Smiles & Giggles Learning Center

22.1-289.035-B-4

“(Repeat Violation) Based on review, facility did not ensure out of state background checks are completed when a staff member has lived outside the state of Virginia within the past 5 years. Evidence: The record for staff #4 (start date 8/8/2024) did not have documentation of completing out of state central registry and sex offender search for the state noted on the sworn statement or affirmation.”

8VAC20-780-260-B

“Based on review, facility did not ensure there is an annual approval from the health department. Evidence: The most recent health inspection report available for review was dated 5/17/2023 which is more than a year old.”

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

“Based on observation, facility did not ensure areas of the center are maintained in a clean and safe manner. Evidence: There were 2 ceiling tiles each in the 2's classroom and infant classroom that were bulging with visible signs of water damage. In the infant room, the ceiling vents had dust hanging down from the cover.”

22.1-289.035-B-4

“(Repeat Violation) Based on review, facility did not ensure out of state background checks are completed when a staff member has lived outside the state of Virginia within the past 5 years. Evidence: The record for staff #4 (start date 8/8/2024) did not have documentation of completing out of state central registry and sex offender search for the state noted on the sworn statement or affirmation.”

8VAC20-780-260-B

“Based on review, facility did not ensure there is an annual approval from the health department. Evidence: The most recent health inspection report available for review was dated 5/17/2023 which is more than a year old.”

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

“Based on observation, facility did not ensure areas of the center are maintained in a clean and safe manner. Evidence: There were 2 ceiling tiles each in the 2's classroom and infant classroom that were bulging with visible signs of water damage. In the infant room, the ceiling vents had dust hanging down from the cover.”

22.1-289.035-B-4

“(Repeat Violation) Based on review, facility did not ensure out of state background checks are completed when a staff member has lived outside the state of Virginia within the past 5 years. Evidence: The record for staff #4 (start date 8/8/2024) did not have documentation of completing out of state central registry and sex offender search for the state noted on the sworn statement or affirmation.”

8VAC20-780-260-B

“Based on review, facility did not ensure there is an annual approval from the health department. Evidence: The most recent health inspection report available for review was dated 5/17/2023 which is more than a year old.”

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

“Based on observation, facility did not ensure areas of the center are maintained in a clean and safe manner. Evidence: There were 2 ceiling tiles each in the 2's classroom and infant classroom that were bulging with visible signs of water damage. In the infant room, the ceiling vents had dust hanging down from the cover.”

8VAC20-780-60-A

“Repeat Based on review of 5 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 record for Child #5 did not include the appropriate legal paperwork on file when the custodial parent requests the center not to release the child to the other parent”

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 Evidence: There resilient surfacing was measured for the playgrounds and determined inadequate as a minimum of 6 inches of resilient surfacing for this equipment is required. 1.There was approximately 4 ? inches to 5 inches of resilient surfacing (mulch) at the base of the slide chute and around the fall zone on the preschool playground 2. There was approximately 3 to3 ? inches of resilient surfacing (mulch) at the base of the slide chute and around the fall zone on the toddler playground”

8VAC20-780-80-A

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 8 children observed in the infant room and only 7 on the attendance list. Center staff verified the 8th infant had been in the classroom for approximately 1 hour and had not been added to the attendance list”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure diapering requirements were followed. Evidence: The diaper pad in the infant had two tears and was no longer nonabsorbent.”

8VAC20-780-550-F

“Based on staff interviews and review of documentation, the licensee did not ensure to practice annually a lockdown drill procedure. Evidence: Center Director confirmed they did not conduct lock down drill in 2023.”

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 for any state where they lived within the last five years from date of hire. (DOH) Evidence: The following did not have out of state background checks as required. 1.Staff #4?s record did not include an out of state CRC for South Carolina prior to first day of employment (DHO 1-26-2024). South Carolina CRC results were dated 2-20-2024 and a South Carolina CPS check was not conducted. 2. Staff #5?s record did not include a CRC or a CPS for Texas. Staff #5?s DHO was 7-18-2023.”

8VAC20-780-60-A

“Repeat Based on review of 5 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 record for Child #5 did not include the appropriate legal paperwork on file when the custodial parent requests the center not to release the child to the other parent”

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 Evidence: There resilient surfacing was measured for the playgrounds and determined inadequate as a minimum of 6 inches of resilient surfacing for this equipment is required. 1.There was approximately 4 ? inches to 5 inches of resilient surfacing (mulch) at the base of the slide chute and around the fall zone on the preschool playground 2. There was approximately 3 to3 ? inches of resilient surfacing (mulch) at the base of the slide chute and around the fall zone on the toddler playground”

8VAC20-780-80-A

“Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: There were 8 children observed in the infant room and only 7 on the attendance list. Center staff verified the 8th infant had been in the classroom for approximately 1 hour and had not been added to the attendance list”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure diapering requirements were followed. Evidence: The diaper pad in the infant had two tears and was no longer nonabsorbent.”

