The T.E.A. Center Preschool

22.1-289.011-F

“Based on observation, the most recently issues license and most recently issued inspection paperwork were not posted. Evidence: 1. The most recently issued license was a Provisional License issued on July 18, 2023. No license was posted. 2. The inspection paperwork posted was dated 2/16/23. The most recent inspection was conducted on 6/21/23.”

8VAC20-780-60-A

“Repeat Violation Based on a review of records, child records did not contain all required information. Evidence: 5 records reviewed. 1 of 5 reviewed did not contain documentation of acceptable emergency contacts. The mother was listed as one of the emergency contacts. (Child 2)”

8VAC20-780-70

“Repeat Violation Based on a review of records, one staff record did not have all required information documented. Evidence: 1 of 2 staff records reviewed was missing documentation of a second reference having been conducted. (Staff A)”

8VAC20-780-270-A

“Based on observation, the center was not maintained in a clean, safe and operable condition. Evidence: The toilet tank lid in the handicapped stall (hallway bathroom) does not sit securely on the tank. It is the wrong shape for the tank. The stall was not blocked off or closed.”

8VAC20-780-290-A-3

“Based on observation, an outlet in the Sky room did not have a protective cover. Evidence: One outlet in the Sky room did not have a protective cap installed.”

8VAC20-780-330-B

“Based on observation, playground climbing equipment did not have a fall zone free of hazardous obstacles. Evidence: The plastic climber’s fall zone included the barrier (wooden timbers) used to contain the resilient surfacing material for the slide.”

8VAC20-780-440-J

“Based on observation, occupied cribs did not have enough space between occupied cribs. Evidence: 1. There were 2 occupied cribs that had less than 6? of space between the cribs. Cribs were in the corner of the infant room, perpendicular to each other. 2. Child #1?s crib did not have 30 inches of space on the service side of the crib. There was less than 6 inches of space available.”

8VAC20-780-500-A

“Based on observation, hands were not washed after toileting. Evidence: 1. A child’s hands were not washed after a diaper change in the Sky room. LI reminded the staff person to wash the child’s hands before leaving the room. (Child 3) 2. Staff member in the Sky room failed to wash their hands after completing a diaper change. LI reminded the staff person to wash their hands before leaving the room.”

8VAC20-780-500-B

“Based on observation, staff did not follow proper procedures for diaper changes. Evidence: 1. A staff person in the Sky room did not clean and sanitize the diapering surface after completing a diaper change for a child. 2. a staff member in the Sky room was observed using their hand to open the disposal container to throw away a diaper, instead of the foot pedal on the container.”

8VAC20-780-510-E

“Repeat Violation Based on a review of medications, a medication authorization was not available for review. Evidence: 1. A long-term, as needed medication (Epi-pen) on site did not have an appropriate authorization form available for review. The authorization form gave permission for a different entity to administer medication. (Child 2) 2. A long-term, as needed medication on site (Childrens Benadryl) did not have an appropriate authorization form available for review. The form available did not give permission of the TEA Center to administer the medication. (Child 5)”

8VAC20-780-510-I

“Based on a review of medications, medication present at the center did not have prescription labels attached. Evidence: 1.Child #2?s Epi-pen did not have a prescription label attached.”

8VAC20-780-280-B

“Based on observation, hazardous materials were not stored locked when not in use. Evidence: Cleaners/Sanitizing solutions in the Sky Room were not stored locked after a diaper change.”

22.1-289.011-F

“Based on observation, the most recently issues license and most recently issued inspection paperwork were not posted. Evidence: 1. The most recently issued license was a Provisional License issued on July 18, 2023. No license was posted. 2. The inspection paperwork posted was dated 2/16/23. The most recent inspection was conducted on 6/21/23.”

8VAC20-780-60-A

“Repeat Violation Based on a review of records, child records did not contain all required information. Evidence: 5 records reviewed. 1 of 5 reviewed did not contain documentation of acceptable emergency contacts. The mother was listed as one of the emergency contacts. (Child 2)”

8VAC20-780-70

“Repeat Violation Based on a review of records, one staff record did not have all required information documented. Evidence: 1 of 2 staff records reviewed was missing documentation of a second reference having been conducted. (Staff A)”

8VAC20-780-270-A

“Based on observation, the center was not maintained in a clean, safe and operable condition. Evidence: The toilet tank lid in the handicapped stall (hallway bathroom) does not sit securely on the tank. It is the wrong shape for the tank. The stall was not blocked off or closed.”

8VAC20-780-290-A-3

“Based on observation, an outlet in the Sky room did not have a protective cover. Evidence: One outlet in the Sky room did not have a protective cap installed.”

8VAC20-780-330-B

“Based on observation, playground climbing equipment did not have a fall zone free of hazardous obstacles. Evidence: The plastic climber’s fall zone included the barrier (wooden timbers) used to contain the resilient surfacing material for the slide.”

8VAC20-780-440-J

“Based on observation, occupied cribs did not have enough space between occupied cribs. Evidence: 1. There were 2 occupied cribs that had less than 6? of space between the cribs. Cribs were in the corner of the infant room, perpendicular to each other. 2. Child #1?s crib did not have 30 inches of space on the service side of the crib. There was less than 6 inches of space available.”

8VAC20-780-500-A

“Based on observation, hands were not washed after toileting. Evidence: 1. A child’s hands were not washed after a diaper change in the Sky room. LI reminded the staff person to wash the child’s hands before leaving the room. (Child 3) 2. Staff member in the Sky room failed to wash their hands after completing a diaper change. LI reminded the staff person to wash their hands before leaving the room.”

