required, annually attend at least 16 hours of training and staff development activities, to include the departments health and safety update course. Evidence: Director confirmed that Staff #2 did not have documentation for their 2022 health and safety update course.”

8VAC20-790-600-D-1

“Based on a record review and staff interviews, the vendor did not ensure staff completed who work directly with children shall have obtained within 90 days of the date of hire a current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in- person competency demonstration. Evidence: The record for Staff #3 (date of hire11-28-2022) did not include documentation of CPR certification.”

8VAC20-780-600-D

“Based on a record review and staff interviews, the vendor did not ensure staff completed who work directly with children shall have obtained within 90 days of the date of hire a current certification in first aid appropriate to the ages of children in care. Evidence: The record for Staff #3 (date of hire 11-28-22) did not include documentation of First Aid certification.”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the diapering area had all required items and staff followed diapering procedures for handwashing. Evidence: 1. The following diapering areas have been determined to have inadequate equipment as the diapering area shall have a sink with running warm water not to exceed 120F. for diapering. In room #103 (transitional toddlers), room #108 (toddlers) and room #109 (2?s and 3?s) there was not a sink available for staff to use to wash their hands before and after diapering or for children to use to wash their hands after diapering. Center staff confirmed the sinks in room #103, #108 and #109 are not operating. Center staff said they use wipes and hand sanitizer after diaper changes instead of soap and warm running water. 2. In classroom #108, Staff #2 was observed conducting a diaper change and the diaper pad was not cleaned or sanitized as required.”

8VAC20-780-500-A

“Based on observation and staff interviews, the licensee did not ensure to wash their hands and did not ensure that children’s hands shall be washed with soap and running water after toileting and any contact with blood, feces, or urine. Evidence: In room #108, staff #2 was observed conducting a diaper change for child #3. Staff #2 did not wash their hands after the diaper change and they placed the child #3 in a crib and did not wash their hands.”

8VAC20-780-440-A

“Based on observation and staff interview the licensee did not ensure cribs shall be provided for children during the designated rest period. Evidence: In room #108, two children, child #1 (date of birth 9-6-22) and child #2 (date of birth 7-20-22) were observed sleeping in a bouncer. Center staff confirmed child #1 is ?not normally in this classroom? and child #2 is ?transitioning to this room" and neither child has a crib.”

8VAC20-780-280-B

“Based on observation, the licensee did not ensure hazardous substances and other harmful agents such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The following items were observed stored in an unlocked manner and were accessible to children. The hazardous chemicals were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning". 1. In the pantry across from the room #106, (pre-k 3), there was an unlocked closet and o the floor there were 5 containers of dish detergent, 4 containers of disinfectant and 1 container of bleach. 2. In the kitchen window accessible to children and next door to the room #106, there was 1 container of disinfectant spray and 1 bottle of hand sanitizer. 3. In room #109 sitting on the sink is 1 container of disinfectant wipes, and 1 container of disinfectant spray”

8VAC20-780-70

“Based on a review of 3 staff records and staff interviews, the licensee did not ensure that staff have documentation to demonstrate the individuals have the education, training and certification, required by the job position. Evidence: The records for Staff #4, designated as a program lead, does not have documentation in their record to demonstrate they have the training/education required for Program Lead”

8VAC20-780-150-B

“Based on record review and provider interview, the licensee did not ensure the physical examination and dates of immunizations shall include the signature of a physician, his designee, or an official of a local health department Evidence: The physical and immunization documents in the records for child #1, child #4 and child #6 did not include a physician or designated individual’s signature. Child #1, #4 and #6 have been attending for more than 30 days.”

22.1-289.035-B-4

“Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment Evidence: Staff #8's record did not include an out of state CPS check and a CRC for Pennsylvania where they had lived within the last five years from date of hire (DOH). Staff #8 DOH was 1-3-2022. Staff #8 was observed working during the inspection.”

8VAC20-790-600-F

“Based on record review and staff interview the vendor did not ensure Staff who work directly with children shall, in addition to preservice and orientation training required, annually attend at least 16 hours of training and staff development activities, to include the departments health and safety update course. Evidence: Director confirmed that Staff #2 did not have documentation for their 2022 health and safety update course.”