8VAC20-780-550-F

“Based on staff interviews and review of documentation, the licensee did not ensure to practice annually a lockdown drill procedure. Evidence: Center Director confirmed they did not conduct lock down drill in 2023.”

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 for any state where they lived within the last five years from date of hire. (DOH) Evidence: The following did not have out of state background checks as required. 1.Staff #4?s record did not include an out of state CRC for South Carolina prior to first day of employment (DHO 1-26-2024). South Carolina CRC results were dated 2-20-2024 and a South Carolina CPS check was not conducted. 2. Staff #5?s record did not include a CRC or a CPS for Texas. Staff #5?s DHO was 7-18-2023.”

8VAC20-780-560-F

“Based on observation and staff interviews, the licensee did not ensure to follow the recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) when they choose to provide meals and snacks . Evidence: The afternoon snacks listed on the menu for the week of 11-6-2023 to 11-10-2023 do not meet. the USDA guidelines as 2 out of 5 of the food groups are required to be served. 1.Snack for 11-6-2023 was vanilla wafers (do not meet the USDA guidelines) and grape juice 2.Snack for 11-7-202 was granola bar and water (only one food group offered) 3. Snack for 11-9-2023 listed veggie straws and water (only one food group offered)”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the required procedures were followed for diapering. Evidence: 1.Staff #6 was observed changing diaper for Child #2 and they lifted the trashcans lid with their hand and disposed of the soiled diaper. Staff #6 did not use the footstep to open the trashcan’s lid. The requirement is that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. 2. Staff #6 was observed changing the diapers of 3 children (Child #1, #2 and Child #6) who were 2 years old and each child stood in the bathroom door way while Staff #6 removed their diaper, used a wipe to clean them and then put on another diaper while they were standing up. Staff #6 did not use a nonabsorbent surface for diapering or changing as required for children younger than three years. The diapering surface for children younger than 3 shall be a changing table or countertop designated for changing.”

8VAC20-780-500-A

“Based on observation and staff interviews, the licensee did not ensure that all staff shall wash their hands with soap and running water after helping a child use the toilet and before and after a diaper change; Evidence: 1.Staff #6 was observed changing the diaper for Child #1 and Child #2. Staff #6 did not wash their hands between these two diaper changes.”

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 toddler room in an unlocked cabinet there were 2 containers of disinfectant spay and a container of bleach and water spray. These hazardous chemicals were observed, and they were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning".”

8VAC20-780-60-A

“Repeat Based on review of 5 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 2 out of 5 of the children’s records reviewed. 1.Child #1 did not have the employment phone number for both parents listed 2.Child #1 and Child #3 did not have the name of any additional programs or schools that the child is concurrently attending and the grade or class level.”

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 on the outdoor playground poses a safety risk to children on the playground. 1.There is a rusty, sharp screw protruding from a white tube that is used for water / sand play. 2.There is red plastic riding toy that has 3 areas (tire, handlebar, and license plate holder) that are broken and has sharp edges.”

8VAC20-780-560-F

“Based on observation and staff interviews, the licensee did not ensure to follow the recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) when they choose to provide meals and snacks . Evidence: The afternoon snacks listed on the menu for the week of 11-6-2023 to 11-10-2023 do not meet. the USDA guidelines as 2 out of 5 of the food groups are required to be served. 1.Snack for 11-6-2023 was vanilla wafers (do not meet the USDA guidelines) and grape juice 2.Snack for 11-7-202 was granola bar and water (only one food group offered) 3. Snack for 11-9-2023 listed veggie straws and water (only one food group offered)”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure the required procedures were followed for diapering. Evidence: 1.Staff #6 was observed changing diaper for Child #2 and they lifted the trashcans lid with their hand and disposed of the soiled diaper. Staff #6 did not use the footstep to open the trashcan’s lid. The requirement is that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. 2. Staff #6 was observed changing the diapers of 3 children (Child #1, #2 and Child #6) who were 2 years old and each child stood in the bathroom door way while Staff #6 removed their diaper, used a wipe to clean them and then put on another diaper while they were standing up. Staff #6 did not use a nonabsorbent surface for diapering or changing as required for children younger than three years. The diapering surface for children younger than 3 shall be a changing table or countertop designated for changing.”

8VAC20-780-500-A

“Based on observation and staff interviews, the licensee did not ensure that all staff shall wash their hands with soap and running water after helping a child use the toilet and before and after a diaper change; Evidence: 1.Staff #6 was observed changing the diaper for Child #1 and Child #2. Staff #6 did not wash their hands between these two diaper changes.”

