Smiling Faces Daycare

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

“Based on observation and interview, it was determined that the center did not ensure that children's hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks. Evidence: 1. Prior to morning snack, the children were observed completing an activity and immediately had snack without appropriate handwashing. 2. Staff #2 confirmed that the children did not wash their hands prior to having their morning snack.”

8VAC20-780-340-C Complaint related: No

“Based on observation and interview, it was determined that the center did not ensure that during the stated hours of operation, there always shall be on the premises when one or more children are present one staff member who meets the qualifications of a program leader or program director and an immediately available staff member, volunteer or other employee who is at least 16 years of age, with direct means for communication between the two of them. Evidence: 1. Staff #2 arrived at the center at 6am and the only staff member present with 7 children. 2. The two additional staff members, Staff #3 and Staff #4 arrived at 8am. They arrived with Staff #2 being the only staff member with 7 children in care. 3. Staff #2 confirmed that they were the only staff member in the morning with 7 children in care.”

8VAC20-780-60-A Complaint related: No

“Based on record review and interview, it was determined that the center did not ensure that they maintain and keep at the center a separate record for each child enrolled which shall contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. Evidence: 1. Child #1 (date of enrollment 5/09/2023) did not have two designated people’s contact information to call in case of an emergency if a parent cannot be reached 2. Child #2 (date of enrollment 4/27/23) Did not have the addresses of the two designated people to contact in case of an emergency if a parent cannot reached.”

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

“Based on record review and interview, it was determined that the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. Staff #4 (date of hire 03/02/2023) has a tuberculosis screening completed on 3/10/2023 which is outside of the required timeframe of submitting documentation of a negative TB screening at the time of employment or prior to coming into contact with children. 2. Staff #1 confirmed that Staff #4 did not have the TB screening completed in the required timeframe.”

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

“Based on observation and interview, it was determined that the center did not ensure that bottle shall not be used while the child is in his designated sleeping location. Evidence: 1. Child #3 and Child #4 were observed in their designated sleeping location with bottles. 2. Staff #2, infant teacher, confirmed that both Child #3 and Child #4 had bottles in their designated sleeping location.”

8VAC20-780-70

“Based on record review and interview, it was determined that the center did not ensure that for staff hired after March 1, 1996, documentation that two or more references as to character and reputation as well as competency were checked before employment. Evidence: 1. The record for Staff #2 (date of hire March 10, 2023) only had one reference check completed before employment when two or more references are required. 2. Staff #1, Director, confirmed that Staff #2 had one reference check completed when two or more references before employment are required.”

8VAC20-780-70

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 (date of hire: 10/28/22) does not contain documentation that two or more references at to character and reputation as well as competency were checked before employment or documentation to demonstrate that she has received the orientation and training as required in 8VAC20-780-240 and 8VAC20-780-245. 2. Staff 2's (date of hire: 4/28/22) job title is documented in the record as program leader. The record for staff 2 does not contain documentation to demonstrate that she possesses the education required for the job position of program leader. 3. The center owner confirmed that the records for staff 1 and staff 2 are missing the above required items.”

8VAC20-780-160-A

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. Evidence: 1. The record for staff 1 (date of hire: 10/28/22) does not contain documentation of a negative tuberculosis screening. Staff 1 was working with children on the day of the inspection. 2. The center owner confirmed that the record for staff 1 is lacking documentation of a negative tuberculosis screening.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The records for child 1 (date of enrollment: 10/3/22) and child 2 (date of enrollment: 9/20/22) do not contain the work phone number and place of employment of each parent who has custody. 2. The center owner confirmed that the records for child 1 and child 2 are lacking the required employment information for the parents.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1 (date of hire: 9/12/22) indicated on her employment application that she has resided in the state of Mississippi within the past five years. The record for staff 1 does not contain the results of a criminal history record information check from the state of Mississippi. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that a criminal history record check for staff 1 was not requested from the state of Mississippi.”

22.1-289.035-B-2

“Based on record review and interview, the center did not ensure that the results of a national fingerprint search is received for each staff member before employment. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the results of a national fingerprint search. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that the record for staff 1 is lacking the results of a national fingerprint search.”