8VAC20-780-500-B

“Based on observation, staff did not follow proper procedures for diaper changes. Evidence: 1. A staff person in the Sky room did not clean and sanitize the diapering surface after completing a diaper change for a child. 2. a staff member in the Sky room was observed using their hand to open the disposal container to throw away a diaper, instead of the foot pedal on the container.”

8VAC20-780-510-E

“Repeat Violation Based on a review of medications, a medication authorization was not available for review. Evidence: 1. A long-term, as needed medication (Epi-pen) on site did not have an appropriate authorization form available for review. The authorization form gave permission for a different entity to administer medication. (Child 2) 2. A long-term, as needed medication on site (Childrens Benadryl) did not have an appropriate authorization form available for review. The form available did not give permission of the TEA Center to administer the medication. (Child 5)”

8VAC20-780-510-I

“Based on a review of medications, medication present at the center did not have prescription labels attached. Evidence: 1.Child #2?s Epi-pen did not have a prescription label attached.”

8VAC20-780-280-B

“Based on observation, hazardous materials were not stored locked when not in use. Evidence: Cleaners/Sanitizing solutions in the Sky Room were not stored locked after a diaper change.”

8VAC20-780-510-E

“Based on a review of medications, a medication authorization was not available for review. Evidence: One long term medication (Avi-Q) on site had no authorization available for review. (Child 1)”

8VAC20-780-70

“Based on a review of records, staff records did not contain all required documentation. Evidence: 2 of 6 records reviewed did not contain documentation of 2 references checked prior to employment. (Staff 2, 3)”

8VAC20-780-60-A

“Based on a review of records, child records do not contain all required documentation. Evidence: 8 child records were reviewed. 1. 4 of 8 records did not contain documentation of an annual update and confirmation of up-to-date information. (Children 3, 5, 6,8) 2. 1 of 8 was missing documentation of complete address information for emergency contacts. (Child 2)”

8VAC20-780-550-E

“Based on a review of records, there was no documentation to show that two shelter-in-place drills were conducted annually, Evidence: There was only 1 shelter-in-place drill documented for 2022. (5/20/22)”

8VAC20-780-250-A

“Based on a review of documentation and staff statement there is no approval from the local health department for meeting requirements for food service, if applicable. Evidence: 1. On June 10, 2022 the facility was made aware that a Health Department Inspection and certificate were required for the facility. 2.The facility has catered food delivered in "hot boxes" that is then redistributed and served to children. Per the local health Department, this requires a health department certificate. the facility does not have a health department certificate available for review. 3. The Health Department was contacted on June 1, 2023, to inquire about the status of the Health certificate and inspection. No complete application is on file.”

8VAC20-770-60-C-2

“Based on a review of records, staff records did not contain documentation of a complete Central Registry Search within 30 days of employment. Evidence: Staff #3's documented DOH is 5/27/22. Central registry Search results are dated 11/17/22.”

22.1-289.035-B-2

“based on a review of records, staff records did not contain documentation of a completed nationwide fingerprint search prior to employment. Evidence: 1. Staff #1's documented Date of Hire (DOH) is 1/6/20. Fingerprint results are dated 12-15-20. 2. Staff #3's documented DOH is 5/27/22. Fingerprint results are dated 10/5/22.”

8VAC20-780-550-D

“Based on a review of records, there is no documentation of a monthly evacuation drills being conducted. Evidence: There is no evacuation drill documented for December 2022,”

8VAC20-780-50-A

“Based on observation, staff and children's information was not kept confidential. Evidence: The Supplemental page of the most recent inspection was posted along with the Violation Notice and Inspection Summary forms. The Supplemental page contained the key to violations and specifically identified children and staff's names.”

8VAC20-780-160-A

“Based on a review of records, staff records did not contain documentation of a negative tuberculosis screening prior to employment and completed within the past 30 days. Evidence: 1. Staff #1's Date of Hire(DOH) is documented as 1-6-20. The TB results on file are dated 12-30-21. At the time of hire, regulations required that the TB screening results be on file within 21 days of employment. 2. Staff #3's DOH is documented as 5/27/22. TB results on file are dated 11/19/22.”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of the required annual health and safety update training, in the time frame allowed. Evidence: 1 of 6 records reviewed did not have the required training completed annually. Staff #1's record contained documentation of the annual training being completed on 5/28/23. The previously documented training was dated 4/2/22.”

8VAC20-790-530-C

“Based on a review of records, records may be kept electronically except attendance, which must be a written hard copy. Evidence: The attendance in the Ocean room did not accurately reflect the children in the room. The written hard copy did not document children's arrival and departure as it occurred. At 10:50 AM the attendance sheet reflected 8 children. There were 9 children present in the room. Staff stated they take attendance "on the hour". 1 child arrived after the 9:00 and 10:00 times, and was not recorded on the sheet.”