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 toddler room in an unlocked cabinet there were 2 containers of disinfectant spay and a container of bleach and water spray. These hazardous chemicals were observed, and they were labeled "keep out of reach of children" and at least one other statement "caution", "flammable" and "warning".”

8VAC20-780-60-A

“Repeat Based on review of 5 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 2 out of 5 of the children’s records reviewed. 1.Child #1 did not have the employment phone number for both parents listed 2.Child #1 and Child #3 did not have the name of any additional programs or schools that the child is concurrently attending and the grade or class level.”

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 on the outdoor playground poses a safety risk to children on the playground. 1.There is a rusty, sharp screw protruding from a white tube that is used for water / sand play. 2.There is red plastic riding toy that has 3 areas (tire, handlebar, and license plate holder) that are broken and has sharp edges.”

8VAC20-780-340-D

“Repeat Systemic Based on 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: The following staff were designated as program lead teachers and their records do not include documentation of the required training/ education required to meet the qualifications of a program lead or program director. 1.Staff #1, the designated program lead staff in the Infant Room was observed as one of two staff supervising 5 infants. Center Director confirmed there was not a staff member in the Infant Room that met qualification for program lead. 2.Staff #5, the designated program lead staff in the Schoolage Room was observed as the only staff supervising 12 Schoolage children. Center Director confirmed Staff #5 did not meet qualification for program lead.”

8VAC20-780-60-A

“Systemic Based on record review and staff interviews, the licensee did not ensure there was a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: The record for child # 1 has a diagnosed food allergy (ham) and the record did not include a written care plan, to include instructions from a physician.”

8VAC20-780-40-M

“Systemic Based on observation and staff interview, 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: The current written list of all children's allergies, sensitivities, and dietary restrictions was not dated.”

8VAC20-780-560-F Complaint related: Yes

“Based on observations and staff interviews, the licensee did not ensure to follow the guidelines when they choose to provide meals and snacks. Evidence: The center did not follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) as listed below; 1.On 4-26-2023, breakfast was observed being served for children age 2 and only 1/4 cup of milk was served in a 3 ounce cup and 4 ounces of milk is required. 2.On 4-26-2023, lunch was observed being served to 15 children, ages 3-5 in Pre-k class. The staff used a plastic spoon, approximately 1 teaspoon to serve the mixed vegetables for each child. Children were served between 1 and 2 teaspoons of vegetables which was less than the ? cup that is required.”

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 infant room, an unlocked cabinet, there were 2 containers of disinfectant, 1 container of all purpose cleaner and 2 containers of disinfectant wipes. 2. In the toddler room underneath changing table there was a container of Damp Rid”

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 date 4-19-22.”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: The record for Staff #2 (hire date 3-23-23), Staff #4 (hire date 2-9-23) and Staff #5 (hire date 3-29-23) did not include information the staff had obtained training in prevention of abusive head trauma and safe sleeping practices.”

8VAC20-780-340-D

“Based on record review, observation and staff interviews, the licensee did not ensure that 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 # 4, the designated program lead staff in the Pre-K room was observed as the only staff supervising 10 children. Staff #4 does not have documentation that indicates they meet the qualifications of a program lead or program director.”

8VAC20-780-60-A

“Based on record review and staff interview the center did not maintain a record for each child enrolled which contained all of the required information. Evidence: Center Director confirmed the following items were missing; 1.The record for child #3 did not contain work phone numbers or location for both for parents listed. 2.The record for child #4 did not contain work location for both for parents listed. 3. The record for child #3 did not include a second emergency contact name or phone number.”

8VAC20-780-40-M

“Based on observation and staff interview, 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: Center Director, confirmed that there was not a allergy list available for staff to view for child #5 that has a physician documented pineapple and lactose food sensitivity”

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 documents in the records for child #3 did not include a physician or designated individual’s signature. Child #3 first date of attendance was 4-12-23.”

8VAC20-780-540-E

“Based on equipment review and staff interview the licensee did not ensure the nonmedical emergency supplies were required. Evidence: Center Director confirmed they did not have a working battery-operated radio.”

8VAC20-780-570-E

“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: In the infant room there were two bottles observed, one was without a name and date and the other was without a date. Both bottle's were observed on the counter near the sink and were confirmed to be formula.”

8VAC20-770-60-C-2

“Based on a record review and staff interviews, the licensee did not ensure each staff member had obtained by the end of the 30th day of hire the results of the Central Registry ( CPS ) finding for the state of Virginia. Evidence: Staff #2?s date of hire 3-23-2023 does not have documentation of a CPS check conducted. Center Director confirmed the CPS check was mailed on 4- 21-2023. Staff #2 was observed working on the day of the day of the inspection.”