8VAC20-780-70

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the name address and telephone number of a person to be notified in an emergency. 2. Staff 2's (date of hire: 4/28/22) job title is documented in the record as program leader. The record for staff 2 does not contain documentation to demonstrate that she possesses the education required for the job position of program leader. 3. The center owner confirmed that the records for staff 1 and staff 2 are missing the above required items.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The records for child 1 (date of enrollment: 10/3/22) and child 2 (date of enrollment: 9/20/22) do not contain the work phone number and place of employment of each parent who has custody. 2. The center owner confirmed that the records for child 1 and child 2 are lacking the required employment information for the parents.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1 (date of hire: 9/12/22) indicated on her employment application that she has resided in the state of Mississippi within the past five years. The record for staff 1 does not contain the results of a criminal history record information check from the state of Mississippi. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that a criminal history record check for staff 1 was not requested from the state of Mississippi.”

22.1-289.035-B-2

“Based on record review and interview, the center did not ensure that the results of a national fingerprint search is received for each staff member before employment. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the results of a national fingerprint search. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that the record for staff 1 is lacking the results of a national fingerprint search.”

8VAC20-780-70

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the name address and telephone number of a person to be notified in an emergency. 2. Staff 2's (date of hire: 4/28/22) job title is documented in the record as program leader. The record for staff 2 does not contain documentation to demonstrate that she possesses the education required for the job position of program leader. 3. The center owner confirmed that the records for staff 1 and staff 2 are missing the above required items.”

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

“Based on observation and interview, the center did not ensure that the staff-to-children ratio of 1:4 for birth up to 16 months is maintained. Evidence: 1. During the inspection on 9/21/22, the licensing inspectors observed 1 staff person caring for 5 infants in the infant room. The number and ages of the children require 2 staff to be present. 2. Staff 2 confirmed that she was the only staff person in the infant room with 5 children.”

8VAC20-780-340-F Complaint related: No

“Based on observation, the center did not ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: 1. During the inspection on 9/21/22, the licensing inspectors observed staff 2 place three infants in an enclosed play yard on the floor of the toddler/two’s classroom in the front of the center and walk back to the infant classroom in the back of the center where two other infants were located. There was no other staff providing actual sight supervision to the three infants in the play yard. The licensing inspectors observed one of the infants crawling on top of another infant in the play yard during this time. 2. The layout of the center prevented staff 2 from being able to provide actual sight supervision to the three infants in the play yard at the front of the center and the two infants in the infant area at the back of the center at the same time. Staff 2 was observed walking back and forth from the infant area to where the play yard was located in order to check on the three infants in the play yard.”

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

“Based on record review and interview, the center did not ensure that an employee of a licensed registered child day program must not be employed until the agency has the person’s completed sworn statement or affirmation. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain a completed sworn statement or affirmation. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that the record for staff 1 is lacking a completed sworn statement or affirmation.”

22.1-289.035-B-4 Complaint related: No

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 1 (date of hire: 9/12/22) indicated on her employment application that she has resided in the state of Mississippi within the past five years. The record for staff 1 does not contain the results of a criminal history record information check from the state of Mississippi. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that a criminal history record check for staff 1 was not requested from the state of Mississippi.”

22.1-289.035-B-2 Complaint related: No

“Based on record review and interview, the center did not ensure that the results of a national fingerprint search is received for each staff member before employment. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the results of a national fingerprint search. Staff 1 was working on the day of the inspection. 2. The center owner confirmed that the record for staff 1 is lacking the results of a national fingerprint search.”

8VAC20-780-80-A Complaint related: No

“Based on a review of the daily attendance log and interview, the center did not ensure that a written record of daily attendance that documents the arrival and departure of each child in care as it occurs shall be maintained. Evidence: 1. On 9/21/22, there were 9 children in care at the center and only 6 children were signed in on the daily attendance log. 2. Staff 3 confirmed that only 6 of the 9 children in care were signed in at the time of their arrival on the attendance log.”