8VAC20-780-510-E

“Based on a review of medications, a medication authorization was not available for review. Evidence: One long term medication (Avi-Q) on site had no authorization available for review. (Child 1)”

8VAC20-780-70

“Based on a review of records, staff records did not contain all required documentation. Evidence: 2 of 6 records reviewed did not contain documentation of 2 references checked prior to employment. (Staff 2, 3)”

8VAC20-780-60-A

“Based on a review of records, child records do not contain all required documentation. Evidence: 8 child records were reviewed. 1. 4 of 8 records did not contain documentation of an annual update and confirmation of up-to-date information. (Children 3, 5, 6,8) 2. 1 of 8 was missing documentation of complete address information for emergency contacts. (Child 2)”

8VAC20-780-550-E

“Based on a review of records, there was no documentation to show that two shelter-in-place drills were conducted annually, Evidence: There was only 1 shelter-in-place drill documented for 2022. (5/20/22)”

8VAC20-780-250-A

“Based on a review of documentation and staff statement there is no approval from the local health department for meeting requirements for food service, if applicable. Evidence: 1. On June 10, 2022 the facility was made aware that a Health Department Inspection and certificate were required for the facility. 2.The facility has catered food delivered in "hot boxes" that is then redistributed and served to children. Per the local health Department, this requires a health department certificate. the facility does not have a health department certificate available for review. 3. The Health Department was contacted on June 1, 2023, to inquire about the status of the Health certificate and inspection. No complete application is on file.”

8VAC20-770-60-C-2

“Based on a review of records, staff records did not contain documentation of a complete Central Registry Search within 30 days of employment. Evidence: Staff #3's documented DOH is 5/27/22. Central registry Search results are dated 11/17/22.”

22.1-289.035-B-2

“based on a review of records, staff records did not contain documentation of a completed nationwide fingerprint search prior to employment. Evidence: 1. Staff #1's documented Date of Hire (DOH) is 1/6/20. Fingerprint results are dated 12-15-20. 2. Staff #3's documented DOH is 5/27/22. Fingerprint results are dated 10/5/22.”

8VAC20-780-550-D

“Based on a review of records, there is no documentation of a monthly evacuation drills being conducted. Evidence: There is no evacuation drill documented for December 2022,”

8VAC20-780-50-A

“Based on observation, staff and children's information was not kept confidential. Evidence: The Supplemental page of the most recent inspection was posted along with the Violation Notice and Inspection Summary forms. The Supplemental page contained the key to violations and specifically identified children and staff's names.”

8VAC20-780-160-A

“Based on a review of records, staff records did not contain documentation of a negative tuberculosis screening prior to employment and completed within the past 30 days. Evidence: 1. Staff #1's Date of Hire(DOH) is documented as 1-6-20. The TB results on file are dated 12-30-21. At the time of hire, regulations required that the TB screening results be on file within 21 days of employment. 2. Staff #3's DOH is documented as 5/27/22. TB results on file are dated 11/19/22.”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of the required annual health and safety update training, in the time frame allowed. Evidence: 1 of 6 records reviewed did not have the required training completed annually. Staff #1's record contained documentation of the annual training being completed on 5/28/23. The previously documented training was dated 4/2/22.”

8VAC20-790-530-C

“Based on a review of records, records may be kept electronically except attendance, which must be a written hard copy. Evidence: The attendance in the Ocean room did not accurately reflect the children in the room. The written hard copy did not document children's arrival and departure as it occurred. At 10:50 AM the attendance sheet reflected 8 children. There were 9 children present in the room. Staff stated they take attendance "on the hour". 1 child arrived after the 9:00 and 10:00 times, and was not recorded on the sheet.”

8VAC20-780-520-B

“Based on observation, sunscreen was not stored inaccessible to children under 5 years of age. Evidence: *Sunscreen stored under the changing table in the 2's room was not inaccessible to children. The door to the table was open. *Sunscreen stored under the sink int he Green room was not stored inaccessible to children. The cabinet was not locked (lock was broken).”

8VAC20-780-520-C

“Based on observation, diaper ointments or creams were not stored inaccessible to children. Evidence: *Diaper ointments were stored under the diaper changing table in the 2's room, accessible to children. The door was open to the cabinet. *Diaper ointments were stored under the sink in the Green room, in an unlocked cabinet. The lock was broken.”

8VAC20-780-560-G

“Based on observation, when food is brought from home, the container was not clearly dated and labeled to identify the owner. Evidence: 2 lunch containers in the Ocean's room (Preschool) were not labeled or dated.”

8VAC20-780-570-E

“Based on observation, infant bottles were not dated. Evidence: 2 infant bottles were labeled with infant's names; however, they were not dated.”

8VAC20-770-60-B

“Based on a review of records, staff records do not contain documentation of a completed Sworn Disclosure Statement (SDS), prior to the first day of employment, Evidence: 2 of 10 staff records reviewed were missing completed SDSs. *Staff A has no SDS available for review. (DOH: 9/2022) *Staff I has a signed form on file; however, none of the questions are answered on the form. (DOH: 12?19/22)”

8VAC20-770-60-C-2

“Based on a review of records, staff records do not contain documentation of a competed Central Registry Search ( CPS ) within 30 days of employment. Evidence: *No CPS results are on file for 3 of 10 records reviewed. (Staff A: DOH 9/2022), (Staff D: DOH 0/12/22), (Staff E: DOH 9/21/2022). *Results on file are dated 11/17/22 for Staff H. (DOH: 5/27/22)”

8VAC20-780-320-B

“Based on observation, multiple bathrooms in the facility did not have toilet paper and disposable towels available for use. Evidence: *3 of 4 stalls in the multi-stall bathroom did not have toilet paper available. (4th stall was open, but had a sign saying do not use). *No disposable towels were available in any bathroom used by children.”