8VAC20-790-600-D-1

“Based on a record review and staff interviews, the vendor did not ensure staff completed who work directly with children shall have obtained within 90 days of the date of hire a current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in- person competency demonstration. Evidence: The record for Staff #3 (date of hire11-28-2022) did not include documentation of CPR certification.”

8VAC20-780-600-D

“Based on a record review and staff interviews, the vendor did not ensure staff completed who work directly with children shall have obtained within 90 days of the date of hire a current certification in first aid appropriate to the ages of children in care. Evidence: The record for Staff #3 (date of hire 11-28-22) did not include documentation of First Aid certification.”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the diapering area had all required items and staff followed diapering procedures for handwashing. Evidence: 1. The following diapering areas have been determined to have inadequate equipment as the diapering area shall have a sink with running warm water not to exceed 120F. for diapering. In room #103 (transitional toddlers), room #108 (toddlers) and room #109 (2?s and 3?s) there was not a sink available for staff to use to wash their hands before and after diapering or for children to use to wash their hands after diapering. Center staff confirmed the sinks in room #103, #108 and #109 are not operating. Center staff said they use wipes and hand sanitizer after diaper changes instead of soap and warm running water. 2. In classroom #108, Staff #2 was observed conducting a diaper change and the diaper pad was not cleaned or sanitized as required.”

8VAC20-780-500-A

“Based on observation and staff interviews, the licensee did not ensure to wash their hands and did not ensure that children’s hands shall be washed with soap and running water after toileting and any contact with blood, feces, or urine. Evidence: In room #108, staff #2 was observed conducting a diaper change for child #3. Staff #2 did not wash their hands after the diaper change and they placed the child #3 in a crib and did not wash their hands.”

8VAC20-780-440-A

“Based on observation and staff interview the licensee did not ensure cribs shall be provided for children during the designated rest period. Evidence: In room #108, two children, child #1 (date of birth 9-6-22) and child #2 (date of birth 7-20-22) were observed sleeping in a bouncer. Center staff confirmed child #1 is ?not normally in this classroom? and child #2 is ?transitioning to this room" and neither child has a crib.”

8VAC20-780-280-B

“Based on observation, the licensee did not ensure hazardous substances and other harmful agents such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The following items were observed stored in an unlocked manner and were accessible to children. The hazardous chemicals were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning". 1. In the pantry across from the room #106, (pre-k 3), there was an unlocked closet and o the floor there were 5 containers of dish detergent, 4 containers of disinfectant and 1 container of bleach. 2. In the kitchen window accessible to children and next door to the room #106, there was 1 container of disinfectant spray and 1 bottle of hand sanitizer. 3. In room #109 sitting on the sink is 1 container of disinfectant wipes, and 1 container of disinfectant spray”

8VAC20-780-70

“Based on a review of 3 staff records and staff interviews, the licensee did not ensure that staff have documentation to demonstrate the individuals have the education, training and certification, required by the job position. Evidence: The records for Staff #4, designated as a program lead, does not have documentation in their record to demonstrate they have the training/education required for Program Lead”

8VAC20-780-150-B

“Based on record review and provider interview, the licensee did not ensure the physical examination and dates of immunizations shall include the signature of a physician, his designee, or an official of a local health department Evidence: The physical and immunization documents in the records for child #1, child #4 and child #6 did not include a physician or designated individual’s signature. Child #1, #4 and #6 have been attending for more than 30 days.”

22.1-289.035-B-4

“Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment Evidence: Staff #8's record did not include an out of state CPS check and a CRC for Pennsylvania where they had lived within the last five years from date of hire (DOH). Staff #8 DOH was 1-3-2022. Staff #8 was observed working during the inspection.”

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

“Based on observation and staff interviews, the licensee did not ensure the diapering area had all required items and staff followed diapering procedures for handwashing. Evidence: 1. The following diapering areas have been determined to have inadequate equipment as the diapering area shall have a sink with running warm water not to exceed 120?F.for diapering. a. In the infant room Staff #1 was observed changing a diaper and then washing their hands after the diaper change. Staff #1 confirmed there was not running warm water available in the infant room at the diaper changing station. Licensing inspector also tested the water temperature and there was not warm water available. b, In the Toddler room there was not a sink available for staff to use to wash their hands before and after diapering or for children to use to wash their hands after diapering. Center staff confirmed they use hand sanitizer after diaper changes instead of soap and warm running water. 2. During inspection on 10-6-2022 Staff #1 and Staff #2 were observed conducting diaper changes and the diaper pad was not cleaned or sanitized as required. Staff #1 conducted a diaper change in the infant room and Staff #2 conducted a diaper change in the hallway outside the restroom near the multipurpose room. After Staff #1 and Staff #2 completed their diaper change, they both spayed the diaper pad with a sanitizing solution and then immediately wiped down the diaper pad. The diaper pad was not sanitized as it was not allowed to air dry or be wiped down only after 2 minutes. The diaper pad was not cleaned with a soap and water solution.”