8VAC20-780-410-2 Complaint related: Yes

“Based on observation and interview, the center did not ensure enclosure in a small confined space or any space that the child cannot freely exit himself is forbidden. Evidence: 1. During the inspection on 9/21/22, the licensing inspectors observed two 2-year old children strapped in high chairs, with no toys or activity to engage in, from the time of the inspectors? arrival at 9:10 am until 9:25am. 2. Staff 1 stated she had put the two children in the high chairs at approximately 8:50am after they had already eaten breakfast at the children’s table. 3. The two children were not taken out of the high chairs until prompted to do so by the licensing inspector.”

8VAC20-780-70 Complaint related: No

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 (date of hire: 9/12/22) does not contain the following: job title; name, address and telephone number of a person to be notified in an emergency; documentation that two or more references as to character and reputation as well as competency were checked before employment; documentation to demonstrate that the individual possesses the education and experience required by the job position; and, documentation of orientation training. 2. The center owner confirmed that the record for staff 1 is lacking the above required information.”

8VAC20-780-340-D Complaint related: No

“Based on record review and interview, the center did not ensure that in each grouping of children, at least one staff member who meets the qualifications of a program leader or program director shall be regularly present. Evidence: 1. On 9/21/22, staff 1 (date of hire: 9/12/22) was observed to be working alone in the toddler/two’s classroom with 4 children between the ages of 21 months and 2 years. Staff 1 is not program leader qualified. 2. Staff 1 stated that she had no previous experience in a child care setting prior to being hired at the center and had no college credits in a child-related field. 3. The center owner confirmed that staff 1 is not program leader qualified and is regularly scheduled to work alone in a classroom with children.”

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

“Based on interview, the center did not ensure that during the stated hours of operation, there shall always be on the premises when one or more children are present one staff member and an immediately available staff member with direct means for communication between the two of them. Evidence: 1. On 9/21/22, staff 2 was the only staff member present from the time the center opened at 6:00am until staff 3 arrived at 7:30am. Four children, between the ages of 5 months and 22 months, arrived at the center between the hours of 6:00am and 7:30am. 2. Staff 2 and staff 3 confirmed that there is regularly only 1 staff member present with one or more children in care for approximately one hour to one and a half hours when the center opens in the morning.”

8VAC20-780-370-1 Complaint related: No

“Based on interview, the center did not ensure that when an infant is placed in his crib, he shall be placed on his back. Evidence: 1. When asked by the licensing inspector about play spaces and ?tummy time? for infants, staff 2 stated that infants are sometimes placed in their crib for ?tummy time?. a. Staff 2 stated that the younger infants are not able to hold up their heads while on their stomach; therefore, they are placed in their crib on their stomach for ?tummy time? in order to keep them from hitting their face on the floor.”

8VAC20-780-370-5 Complaint related: Yes

“Based on observation and interview, the center did not ensure that staff shall provide awake infants not playing on the floor or ground a change in play space at least every 30 minutes or more often as determined by the individual infant’s needs. Evidence: 1. During the inspection on 9/21/22, the licensing inspectors observed 5 infants seated in infant bouncer seats from the time of the inspectors? arrival at the center at 9:10am until approximately 10:00am. 2. The licensing inspectors observed two of the infants to repeatedly try to turn and twist around in the bouncer seats after being in them for approximately 30 minutes. a. When questioned what staff do when an infant is trying to twist out of the bouncer seat, staff 2 stated that they ?just pull the seat belt tighter?. 3. The 5 infants were not taken out of the bouncer seats by staff until prompted to do so by the licensing inspectors. 4. Staff 2 stated that the infants are ?usually? in their bouncer seat or their crib ?for most of the day?.”

8VAC20-780-70

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 does not contain a date of employment; a name, address and telephone number of a person to be notified in an emergency; or, documentation that two or more references as to character and reputation as well a competency were checked before employment. 2. The record for staff 2 (date of hire: 5/14/22) does not contain documentation that two or more references as to character and reputation as well a competency were checked before employment. 3. The center director confirmed that the records for staff 1 and staff 2 are lacking the above missing information.”

8VAC20-780-450-A

“Based on observation and interview, the center did not ensure that cots and mats used by children other than infants during the designated rest period shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Evidence: 1. Three of the children did not have bottom covers during the designated rest period. 2. Staff confirmed that not all of the children in care have the required bottom covers during nap time.”