8VAC20-780-560-F Complaint related: Yes

“Based on observations and staff interviews, the licensee did not ensure to follow the guidelines when they choose to provide meals and snacks. Evidence: The center did not follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) as listed below; 1.On 4-26-2023, breakfast was observed being served for children age 2 and only 1/4 cup of milk was served in a 3 ounce cup and 4 ounces of milk is required. 2.On 4-26-2023, lunch was observed being served to 15 children, ages 3-5 in Pre-k class. The staff used a plastic spoon, approximately 1 teaspoon to serve the mixed vegetables for each child. Children were served between 1 and 2 teaspoons of vegetables which was less than the ? cup that is required.”

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 infant room, an unlocked cabinet, there were 2 containers of disinfectant, 1 container of all purpose cleaner and 2 containers of disinfectant wipes. 2. In the toddler room underneath changing table there was a container of Damp Rid”

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 date 4-19-22.”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: The record for Staff #2 (hire date 3-23-23), Staff #4 (hire date 2-9-23) and Staff #5 (hire date 3-29-23) did not include information the staff had obtained training in prevention of abusive head trauma and safe sleeping practices.”

8VAC20-780-340-D

“Based on record review, observation and staff interviews, the licensee did not ensure that 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 # 4, the designated program lead staff in the Pre-K room was observed as the only staff supervising 10 children. Staff #4 does not have documentation that indicates they meet the qualifications of a program lead or program director.”

8VAC20-780-60-A

“Based on record review and staff interview the center did not maintain a record for each child enrolled which contained all of the required information. Evidence: Center Director confirmed the following items were missing; 1.The record for child #3 did not contain work phone numbers or location for both for parents listed. 2.The record for child #4 did not contain work location for both for parents listed. 3. The record for child #3 did not include a second emergency contact name or phone number.”

8VAC20-780-40-M

“Based on observation and staff interview, 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: Center Director, confirmed that there was not a allergy list available for staff to view for child #5 that has a physician documented pineapple and lactose food sensitivity”

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 documents in the records for child #3 did not include a physician or designated individual’s signature. Child #3 first date of attendance was 4-12-23.”

8VAC20-780-540-E

“Based on equipment review and staff interview the licensee did not ensure the nonmedical emergency supplies were required. Evidence: Center Director confirmed they did not have a working battery-operated radio.”

8VAC20-780-570-E

“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: In the infant room there were two bottles observed, one was without a name and date and the other was without a date. Both bottle's were observed on the counter near the sink and were confirmed to be formula.”

8VAC20-770-60-C-2

“Based on a record review and staff interviews, the licensee did not ensure each staff member had obtained by the end of the 30th day of hire the results of the Central Registry ( CPS ) finding for the state of Virginia. Evidence: Staff #2?s date of hire 3-23-2023 does not have documentation of a CPS check conducted. Center Director confirmed the CPS check was mailed on 4- 21-2023. Staff #2 was observed working on the day of the day of the inspection.”

8VAC20-780-560-F Complaint related: Yes

“Based on observations and staff interviews, the licensee did not ensure to follow the guidelines when they choose to provide meals and snacks. Evidence: The center did not follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) as listed below; 1.On 4-26-2023, breakfast was observed being served for children age 2 and only 1/4 cup of milk was served in a 3 ounce cup and 4 ounces of milk is required. 2.On 4-26-2023, lunch was observed being served to 15 children, ages 3-5 in Pre-k class. The staff used a plastic spoon, approximately 1 teaspoon to serve the mixed vegetables for each child. Children were served between 1 and 2 teaspoons of vegetables which was less than the ? cup that is required.”

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 infant room, an unlocked cabinet, there were 2 containers of disinfectant, 1 container of all purpose cleaner and 2 containers of disinfectant wipes. 2. In the toddler room underneath changing table there was a container of Damp Rid”

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 date 4-19-22.”

8VAC20-780-240-C

“Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: The record for Staff #2 (hire date 3-23-23), Staff #4 (hire date 2-9-23) and Staff #5 (hire date 3-29-23) did not include information the staff had obtained training in prevention of abusive head trauma and safe sleeping practices.”

8VAC20-780-340-D

“Based on record review, observation and staff interviews, the licensee did not ensure that 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 # 4, the designated program lead staff in the Pre-K room was observed as the only staff supervising 10 children. Staff #4 does not have documentation that indicates they meet the qualifications of a program lead or program director.”

8VAC20-780-60-A

“Based on record review and staff interview the center did not maintain a record for each child enrolled which contained all of the required information. Evidence: Center Director confirmed the following items were missing; 1.The record for child #3 did not contain work phone numbers or location for both for parents listed. 2.The record for child #4 did not contain work location for both for parents listed. 3. The record for child #3 did not include a second emergency contact name or phone number.”