22VAC40-185-340-F

“Based on interviews with staff and other parties involved, the licensee failed to ensure children under 10 years of age are within actual sight and sound supervision of staff. Evidence: On April 8, 2022, Child #1, age 3 was left unsupervised on the fenced in playground between approximately 12:04 pm and 12:11 pm. 1) Video recording shows at approximately 12:04 pm, Child #1?s class came inside from the playground by going through the playground back door and walking through the large multipurpose room and then heading to their classroom. 2) Video recording shows a church volunteer, Volunteer #3 working in the multipurpose room and at approximately 12:11 pm, Child #1 opens the playground back door on their own and enters the multipurpose room. Child #1 asked Volunteer #3 ?where did everybody go?? 3) Volunteer #1 confirmed Child #1 was not in distress, crying or upset.”

22VAC40-185-340-A

“Based on a review of the center's documentation and interviews, the licensee did not ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: On April 8, 2022, Child #1, age 3 was left unsupervised on the fenced in playground between approximately 12:04 pm and 12:11 pm. Center Director confirmed Staff #1 and Staff # 2 did not know that Child #1 was left unsupervised on the playground until the Center Director brought it to their attention.”

8VAC20-780-280-B

“Based on observation and staff interviews, the licensee did not ensure that all hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The following items were observed in the classrooms and stored in areas that were not locked and were labeled "Keep out of reach of children" and at least one of the other statements "hazardous", "flammable" and "warning". 1) In the Pre-K 2 room in an unlocked cabinet there were 3 containers of sanitizing wipes, and 1 container of hand sanitizer. 2) In the toddler room on a shelf there were 2 containers of hand sanitizer.”

8VAC20-780-260-B

“Based on documentation review and staff interviews, the licensee did not ensure to obtain annual approval from the health department. Evidence: The most recent health inspection was dated 3-9-2021.”

8VAC20-780-280-B

“Based on observation and staff interviews, the licensee did not ensure that all hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The following items were observed in the classrooms and stored in areas that were not locked and were labeled "Keep out of reach of children" and at least one of the other statements "hazardous", "flammable" and "warning". 1) In the Pre-K 2 room in an unlocked cabinet there were 3 containers of sanitizing wipes, and 1 container of hand sanitizer. 2) In the toddler room on a shelf there were 2 containers of hand sanitizer.”

8VAC20-780-260-B

“Based on documentation review and staff interviews, the licensee did not ensure to obtain annual approval from the health department. Evidence: The most recent health inspection was dated 3-9-2021.”

22VAC40-665-540-A

“Based on record review and staff interviews, the licensee did not ensure staff shall be evaluated by a health professional and be issued a statement the individual is determined to be free of communicable tuberculosis (TB). 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: The following staff did not have a TB screening conducted prior to employment. 1) The TB screening for staff #2 was dated 10-1-2021 and date of employment was 9-27-2021. 2) The TB screening for staff #3 was dated 10-1-2021 and date of employment was 9-21-2021. Documentation was confirmed by center director.”

63.2(17)-1720.1-B-4

“Based on record review and staff interviews, the licensee did not obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry ( CPS ) or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: The licensee did not obtain the required out of state background check for staff #5 for Florida where they had lived within the last 5 years. Staff #5 date of hire was 4-27-2021. 1) There were no results of a sex offender check available for review. The sex offender check is required prior to the first day of employment. 2) There were no results of a CPS check available for review. Staff #1 documented the check had been submitted but not followed up within the required time frame.”

22VAC40-185-570-I

“Based on observation and staff interviews, the licensee did not ensure that a one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care shall be maintained at the center. Evidence: Emergency bottles and formula were observed for infants the one infant did not have the required emergency formula.”