8VAC20-780-440-B

“Based on record review and interview, the center did not ensure cribs shall be identified for use by a specific child. Evidence: 1. In the infant room, there were 3 infants who were placed in cribs identified for use by other children. 2. In the infant room, 1 infant did not have a crib identified for use by that child. 3. Staff 3 confirmed that the infants were not placed in the correct cribs and that one infant did not have a crib identified for use.”

8VAC20-780-410-2

“Based on observation and interview, the center did not ensure enclosure in a small confined space or any space that the child cannot freely exit himself is forbidden. Evidence: 1. During the inspection on 5/27/22, the inspectors observed child 4 (age 23 months), child 5 (age 20 months) and child 7 (age 17 months) strapped in their high chairs from the time of inspectors' arrival at 12:45pm until 1:20pm. 2. Staff 1 and staff 2 stated child 4, child 5 and child 7 had been in the high chairs since 11:45am and that they kept them in the high chairs because they would not lay down at nap time and would run around the center and wake the other children who were napping. a. Child 4, child 5 and child 7 were not taken out of the high chairs until the licensing inspectors asked staff 1 and 2 why the children were still confined to the their high chairs.”

22.1-289.035-B-2

“Based on record review and interview, the center did not ensure that the results of a national fingerprint search are received for each staff member before employment. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain the results of a national fingerprint search. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking documentation of the results of a national fingerprint search.”

8VAC20-780-160-A

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening. Evidence: 1. The record for staff 2 (date of hire: 5/14/22) does not contain documentation of a negative tuberculosis screening. 2. The center owner confirmed that the record for staff 2 is lacking documentation of a negative tuberculosis screening.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation that each child has received the immunizations required by the State Board of Health are obtained before the child can attend the center. Evidence: 1. The records for child 2 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of immunizations. Both children were in care on the day of the inspection. 2. The center owner confirmed that the records for child 2 and child 6 are lacking documentation of immunizations.”

8VAC20-770-60-B

“Based on record review and interview, the center did not ensure that an employee of a licensed registered child day program must not be employed until the agency has the person's completed sworn statement or affirmation. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain a sworn statement or affirmation. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking a sworn statement or affirmation.”

8VAC20-780-510-G

“Based on observation and interview, the center did not ensure that medication shall be labeled with the child's name. Evidence: 1. There was a bottle of children's Tylenol in the center that was not labeled with the child's name. 2. Staff confirmed that the medication was not labeled with the child's name and could not state who the medication belonged to.”

8VAC20-770-60-C-2

“Based on record review and interview, the center did not ensure that the results of a central registry finding are received within 30 days of employment. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain the results of a central registry finding. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking documentation of a central registry finding.”

8VAC20-780-340-F

“Based on observation and interview, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. During the inspection on 5/27/22, inspectors observed staff 3 (infant teacher) take an infant into the restroom and close the door to change that child's diaper, leaving the other 4 infants in her care without sight and sound supervision. 2. Staff 3 confirmed that she took one of the infants into the restroom to change her diaper and closed the door, leaving the other 4 infants in her care without sight and sound supervision.”

8VAC20-780-350-B-1

“Based on observation and interview, the center did not ensure that the staff-to-children ratio of 1:4 for birth up to 16 months is maintained. Evidence: 1. During the inspection on 5/27/22, the inspectors observed 1 staff person caring for 5 infants in the infant room. The number and ages of the children required 2 staff to be present. 2. Staff 3 confirmed that she was the only staff person in the infant room with 5 children.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 2 has a hire date of 5/14/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of Georgia within the past five years. The results of a central registry search from the state of Georgia was not available for staff 2. 2. The center owner confirmed that the central registry search for staff 2 from the state of Georgia has not been requested.”

8VAC20-780-140-A

“Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. The records for child 2 (date of enrollment unknown), child 3 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of a physical examination. 2. The center owner confirmed that the records for child 2, child 3 and child 6 are lacking documentation of a physical examination.”