8VAC20-780-40-M

“Based on observation and staff interview, 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: Center Director, confirmed that there was not a allergy list available for staff to view for child #5 that has a physician documented pineapple and lactose food sensitivity”

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 documents in the records for child #3 did not include a physician or designated individual’s signature. Child #3 first date of attendance was 4-12-23.”

8VAC20-780-540-E

“Based on equipment review and staff interview the licensee did not ensure the nonmedical emergency supplies were required. Evidence: Center Director confirmed they did not have a working battery-operated radio.”

8VAC20-780-570-E

“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: In the infant room there were two bottles observed, one was without a name and date and the other was without a date. Both bottle's were observed on the counter near the sink and were confirmed to be formula.”

8VAC20-770-60-C-2

“Based on a record review and staff interviews, the licensee did not ensure each staff member had obtained by the end of the 30th day of hire the results of the Central Registry ( CPS ) finding for the state of Virginia. Evidence: Staff #2?s date of hire 3-23-2023 does not have documentation of a CPS check conducted. Center Director confirmed the CPS check was mailed on 4- 21-2023. Staff #2 was observed working on the day of the day of 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 in subsections A through D of this section, 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 #4 (date of hire 4-6-2022) did not have documentation for their 2022 health and safety update course.”

22.1-289.035-B-4

“Based on record review and staff interview the licensee did not ensure to obtain a copy of the results of a criminal history record information check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: Director confirmed that they had not obtained an out of state criminal history check or an out of state child abuse and neglect record check for South Carolina where staff #4 (hire date 4-6-2022) had lived within the last five years.”

8VAC20-780-160-A

“Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment and prior to coming into contact with children. Evidence: Staff confirmed that Staff #1 did not have documentation of a TB screening and the first date of employment was 12-16-2019.”

8VAC20-780-40-K

“Based on review of center documentation and staff interviews, the licensee did not ensure the center shall develop written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices, and sudden infant death syndrome awareness. Evidence: Director confirmed that the center's written procedures did not include abusive head trauma.”

8VAC20-780-40-M

“Based on observation and staff interview, 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: Staff #3, in the infant room, confirmed that the allergy list was hanging in sight and that parents enter the room to drop off and pick up their children.”

8VAC20-780-60-A

“Based on record review and staff interview the center did not maintain a record for each child enrolled which contained all of the required information. Evidence: Director confirmed that the following items were missing from children’s records: 1. The record for child #1 did not contain proof of identity. 2. The record for child #3 did not contain work phone numbers for both parents listed. 3. The record for child #5 did not include a second emergency contact.”

8VAC20-780-210-A-4-b

“Based on record review and staff interview the licensee did not ensure that program leaders within six months before being promoted or beginning work or one month after being promoted or beginning work, a minimum of 24 hours of training shall be received related to the care of children. Evidence: Director confirmed that Staff #3 only had 12 of the required 24 hours of training needed for program leader qualification. Staff #3 confirmed they were the designated lead teacher.”

8VAC20-780-245-A

“Based on record review and staff interview the licensee did not ensure staff shall complete annually a minimum of 16 hours of training appropriate to the age of the children in care. Evidence: Director confirmed their training calendar was January to December and the following did not complete the required 16 hours of training: ? staff #1 (hire date 12-16-2019) completed 7 hours of training for 2022. ? staff #2 (hire date 3-12-2021) completed 3 hours of training for 2022. ? staff #3 (hire date 12-15-2020) completed 3 hours of training for 2022. ? staff #4 (hire date 4-6-2022) completed 4 hours of training for 2022.”

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: The following inadequate fall zones and resilient surfacing were observed on the pay ground. 1. On the preschool playground the resilient surfacing (mulch) was measured and it was between 1/2 inch and 2 inches deep at the base of both blue slide chutes and around the fall zone area. A minimum of 6 inches of resilient surfacing is required 2. On the toddler playground there was a plastic playhouse directly next to the right side of the blue slide and therefore the required 6 feet of fall zone was not met. There was only approximately 1 inch of fall zone on the right side of the slide.”

8VAC20-780-450-A

“Based on observation and Staff interview the center did not ensure Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Cribs when being used by infants shall have a bottom cover. Evidence: The following was observed and confirmed by staff: ? In the Toddler room there were 2 out of 5 children that did not have a bottom cover. ? In the Two’s room 6 out of 16 children that did not have a bottom cover ? In the Three’s and Four’s room 8 out of 18 children that did not have a bottom cover”

8VAC20-780-540-E

“Based on equipment review and staff interview the licensee did not ensure the nonmedical emergency supplies were required. Evidence: Director confirmed they did not have a working battery-operated flashlight or a battery-operated radio.”