8VAC20-780-130-E

“Based on a review of records, child records do not include an updated immunization record every 6 months until the age of 2 years of age. Evidence: No updated record of immunizations is on file. (Child 2,3)”

8VAC20-780-140-A

“Based on a review of records, one child record does not contain documentation of a completed physical within 30 days of enrollment. Evidence: The physical form available for review is blank, there is no information on the form. (Child 4: First day of attendance: 7/16/21)”

8VAC20-780-160-A

“Based on a review of records, staff records do not contain documentation of a negative tuberculosis screening, at the time of employment that was completed within the last 30 calendar days of the date of employment. Evidence: *Staff G has no documentation on file (DOH: 1/12/23) *Staff E screening is dated 1/27/22. (DOH: 9/21/22) *Staff F screening is dare 7/12/22. (DOH: 9/21/22) *Staff H(DOH: 5/27/22) has 1 screening on file dated 4/16/22 (more than 30 days prior to employment), and a second screening dated 11/19 22 (not prior to employment),”

8VAC20-780-40-E

“Based on a review of policies and procedures, the facility failed to follow their written policy for medication administration. Evidence: The parent handbook states: "The medication must be in the original container/packaging, including the pharmacist instructions." One medication (Avi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.”

8VAC20-780-40-M

“Based on observation, the list of children's allergies was not kept confidential. Evidence: The posted allergy list in 2 rooms was not kept confidential. The list showed children that have allergies, names and their allergy. (Infant room, 2's room)”

8VAC20-780-60-A

“Based on a review of records, child records do not contain all required components. Evidence: 6 child records were reviewed. Missing information includes: *Previous School information (Child 1) *Documentation of an annual update and confirmation of up-to-date information. (Child 5: record is dated 9/10/21), (Child 4: record is dated 11/23/21) *Parent work information for 1 parent (Child 4) *Parent work information for both parents (Child 5)”

8VAC20-780-60-A-7

“Based on a review of records, one child record does not contain documentation of allergies. Evidence: There is no information regarding allergies on file. (Child 1)”

8VAC20-780-60-A-8

“Based on a review of records, child records do not contain documentation of a written allergy action plan for a diagnosed food allergy that included instructions from a physician and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 3 of 3 child records were reviewed with a documented food allergy. *1 of 3 records had no allergy action plan available. (Child 6) *2 of 3 records had an allergy plan signed by the parent only that did not include physician's instructions. (Child ren 2,3)”

8VAC20-780-70

“Based on a review of records, staff records do not contain all required information. Evidence: 8 of 10 records reviewed were missing documentation of the following information: 1. References: *3 of 8 missing 2 references (Staff E, G, I) *1 of 8 missing a second reference (Staff D) * 1 of 8 missing a signature of the person completing 2 phone references. (Staff F) 2. 3 of 8 were missing an emergency contact. (Staff A, H, I) 3. Documentation to demonstrate the individual posses the education and experience required for the job position. * No experience documented (Staff C, I) * No qualifications documented (Staff F, I)”

8VAC20-780-240-A

“Based on a review of records, staff records do not contain documentation of the required Virginia Department of Education-sponsored orientation course being completed within 90 days of employment. Evidence: There is no documentation of the completed training course available for review. (Staff A: DOH 9/22), (Staff C: DOH: 10/31/22)”

8VAC20-780-240-B

“Based on a review of records, there is no documentation of completed orientation within the allowable time frame. Evidence: *No documentation of orientation: (Staff A,C,G, I) *No documentation of the required 10 hour training within 90 days of employment. (Staff C Date of Hire (DOH): 10/31/22) *No documentation of first aid training within 30 days of employment (Staff A: DOH 9/2022) (Staff B: DOH 8/30/22), (Staff C: DOH 10/31/22).”

8VAC20-780-245-J-3

“Based on observation, a child with an emergency medication was not always in the care of a staff member who meets the requirements of having Medication Administration Training (MAT) certification. Evidence: Child #6 has an emergency medication on site. At the time of LI arrival, there was no staff with MAT certification present.”

8VAC20-780-270-A

“Based on observation, areas and equipment of the center inside and out was not maintained in a clean safe and operable manner. Evidence: *A plastic play structure on the playground is broken, with sharp edges exposed and finger entrapment holes. *One toilet in the large multi-stall bathroom has a broken tank lid with sharp edges exposed.”

8VAC20-780-280-B

“Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children. Evidence: *Cleaning materials were under the cabinet under the sink in the bathroom, unlocked. A gallon jug of soap labeled keep out of reach of children was sitting on the counter. (Preschool room) *Hand sanitizer container was accessible in the "false window frame" next to the kitchen play structure. (Green room) *Air freshener plug-ins and solid air fresheners were accessible in multiple rooms.”

8VAC20-780-290-A-3

“Based on observation electrical outlets did not have protective covers. Evidence: In the Ocean's room, 2 outlets were uncapped.”

22.1-289.035-B-4

“Based on a review of records, staff records do not contain all required background search documentation for residences outside of the state of Virginia in the past 5 years. Criminal History search results prior to the first day of employment and a child abuse and neglect search ( CPS ) submitted within 30 days of employment with results received within 45 days of employment. Evidence: *Staff B (DOH: 8/30/22) CPS search was submitted 12/1/22. Results on file 1/12/23. *Staff C (DOH;10/31/22) Has no CPS results on file for 2 residences outside of Virginia within the last 5 years. No Criminal History search results for one of those residences. *Staff D (DOH: 9/12/22) has no CPS search results on file for one residence outside of Virginia in the past 5 years.”

22.1-289.035-B-2

“Based on a review of records, staff records do not contain documentation of a completed nationwide fingerprint search prior to employment. Evidence: *Results are dated 10/05/2022 for Staff H. (DOH: 5/27/22) *No results are on file for Staff A.”