8VAC20-780-520-C

“Based on observation and interview, the center did not ensure that if diaper ointment or cream is used that they shall be inaccessible to children. Evidence: 1. There was a container of diaper cream on an open shelf under the changing table in the bathroom that was accessible to children in care. 2. Staff 3 confirmed that the diaper cream was accessible to children.”

8VAC20-780-570-B

“Based on observation and interview, the center did not ensure that bottle fed infants who cannot hold their own bottles shall be held when fed and that bottles shall not be propped. Evidence: 1. There were 3 infants in infant carrier seats drinking from bottles that were propped up with blankets, creating a choking hazard. 2. Staff 3 confirmed that the infants were being fed bottles by propping the bottles with blankets.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The records for child 1, child 2, child 3, child 4 and child 5 do not contain the first dates of attendance. 2. The record for child 3 does not contain the address for one of the two designated people to call in an emergency if a parent cannot be reached. 3. There is no record for child 6 available for review. 3. The center owner confirmed that the records for child 1, child 2, child 3, child 4 and child 5 are lacking the above missing information and that there is no record available for review for child 6.”

8VAC20-780-510-L

“Based on observation and interview, the center did not ensure that medication shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was a bottle of children's Tylenol, a bottle of over-the-counter liquid allergy medication and a Flonase spray in an unlocked cubby in the preschool classroom and was assessible to the children in care. 2. Staff 3 confirmed that the medication was not in a locked place and was assessible to children in care.”

8VAC20-780-70

“Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. The record for staff 1 does not contain a date of employment; a name, address and telephone number of a person to be notified in an emergency; or, documentation that two or more references as to character and reputation as well a competency were checked before employment. 2. The record for staff 2 (date of hire: 5/14/22) does not contain documentation that two or more references as to character and reputation as well a competency were checked before employment. 3. The center director confirmed that the records for staff 1 and staff 2 are lacking the above missing information.”

8VAC20-780-450-A

“Based on observation and interview, the center did not ensure that cots and mats used by children other than infants during the designated rest period shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Evidence: 1. Three of the children did not have bottom covers during the designated rest period. 2. Staff confirmed that not all of the children in care have the required bottom covers during nap time.”

8VAC20-780-440-B

“Based on record review and interview, the center did not ensure cribs shall be identified for use by a specific child. Evidence: 1. In the infant room, there were 3 infants who were placed in cribs identified for use by other children. 2. In the infant room, 1 infant did not have a crib identified for use by that child. 3. Staff 3 confirmed that the infants were not placed in the correct cribs and that one infant did not have a crib identified for use.”

8VAC20-780-410-2

“Based on observation and interview, the center did not ensure enclosure in a small confined space or any space that the child cannot freely exit himself is forbidden. Evidence: 1. During the inspection on 5/27/22, the inspectors observed child 4 (age 23 months), child 5 (age 20 months) and child 7 (age 17 months) strapped in their high chairs from the time of inspectors' arrival at 12:45pm until 1:20pm. 2. Staff 1 and staff 2 stated child 4, child 5 and child 7 had been in the high chairs since 11:45am and that they kept them in the high chairs because they would not lay down at nap time and would run around the center and wake the other children who were napping. a. Child 4, child 5 and child 7 were not taken out of the high chairs until the licensing inspectors asked staff 1 and 2 why the children were still confined to the their high chairs.”

22.1-289.035-B-2

“Based on record review and interview, the center did not ensure that the results of a national fingerprint search are received for each staff member before employment. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain the results of a national fingerprint search. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking documentation of the results of a national fingerprint search.”

8VAC20-780-160-A

“Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening. Evidence: 1. The record for staff 2 (date of hire: 5/14/22) does not contain documentation of a negative tuberculosis screening. 2. The center owner confirmed that the record for staff 2 is lacking documentation of a negative tuberculosis screening.”

8VAC20-780-130-A

“Based on record review and interview, the center did not ensure that documentation that each child has received the immunizations required by the State Board of Health are obtained before the child can attend the center. Evidence: 1. The records for child 2 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of immunizations. Both children were in care on the day of the inspection. 2. The center owner confirmed that the records for child 2 and child 6 are lacking documentation of immunizations.”