8VAC20-780-40-J

“Based on document review and staff interview the licensee did not ensure injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services. Evidence: Director confirmed they did not have an updated injury prevention plan.”

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 in subsections A through D of this section, 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 #4 (date of hire 4-6-2022) did not have documentation for their 2022 health and safety update course.”

22.1-289.035-B-4

“Based on record review and staff interview the licensee did not ensure to obtain a copy of the results of a criminal history record information check, and a search of the child abuse and neglect registry or equivalent registry from any state in which the individual has resided in the preceding five years. Evidence: Director confirmed that they had not obtained an out of state criminal history check or an out of state child abuse and neglect record check for South Carolina where staff #4 (hire date 4-6-2022) had lived within the last five years.”

8VAC20-780-160-A

“Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment and prior to coming into contact with children. Evidence: Staff confirmed that Staff #1 did not have documentation of a TB screening and the first date of employment was 12-16-2019.”

8VAC20-780-40-K

“Based on review of center documentation and staff interviews, the licensee did not ensure the center shall develop written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices, and sudden infant death syndrome awareness. Evidence: Director confirmed that the center's written procedures did not include abusive head trauma.”

8VAC20-780-40-M

“Based on observation and staff interview, 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: Staff #3, in the infant room, confirmed that the allergy list was hanging in sight and that parents enter the room to drop off and pick up their children.”

8VAC20-780-60-A

“Based on record review and staff interview the center did not maintain a record for each child enrolled which contained all of the required information. Evidence: Director confirmed that the following items were missing from children’s records: 1. The record for child #1 did not contain proof of identity. 2. The record for child #3 did not contain work phone numbers for both parents listed. 3. The record for child #5 did not include a second emergency contact.”

8VAC20-780-210-A-4-b

“Based on record review and staff interview the licensee did not ensure that program leaders within six months before being promoted or beginning work or one month after being promoted or beginning work, a minimum of 24 hours of training shall be received related to the care of children. Evidence: Director confirmed that Staff #3 only had 12 of the required 24 hours of training needed for program leader qualification. Staff #3 confirmed they were the designated lead teacher.”

8VAC20-780-245-A

“Based on record review and staff interview the licensee did not ensure staff shall complete annually a minimum of 16 hours of training appropriate to the age of the children in care. Evidence: Director confirmed their training calendar was January to December and the following did not complete the required 16 hours of training: ? staff #1 (hire date 12-16-2019) completed 7 hours of training for 2022. ? staff #2 (hire date 3-12-2021) completed 3 hours of training for 2022. ? staff #3 (hire date 12-15-2020) completed 3 hours of training for 2022. ? staff #4 (hire date 4-6-2022) completed 4 hours of training for 2022.”

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: The following inadequate fall zones and resilient surfacing were observed on the pay ground. 1. On the preschool playground the resilient surfacing (mulch) was measured and it was between 1/2 inch and 2 inches deep at the base of both blue slide chutes and around the fall zone area. A minimum of 6 inches of resilient surfacing is required 2. On the toddler playground there was a plastic playhouse directly next to the right side of the blue slide and therefore the required 6 feet of fall zone was not met. There was only approximately 1 inch of fall zone on the right side of the slide.”

8VAC20-780-450-A

“Based on observation and Staff interview the center did not ensure Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Cribs when being used by infants shall have a bottom cover. Evidence: The following was observed and confirmed by staff: ? In the Toddler room there were 2 out of 5 children that did not have a bottom cover. ? In the Two’s room 6 out of 16 children that did not have a bottom cover ? In the Three’s and Four’s room 8 out of 18 children that did not have a bottom cover”

8VAC20-780-540-E

“Based on equipment review and staff interview the licensee did not ensure the nonmedical emergency supplies were required. Evidence: Director confirmed they did not have a working battery-operated flashlight or a battery-operated radio.”

8VAC20-780-40-J

“Based on document review and staff interview the licensee did not ensure injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services. Evidence: Director confirmed they did not have an updated injury prevention plan.”

8VAC20-780-410-1

“Based on review of video footage and staff interviews, it was confirmed that the center failed to ensure that a staff does not use the/a forbidden action of rough handling. Evidence: 1. In the two’s room on February 21, 2023, at approximately 12:05 PM, during nap time Child #1 was observed lying on their cot and Staff #1 leaned down and smacked Child #1 in the mouth and said ?Shut your mouth? and then Child #1 began to make a crying sound. 2.Child #2 was observed lying on their cot with their arm and hand raised. Staff #1 was observed leaning down towards Child #2, slapping the child's hand and saying, "lay down it's naptime, go to sleep". Staff #1 described that day as "rough day, chaotic and it was a mistake, I know I should not have done that".”