8VAC20-780-130-A

“Based on a review of records, child records do not include documentation of immunizations prior to the first day of attendance. Evidence: *No immunization record available. (Child 1) *Immunization record on file has no immunizations recorded, the form is blank. (Child 4)”

8VAC20-780-440-B

“Based on observation, cribs and cots were not identified for use by a specific child. Evidence: *1 crib in use in the infant room was not labeled to identify the user. *Cots in multiple rooms were not labeled to identify the child using them.”

8VAC20-780-500-B

“Based on observation, diaper disposal trash can does not have plastic liner. Evidence: The trash can in the green room for diaper disposal is not leak-proof or have a plastic liner.”

8VAC20-780-510-E

“Based on a review of medications, medication authorizations are not available for review. Evidence: One long term medication (Avi-Q) on site has no authorization available for review. (Child 6)”

8VAC20-780-510-I

“Based on a review of medication, one medication is not in the original box with a prescription label attached. Evidence: One Avi-Q medication on site, is in a plastic zip-lock baggie with no box or prescription label attached. (Child 6)”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of the required health and safety update course. Evidence: Documentation available for review showed the annual health and safety course was last completed 1/1/2022. The course should have been repeated by 1/1/2023. (Staff #1)”

8VAC20-780-520-B

“Based on observation, sunscreen was not stored inaccessible to children under 5 years of age. Evidence: *Sunscreen stored under the changing table in the 2's room was not inaccessible to children. The door to the table was open. *Sunscreen stored under the sink int he Green room was not stored inaccessible to children. The cabinet was not locked (lock was broken).”

8VAC20-780-520-C

“Based on observation, diaper ointments or creams were not stored inaccessible to children. Evidence: *Diaper ointments were stored under the diaper changing table in the 2's room, accessible to children. The door was open to the cabinet. *Diaper ointments were stored under the sink in the Green room, in an unlocked cabinet. The lock was broken.”

8VAC20-780-560-G

“Based on observation, when food is brought from home, the container was not clearly dated and labeled to identify the owner. Evidence: 2 lunch containers in the Ocean's room (Preschool) were not labeled or dated.”

8VAC20-780-570-E

“Based on observation, infant bottles were not dated. Evidence: 2 infant bottles were labeled with infant's names; however, they were not dated.”

8VAC20-770-60-B

“Based on a review of records, staff records do not contain documentation of a completed Sworn Disclosure Statement (SDS), prior to the first day of employment, Evidence: 2 of 10 staff records reviewed were missing completed SDSs. *Staff A has no SDS available for review. (DOH: 9/2022) *Staff I has a signed form on file; however, none of the questions are answered on the form. (DOH: 12?19/22)”

8VAC20-770-60-C-2

“Based on a review of records, staff records do not contain documentation of a competed Central Registry Search ( CPS ) within 30 days of employment. Evidence: *No CPS results are on file for 3 of 10 records reviewed. (Staff A: DOH 9/2022), (Staff D: DOH 0/12/22), (Staff E: DOH 9/21/2022). *Results on file are dated 11/17/22 for Staff H. (DOH: 5/27/22)”

8VAC20-780-320-B

“Based on observation, multiple bathrooms in the facility did not have toilet paper and disposable towels available for use. Evidence: *3 of 4 stalls in the multi-stall bathroom did not have toilet paper available. (4th stall was open, but had a sign saying do not use). *No disposable towels were available in any bathroom used by children.”

8VAC20-780-130-E

“Based on a review of records, child records do not include an updated immunization record every 6 months until the age of 2 years of age. Evidence: No updated record of immunizations is on file. (Child 2,3)”

8VAC20-780-140-A

“Based on a review of records, one child record does not contain documentation of a completed physical within 30 days of enrollment. Evidence: The physical form available for review is blank, there is no information on the form. (Child 4: First day of attendance: 7/16/21)”

8VAC20-780-160-A

“Based on a review of records, staff records do not contain documentation of a negative tuberculosis screening, at the time of employment that was completed within the last 30 calendar days of the date of employment. Evidence: *Staff G has no documentation on file (DOH: 1/12/23) *Staff E screening is dated 1/27/22. (DOH: 9/21/22) *Staff F screening is dare 7/12/22. (DOH: 9/21/22) *Staff H(DOH: 5/27/22) has 1 screening on file dated 4/16/22 (more than 30 days prior to employment), and a second screening dated 11/19 22 (not prior to employment),”

8VAC20-780-40-E

“Based on a review of policies and procedures, the facility failed to follow their written policy for medication administration. Evidence: The parent handbook states: "The medication must be in the original container/packaging, including the pharmacist instructions." One medication (Avi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.”

8VAC20-780-40-M

“Based on observation, the list of children's allergies was not kept confidential. Evidence: The posted allergy list in 2 rooms was not kept confidential. The list showed children that have allergies, names and their allergy. (Infant room, 2's room)”

8VAC20-780-60-A

“Based on a review of records, child records do not contain all required components. Evidence: 6 child records were reviewed. Missing information includes: *Previous School information (Child 1) *Documentation of an annual update and confirmation of up-to-date information. (Child 5: record is dated 9/10/21), (Child 4: record is dated 11/23/21) *Parent work information for 1 parent (Child 4) *Parent work information for both parents (Child 5)”

8VAC20-780-60-A-7

“Based on a review of records, one child record does not contain documentation of allergies. Evidence: There is no information regarding allergies on file. (Child 1)”

8VAC20-780-60-A-8

“Based on a review of records, child records do not contain documentation of a written allergy action plan for a diagnosed food allergy that included instructions from a physician and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 3 of 3 child records were reviewed with a documented food allergy. *1 of 3 records had no allergy action plan available. (Child 6) *2 of 3 records had an allergy plan signed by the parent only that did not include physician's instructions. (Child ren 2,3)”