8VAC20-770-60-B

“Based on record review and interview, the center did not ensure that an employee of a licensed registered child day program must not be employed until the agency has the person's completed sworn statement or affirmation. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain a sworn statement or affirmation. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking a sworn statement or affirmation.”

8VAC20-780-510-G

“Based on observation and interview, the center did not ensure that medication shall be labeled with the child's name. Evidence: 1. There was a bottle of children's Tylenol in the center that was not labeled with the child's name. 2. Staff confirmed that the medication was not labeled with the child's name and could not state who the medication belonged to.”

8VAC20-770-60-C-2

“Based on record review and interview, the center did not ensure that the results of a central registry finding are received within 30 days of employment. Evidence: 1. The record for staff 1 (date of hire unknown) does not contain the results of a central registry finding. Staff 1 was working on the date of the inspection and stated she thinks she began employment at the center on or around 5/6/22. 2. The center owner confirmed that the record for staff 1 is lacking documentation of a central registry finding.”

8VAC20-780-340-F

“Based on observation and interview, the center did not ensure that children under 10 years of age always shall be within actual sight and sound supervision of staff. Evidence: 1. During the inspection on 5/27/22, inspectors observed staff 3 (infant teacher) take an infant into the restroom and close the door to change that child's diaper, leaving the other 4 infants in her care without sight and sound supervision. 2. Staff 3 confirmed that she took one of the infants into the restroom to change her diaper and closed the door, leaving the other 4 infants in her care without sight and sound supervision.”

8VAC20-780-350-B-1

“Based on observation and interview, the center did not ensure that the staff-to-children ratio of 1:4 for birth up to 16 months is maintained. Evidence: 1. During the inspection on 5/27/22, the inspectors observed 1 staff person caring for 5 infants in the infant room. The number and ages of the children required 2 staff to be present. 2. Staff 3 confirmed that she was the only staff person in the infant room with 5 children.”

22.1-289.035-B-4

“Based on record review and interview, the center did not ensure that a copy of the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 2 has a hire date of 5/14/22. Staff 1 indicated on her sworn statement or affirmation that she has resided in the state of Georgia within the past five years. The results of a central registry search from the state of Georgia was not available for staff 2. 2. The center owner confirmed that the central registry search for staff 2 from the state of Georgia has not been requested.”

8VAC20-780-140-A

“Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within 30 days after the first day of attendance. Evidence: 1. The records for child 2 (date of enrollment unknown), child 3 (date of enrollment unknown) and child 6 (date of enrollment unknown) do not contain documentation of a physical examination. 2. The center owner confirmed that the records for child 2, child 3 and child 6 are lacking documentation of a physical examination.”

8VAC20-780-520-C

“Based on observation and interview, the center did not ensure that if diaper ointment or cream is used that they shall be inaccessible to children. Evidence: 1. There was a container of diaper cream on an open shelf under the changing table in the bathroom that was accessible to children in care. 2. Staff 3 confirmed that the diaper cream was accessible to children.”

8VAC20-780-570-B

“Based on observation and interview, the center did not ensure that bottle fed infants who cannot hold their own bottles shall be held when fed and that bottles shall not be propped. Evidence: 1. There were 3 infants in infant carrier seats drinking from bottles that were propped up with blankets, creating a choking hazard. 2. Staff 3 confirmed that the infants were being fed bottles by propping the bottles with blankets.”

8VAC20-780-60-A

“Based on record review and interview, the center did not ensure that children's records contain all the required information. Evidence: 1. The records for child 1, child 2, child 3, child 4 and child 5 do not contain the first dates of attendance. 2. The record for child 3 does not contain the address for one of the two designated people to call in an emergency if a parent cannot be reached. 3. There is no record for child 6 available for review. 3. The center owner confirmed that the records for child 1, child 2, child 3, child 4 and child 5 are lacking the above missing information and that there is no record available for review for child 6.”

8VAC20-780-510-L

“Based on observation and interview, the center did not ensure that medication shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was a bottle of children's Tylenol, a bottle of over-the-counter liquid allergy medication and a Flonase spray in an unlocked cubby in the preschool classroom and was assessible to the children in care. 2. Staff 3 confirmed that the medication was not in a locked place and was assessible to children in care.”