8VAC20-780-360-A

“Based on a review of video footage and staff interview the center did not ensure the variety of daily activities for all age groups shall be age and stage appropriate Evidence: The center’s video recording showed that on March 8, 2023 center staff were watching an R rated movie (Precious) in the presence of a Child #8, age 5 and within earshot of sleeping toddlers. Staff #2 confirmed they were watching the movie, with the sound on, and Child #5 was present and watching with them. Staff #2 said they began watching the movie around noon and finished around 2:00 PM. As per the MPAA's (Motion Picture Association of America) film rating policy, patrons under the age of 17 will require an accompanying parent or guardian to attend an "R" rated film.”

8VAC20-780-400-B

“Based on video footage and staff interview, the center did not ensure to offer constructive behavioral guidance and redirect children to appropriate behavior. Evidence: 1. Video-footage shows that on March 8, from approximately 8:04 AM until 8:13 AM in the center’s multipurpose room, Child #3, age 7, was running around the room ?roughhousing? and pushing multiple children as listed below; a. Child #3 pushes Child #4 (age 3) onto a large stuffed animal. b. Child #3 pulls Child #4 to the ground by the back of their sweatshirt. Then Child #4 gets up and begins to chase Child #3 around the classroom. c. Child #3 puts both of their hands on the cheeks of Child #4 and then pushes Child #4 to the ground. d. Child #3 pushes Child #7 (age 2). e. Child #3 walks up behind Child #6 (age 3) and puts their arms around their shoulders and neck and pushes them onto a large stuffed animal. 2.Staff #3, Staff #4 and Staff #5 were all observed in the multipurpose room and did not redirect children to appropriate behavior. 3.There were 17 children in the multipurpose room and most of the children were watching tv during this time. 4.Staff #2 watched this video-footage with the Licensing Inspector and described the children’s actions as ?only roughhousing?.”

8VAC20-820-120-E-5

“Based on observation and staff interviews, the licensee did not ensure that a copy of the notice of intent provided by the department was posted in a prominent place at each public entrance of the facility to advise consumers of serious or persistent violations. Evidence: The notice of intent was not posted at the entrance of the facility. Center director confirmed it had not been posted.”

8VAC20-780-350-B-4

“Based on observation, center documentation and staff interviews, the licensee did not ensure to follow the required staff to child ratio for children ages 3 years old up to school age eligible. Evidence: At approximately 2:18 pm, Child #1 (age 4 yrs 5 months) was observed in the school age room with 13 school age children (4 years 9 months to age 12). Center Director confirmed Child #1 had been assigned to school age classroom since August 9, 2022. The ratio of 1 staff for every 10 children age 3- to age 4 years 9 months was not followed.”

8VAC20-780-340-A

“Based on observation, documentation review and interviews, the licensee did not ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: Staff #2 did not ensure care, protection and guidance for the children they were responsible for supervising, as seven children were observed alone in the school-age area, that includes the TV room and multipurpose room for approximately five to 1ten minutes.”

8VAC20-780-500-A

“Based on observation and staff interviews, the licensee did not ensure staff wash their hands with soap and running water before and after a diaper change. Evidence: On June 22, 2022, a soiled diaper was observed sitting on the floor inside the doorway of the restroom in the two year old room. Staff #3 confirmed it was a soiled diaper, picked it up and placed it in the trashcan. Staff #3 did not wash their hands after disposing of the soiled diaper.”

8VAC20-780-340-F

“Based on observation and staff interviews, the license did not ensure children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. Upon Licensing Inspector arrival on June 22, 2022, at approximately 9:42 am, Staff #1 was observed in the center’s lobby. Beyond the lobby doors there is a ?TV room? where there were three school-age children observed (child #1, #2, and #3) and to the left of the lobby doors, there is a school age room/ multipurpose room where there were four additional school-age children (child #4, #5, #6 and #7). There was not a staff member observed supervising the children in the TV room or in the school age /multipurpose room. 2. Staff #1 stated Staff #2 was responsible for supervising the children in the two rooms. Staff #2 was observed working in the kitchen. Staff #2 said they were preparing lunch. Staff #1 confirmed Staff #2 was in the kitchen for about 5 five to 10 minutes and that there was not a staff member supervising the children in the TV room or in the school age multipurpose room during that time. 3. Six children under the age of 10 were observed without site and sound supervision along with a 12 year old child. Staff #1 and Staff #2 confirmed the children were not being supervised by a staff member.”