8VAC20-780-70

“Based on a review of records, staff records do not contain all required information. Evidence: 8 of 10 records reviewed were missing documentation of the following information: 1. References: *3 of 8 missing 2 references (Staff E, G, I) *1 of 8 missing a second reference (Staff D) * 1 of 8 missing a signature of the person completing 2 phone references. (Staff F) 2. 3 of 8 were missing an emergency contact. (Staff A, H, I) 3. Documentation to demonstrate the individual posses the education and experience required for the job position. * No experience documented (Staff C, I) * No qualifications documented (Staff F, I)”

8VAC20-780-240-A

“Based on a review of records, staff records do not contain documentation of the required Virginia Department of Education-sponsored orientation course being completed within 90 days of employment. Evidence: There is no documentation of the completed training course available for review. (Staff A: DOH 9/22), (Staff C: DOH: 10/31/22)”

8VAC20-780-240-B

“Based on a review of records, there is no documentation of completed orientation within the allowable time frame. Evidence: *No documentation of orientation: (Staff A,C,G, I) *No documentation of the required 10 hour training within 90 days of employment. (Staff C Date of Hire (DOH): 10/31/22) *No documentation of first aid training within 30 days of employment (Staff A: DOH 9/2022) (Staff B: DOH 8/30/22), (Staff C: DOH 10/31/22).”

8VAC20-780-245-J-3

“Based on observation, a child with an emergency medication was not always in the care of a staff member who meets the requirements of having Medication Administration Training (MAT) certification. Evidence: Child #6 has an emergency medication on site. At the time of LI arrival, there was no staff with MAT certification present.”

8VAC20-780-270-A

“Based on observation, areas and equipment of the center inside and out was not maintained in a clean safe and operable manner. Evidence: *A plastic play structure on the playground is broken, with sharp edges exposed and finger entrapment holes. *One toilet in the large multi-stall bathroom has a broken tank lid with sharp edges exposed.”

8VAC20-780-280-B

“Based on observation, hazardous substances were not kept in a locked place using a safe locking method that prevents access by children. Evidence: *Cleaning materials were under the cabinet under the sink in the bathroom, unlocked. A gallon jug of soap labeled keep out of reach of children was sitting on the counter. (Preschool room) *Hand sanitizer container was accessible in the "false window frame" next to the kitchen play structure. (Green room) *Air freshener plug-ins and solid air fresheners were accessible in multiple rooms.”

8VAC20-780-290-A-3

“Based on observation electrical outlets did not have protective covers. Evidence: In the Ocean's room, 2 outlets were uncapped.”

22.1-289.035-B-4

“Based on a review of records, staff records do not contain all required background search documentation for residences outside of the state of Virginia in the past 5 years. Criminal History search results prior to the first day of employment and a child abuse and neglect search ( CPS ) submitted within 30 days of employment with results received within 45 days of employment. Evidence: *Staff B (DOH: 8/30/22) CPS search was submitted 12/1/22. Results on file 1/12/23. *Staff C (DOH;10/31/22) Has no CPS results on file for 2 residences outside of Virginia within the last 5 years. No Criminal History search results for one of those residences. *Staff D (DOH: 9/12/22) has no CPS search results on file for one residence outside of Virginia in the past 5 years.”

22.1-289.035-B-2

“Based on a review of records, staff records do not contain documentation of a completed nationwide fingerprint search prior to employment. Evidence: *Results are dated 10/05/2022 for Staff H. (DOH: 5/27/22) *No results are on file for Staff A.”

8VAC20-780-130-A

“Based on a review of records, child records do not include documentation of immunizations prior to the first day of attendance. Evidence: *No immunization record available. (Child 1) *Immunization record on file has no immunizations recorded, the form is blank. (Child 4)”

8VAC20-780-440-B

“Based on observation, cribs and cots were not identified for use by a specific child. Evidence: *1 crib in use in the infant room was not labeled to identify the user. *Cots in multiple rooms were not labeled to identify the child using them.”

8VAC20-780-500-B

“Based on observation, diaper disposal trash can does not have plastic liner. Evidence: The trash can in the green room for diaper disposal is not leak-proof or have a plastic liner.”

8VAC20-780-510-E

“Based on a review of medications, medication authorizations are not available for review. Evidence: One long term medication (Avi-Q) on site has no authorization available for review. (Child 6)”

8VAC20-780-510-I

“Based on a review of medication, one medication is not in the original box with a prescription label attached. Evidence: One Avi-Q medication on site, is in a plastic zip-lock baggie with no box or prescription label attached. (Child 6)”

8VAC20-790-600-F

“Based on a review of records, one staff record did not contain documentation of the required health and safety update course. Evidence: Documentation available for review showed the annual health and safety course was last completed 1/1/2022. The course should have been repeated by 1/1/2023. (Staff #1)”

8VAC20-780-350-B-4

“Based on observation a room containing children age 3 years old to school age eligible did not maintain a 1 staff to 10 children ration. Evidence: A LI arrival, approximately 10:15 AM, 15 children were observed in the "Red" and "Green" rooms with one staff member standing in the doorway between the two rooms. 10 children were in the "Red Room", 5 children were in the "Green" room. The children were identified as 4 year old children by the staff member supervising the rooms. A second staff person arrived after 1-2 minutes.”