8VAC20-780-500-B

“Based on observation and staff interviews, the licensee did not ensure that staff disposed of disposable diapers in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: On June 22, 2022, a soiled diaper was observed sitting on the floor inside the doorway of the restroom in the two year old room. Staff #3 confirmed it was a soiled diaper and indicated they had not yet had a chance to throw it away because they had gotten busy. The diaper had not been disposed of in a leakproof or plastic-lined storage system.”

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

“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 February 25, 2022 between approximately 8:00 am and 8:30 am, Child #1 age 4, walked out the front door of the center without staff supervision to get on their school bus. The center's supervision policy includes the following information; "Teachers are assigned to a class by the administrator and must always stay in the class". "Teachers are responsible for always having students in their sight and sound". 1) Witness observed the front door to the center was open when the bus pulled into the center's parking lot. Witness confirmed there were no staff visible. Witness asked Child #1 "where is your teacher?" and Child #1 said "I don't know.". 2) Staff #1's written statement was "I step in the kitchen no more than 10 seconds I come back in the media room" Child #1 "had got her coat and went out to the bus". 3) Interviews confirm Staff #1 walked out to the school bus once they had noticed Child #1 was outside. 4) Staff #1 was supervising Child #1 in the media room during this time. 5) The center is located on a four lane undivided road with a speed limit of 35.”

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

“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: 1) On February 25, 2022 between approximately 8:00 am and 8:30 am, Staff #1 left Child #1, age 4, unsupervised. Child #1 was able to leave the center and get on a public school bus that was parked in the center’s parking lot. 2) Witness #1 confirmed Child #1, age 4, walked out of the building and through the parking lot without supervision to get on the school bus. 3) Staff #1 did not follow their bus policy which states ?staff have students gather their belongings and escort them to the front door. Once the bus arrives staff walk the students to the bus and wait for all students to get on the bus before going back into the center".”

22.1-289.035-B-4

“Base on record review and staff interviews, the licensee did not ensue to obtain the results of a criminal history record ( CRC ) information check, a sex offender registry check and a search of the child abuse and neglect registry ( CPS ) or equivalent registry from any state from any state in which the individual has resided in the preceding five years before reporting to the child day center. Evidence: The record for staff #1 did not include the CRC or the sex offender check from Texas where the staff had lived within the last 5 years prior to beginning employment and did not include a Texas CPS check within 30 days of employment. Staff #1 date of employment 11-12-2021..”

8VAC20-780-160-B

“Based on record review and staff interview, the license did not ensure to obtain documentation of a negative results of ( PPD ) tuberculosis screening that included a clearance statement signed by a physician, the physician's designee or an official of the local health department. This statement shall include language that the individual does not have any current symptoms of active tuberculosis, does not have either a risk factor for acquiring tuberculosis infection or a risk factor for progression to active tuberculosis disease as defined by the local health department, or has been treated for these conditions in the past, and is currently free of tuberculosis in a communicable form. Evidence: The record for staff #1 did not include documentation of a negative PP screening.”

8VAC20-780-280-G

“Based on observation and staff interviews the license did not ensure all if hazardous substances are not kept in original containers, the substitute containers shall clearly indicate their contents and shall not resemble food or beverage containers. Evidence: In a cabinet in the toddler room there were two spray containers with clear liquid and the contents was not labeled. The center staff said one container was a bleach and water solution and the other was a soap and water solution.”

22.1-289.035-B-4

“Base on record review and staff interviews, the licensee did not ensue to obtain the results of a criminal history record ( CRC ) information check, a sex offender registry check and a search of the child abuse and neglect registry ( CPS ) or equivalent registry from any state from any state in which the individual has resided in the preceding five years before reporting to the child day center. Evidence: The record for staff #1 did not include the CRC or the sex offender check from Texas where the staff had lived within the last 5 years prior to beginning employment and did not include a Texas CPS check within 30 days of employment. Staff #1 date of employment 11-12-2021..”

8VAC20-780-160-B

“Based on record review and staff interview, the license did not ensure to obtain documentation of a negative results of ( PPD ) tuberculosis screening that included a clearance statement signed by a physician, the physician's designee or an official of the local health department. This statement shall include language that the individual does not have any current symptoms of active tuberculosis, does not have either a risk factor for acquiring tuberculosis infection or a risk factor for progression to active tuberculosis disease as defined by the local health department, or has been treated for these conditions in the past, and is currently free of tuberculosis in a communicable form. Evidence: The record for staff #1 did not include documentation of a negative PP screening.”

8VAC20-780-280-G

“Based on observation and staff interviews the license did not ensure all if hazardous substances are not kept in original containers, the substitute containers shall clearly indicate their contents and shall not resemble food or beverage containers. Evidence: In a cabinet in the toddler room there were two spray containers with clear liquid and the contents was not labeled. The center staff said one container was a bleach and water solution and the other was a soap and water solution.”