8VAC20-780-250-A Complaint related: No

“Based on a review of documentation ant staff statement there is no approval from the local health department for meeting requirements for food service, if applicable. Evidence: The facility has catered food delivered in "hot boxes" that is then redistributed and served to children. Per the local health Department, this requires a health department certificate. the facility does not have a health department certificate available for review.”

8VAC20-780-400-A Complaint related: Yes

“Based on staff interviews, the center failed to promote the child's physical, intellectual, emotional and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort and support. Evidence: 1. Staff A was observed "yelling, screaming and waving her arms" at children to stop them from entering a classroom through an exterior door. 2. Staff A was observed interrupting and "yelling" at a staff member that was having a conversation with another adult.”

8VAC20-780-355-B-4

“Based on observation, the ratio of 1:10 (staff:children) was not maintained for a group of children that contained children 3 years old to school age eligible. Evidence: At approximately 11:30 AM the Red room was observed to have 13 children with 1 staff person.”

8VAC20-790-600-D-2

“Based on a review of records, one staff record does not contain all required components Evidence: 1 of 2 records reviewed did not contain documentation of First Aid certification within 90 days of employment. (Staff 1 Date of Hire: 10/26/21).”

8VAC20-790-600-D-1

“Based on a review of records, one staff record does not contain all required components Evidence: 1 of 2 records reviewed did not contain documentation of CPR certification within 90 days of employment Staff 1 Date of Hire: 10/26/21).”

8VAC20-780-40-M Complaint related: No

“Based on observation, allergy lists for children were not kept confidential. Evidence: The allergy lists in the Red room and the Green room were posted on a bulletin board in full view of anyone entering or standing in the classroom.”

8VAC20-780-50-B Complaint related: No

“Based on the Owner's statement, staff files were not available for review. Evidence; *4/21/22 the Owner stated the Director had been working on the files, and she was not sure where they were currently located. Files were not available for review.”

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

“Based on a review of records, a separate record was not maintained for each child. Evidence: 3 child records were requested for review. 1 of 3 child records could not be located during the inspection for review. The child has allergies and emergency medications at the facility. (Child 1)”

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

“Based on staff statements and direct observation, written attendance has not been maintained in each group of children documenting arrival and departure. Evidence: 1, The infant room did not have any written attendance available for review. Staff stared they had not kept attendance, either on paper or on the Ipad. 2. The Green room did not have attendance documenting children's arrival or departures. There were 14 children in the Green room. The attendance, kept on the Ipad, inaccurately reflected 10 children in the room. When the teacher updated the attendance, the Ipad reflected 13 children. When questioned, as to the discrepancy, staff could not reconcile the children in the room with the attendance sheet. One child in the room had never been added to the attendance on the Ipad attendance system.”

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

“Based on direct observation, a ratio of 1:10 (staff:children) was not maintained in the room containing children aged 3 years to school age eligible. Evidence: On 3 separate instances during the inspection, one staff person left the classroom containing 14 children leaving one staff with more than 10 children. Once to make copies of work sheets in the office, twice to take one child (each time) to the bathroom down the hallway.”

8VAC20-780-350-I Complaint related: Yes

“Based on direct observation, during the designated rest period, when children are resting, ratios that Evidence: 1. The classroom containing children aged 16 months through 24 months, did not maintain a 1:10 (staff:children) ratio. LI observed the classroom during the designated rest period to have 1 staff person with 11 children. 2. The classroom containing children aged two years of age did not maintain a 1:16 ratio. LI observed the classroom during the designated rest period to have 1 staff to 19 children.”

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

“Based on observation, the diaper disposal system in the Toddler room is not foot operated. Evidence: The diapers are disposed of into a trash can that does not have a lid on it.”

8VAC20-780-510-I Complaint related: No

“Based on a review of medications, one medication was not maintained in the original container with the prescription label attached. Evidence: *4/21/22 -One emergency medication was in a plastic "ziplock" baggie, not in the original prescription box. (Child #2) *5/11/22 - Same emergency medication is still in a plastic "ziplock" baggie.”

8VAC20-780-510-P Complaint related: No

“Based on a review of medication authorizations, medications were not returned or the authorization renewed after 14 days of the authorization expiring. Evidence: Two authorizations for medication present at the center were expired. The authorizations expired 4/5/22. (Child #2)”

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

“Based on multiple staff interviews, children are not allowed second helpings of food. Evidence: Through multiple staff interviews it was determined that there is not always second helpings of food available for children. Staff have searched the kitchen and asked other classrooms for additional food for children.”

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

“Based on direct observation, a child under 10 years of age was not kept in actual sight and sound supervision. Evidence: At LI arrival (11:00 AM) classrooms were observed leaving the playground area and entering the stairwell adjacent to the parking lot to enter the facility. LI witnessed one child (4 yr. old) run ahead of the group and go behind 3 large boxes that had been delivered to the main entrance of the facility. The child was entirely out of sight of the classroom staff. As the reminder of the children and staff entered the classroom, the child remained outside of the facility. Upon hearing the classroom door close, the child came out from behind the boxes and ran approximately 20 feet to the door, opening the door himself and entering the room.”

22.1-289.035-B-4 Complaint related: No

“Based on a review of 2 records, staff records do not contain documentation of a completed Sex Offender search and a Child Abuse and Neglect Search for residences outside of the state of Virginia in the past 5 years. Evidence: 2 of 2 records reviewed did not include documentation of out of state background searches for another state of residency within the past 5 years. Sex Offender and Child Abuse and neglect are both required for these staff. (Staff 1,2)”

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

“Based on a review of records, one staff record does not include documentation of a completed Central Registry Search ( CPS ) within 30 days of employment. Evidence: There is no CPS search result on file for Staff 1. (Date of Hire: 10/26/21)”

8VAC20-780-40-E Complaint related: No

“Based on a review of policies and procedures, the facility failed to follow their written policy for medication administration. Evidence: The parent handbook states: "The medication must be in the original container/packaging, including the pharmacist instructions." Evidence: One medication (Auvi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.”

8VAC20-790-600-D-2

“Based on a review of records, one staff record does not contain all required components Evidence: 1 of 2 records reviewed did not contain documentation of First Aid certification within 90 days of employment. (Staff 1 Date of Hire: 10/26/21).”

8VAC20-790-600-D-1

“Based on a review of records, one staff record does not contain all required components Evidence: 1 of 2 records reviewed did not contain documentation of CPR certification within 90 days of employment Staff 1 Date of Hire: 10/26/21).”

8VAC20-780-40-M Complaint related: No

“Based on observation, allergy lists for children were not kept confidential. Evidence: The allergy lists in the Red room and the Green room were posted on a bulletin board in full view of anyone entering or standing in the classroom.”

8VAC20-780-50-B Complaint related: No

“Based on the Owner's statement, staff files were not available for review. Evidence; *4/21/22 the Owner stated the Director had been working on the files, and she was not sure where they were currently located. Files were not available for review.”

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

“Based on a review of records, a separate record was not maintained for each child. Evidence: 3 child records were requested for review. 1 of 3 child records could not be located during the inspection for review. The child has allergies and emergency medications at the facility. (Child 1)”

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

“Based on staff statements and direct observation, written attendance has not been maintained in each group of children documenting arrival and departure. Evidence: 1, The infant room did not have any written attendance available for review. Staff stared they had not kept attendance, either on paper or on the Ipad. 2. The Green room did not have attendance documenting children's arrival or departures. There were 14 children in the Green room. The attendance, kept on the Ipad, inaccurately reflected 10 children in the room. When the teacher updated the attendance, the Ipad reflected 13 children. When questioned, as to the discrepancy, staff could not reconcile the children in the room with the attendance sheet. One child in the room had never been added to the attendance on the Ipad attendance system.”

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

“Based on direct observation, a ratio of 1:10 (staff:children) was not maintained in the room containing children aged 3 years to school age eligible. Evidence: On 3 separate instances during the inspection, one staff person left the classroom containing 14 children leaving one staff with more than 10 children. Once to make copies of work sheets in the office, twice to take one child (each time) to the bathroom down the hallway.”

8VAC20-780-350-I Complaint related: Yes

“Based on direct observation, during the designated rest period, when children are resting, ratios that Evidence: 1. The classroom containing children aged 16 months through 24 months, did not maintain a 1:10 (staff:children) ratio. LI observed the classroom during the designated rest period to have 1 staff person with 11 children. 2. The classroom containing children aged two years of age did not maintain a 1:16 ratio. LI observed the classroom during the designated rest period to have 1 staff to 19 children.”

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

“Based on observation, the diaper disposal system in the Toddler room is not foot operated. Evidence: The diapers are disposed of into a trash can that does not have a lid on it.”

8VAC20-780-510-I Complaint related: No

“Based on a review of medications, one medication was not maintained in the original container with the prescription label attached. Evidence: *4/21/22 -One emergency medication was in a plastic "ziplock" baggie, not in the original prescription box. (Child #2) *5/11/22 - Same emergency medication is still in a plastic "ziplock" baggie.”

8VAC20-780-510-P Complaint related: No

“Based on a review of medication authorizations, medications were not returned or the authorization renewed after 14 days of the authorization expiring. Evidence: Two authorizations for medication present at the center were expired. The authorizations expired 4/5/22. (Child #2)”

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

“Based on multiple staff interviews, children are not allowed second helpings of food. Evidence: Through multiple staff interviews it was determined that there is not always second helpings of food available for children. Staff have searched the kitchen and asked other classrooms for additional food for children.”

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

“Based on direct observation, a child under 10 years of age was not kept in actual sight and sound supervision. Evidence: At LI arrival (11:00 AM) classrooms were observed leaving the playground area and entering the stairwell adjacent to the parking lot to enter the facility. LI witnessed one child (4 yr. old) run ahead of the group and go behind 3 large boxes that had been delivered to the main entrance of the facility. The child was entirely out of sight of the classroom staff. As the reminder of the children and staff entered the classroom, the child remained outside of the facility. Upon hearing the classroom door close, the child came out from behind the boxes and ran approximately 20 feet to the door, opening the door himself and entering the room.”

22.1-289.035-B-4 Complaint related: No

“Based on a review of 2 records, staff records do not contain documentation of a completed Sex Offender search and a Child Abuse and Neglect Search for residences outside of the state of Virginia in the past 5 years. Evidence: 2 of 2 records reviewed did not include documentation of out of state background searches for another state of residency within the past 5 years. Sex Offender and Child Abuse and neglect are both required for these staff. (Staff 1,2)”

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

“Based on a review of records, one staff record does not include documentation of a completed Central Registry Search ( CPS ) within 30 days of employment. Evidence: There is no CPS search result on file for Staff 1. (Date of Hire: 10/26/21)”

8VAC20-780-40-E Complaint related: No

“Based on a review of policies and procedures, the facility failed to follow their written policy for medication administration. Evidence: The parent handbook states: "The medication must be in the original container/packaging, including the pharmacist instructions." Evidence: One medication (Auvi-Q) was received at the center, that was not in the original container with pharmacist instructions attached.”