Tiffany's Learning Center

8VAC20-790-600-D-1

“All staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. The CPR certification in the record of Staff #4, who has been employed for five months and works directly with children, does not include an in-person competency demonstration.”

8VAC20-780-240-A

“Staff are to complete the VDOE sponsored online orientation course within 90 days of employment. Staff #3 completed the course four months late.”

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. The record of Child #1 (enrolled for six months) and the record of Child #2 (enrolled for 18 months) were missing the address of the two designated people to call in an emergency if a parent cannot be reached.”

8VAC20-780-500-B

“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. The foot-operated trashcan in the diapering area used in the Infant classroom was broken. The trashcan could not be opened with the foot portion and staff had to touch the lid in order to dispose of soiled diapers.”

8VAC20-780-160-A

“Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment. The TB in the record of Staff #4 was dated 36 days prior to the date of employment.”

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #5, employed for more than four months, did not have documentation of requesting a criminal history check from one state. The request of the central registry for that state was dated three months after the date of employment. The out-of-state background checks must be requested prior to employment.”

8VAC20-780-80-A

“REPEAT VIOLATION Based on observation and review of documentation, the center did not ensure that for each group of children, a written record of daily attendance was maintained that documented the arrival and departure of each child in care as it occurred. Evidence: At approximately 10:24am on 5/30/24, 14 children were observed in the PreK classroom. The attendance in the center’s app contained documentation of 13 children present. Staff reported that the 14th child had arrived at approximately 9:24am.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevented access by children. Evidence: On 5/30/24 a container of disinfectant wipes was observed in a open bin next to the changing table in the toddler classroom.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that children’s hands were washed with soap and running water or disposable wipes before and after eating meals or snacks. Evidence: On 5/30/24 the two-year-old class was observed transitioning from playing with blocks to snack time without washing hands or using disposable wipes.”

8VAC20-780-140-A

“Based on review of five child records, the center did not obtain a physical examination for children within 30 days after the first day of attendance. Evidence: The physical on record for Child C, with a start date of 3/6/23, was dated 8/18/23. The physical on record for Child E, with a start date of 4/26/23, was dated 11/21/23.”

8VAC20-780-510-I

“Based on review of 10 medications and authorizations, the center did not obtain written authorization from a parent to administer a medication. Evidence: There was no written authorization from the parent of Child F to administer a nonprescription medication that was observed onsite on 5/30/24.”

8VAC20-780-560-J

“Based on observation, the center did not ensure that tables were sanitized before and after each use for feeding. Evidence: On 5/30/24 the two-year-old class was observed transitioning from playing to snack and the tables were not sanitized before the children were served snack.”

8VAC20-780-510-P

“Based on review of 10 medications and authorizations, the center did not ensure that when an authorization for medication expired, that parents were notified that the medication needed to be picked up within 14 days or the parent must renew the authorization; and that medications that were not picked up by the parent within 14 days were disposed of by the center. Evidence: 1. The parent and doctor long-term authorization for an emergency medication for Child F expired on 8/12/23. The emergency medication was observed onsite on 5/30/24. 2. The parent long-term authorization for a second emergency medication for Child F expired on 3/21/24. The emergency medication was observed onsite on 5/30/24.”

8VAC20-780-80-A

“REPEAT VIOLATION Based on observation and review of documentation, the center did not ensure that for each group of children, a written record of daily attendance was maintained that documented the arrival and departure of each child in care as it occurred. Evidence: At approximately 10:24am on 5/30/24, 14 children were observed in the PreK classroom. The attendance in the center’s app contained documentation of 13 children present. Staff reported that the 14th child had arrived at approximately 9:24am.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevented access by children. Evidence: On 5/30/24 a container of disinfectant wipes was observed in a open bin next to the changing table in the toddler classroom.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that children’s hands were washed with soap and running water or disposable wipes before and after eating meals or snacks. Evidence: On 5/30/24 the two-year-old class was observed transitioning from playing with blocks to snack time without washing hands or using disposable wipes.”

8VAC20-780-140-A

“Based on review of five child records, the center did not obtain a physical examination for children within 30 days after the first day of attendance. Evidence: The physical on record for Child C, with a start date of 3/6/23, was dated 8/18/23. The physical on record for Child E, with a start date of 4/26/23, was dated 11/21/23.”

8VAC20-780-510-I

“Based on review of 10 medications and authorizations, the center did not obtain written authorization from a parent to administer a medication. Evidence: There was no written authorization from the parent of Child F to administer a nonprescription medication that was observed onsite on 5/30/24.”

8VAC20-780-560-J

“Based on observation, the center did not ensure that tables were sanitized before and after each use for feeding. Evidence: On 5/30/24 the two-year-old class was observed transitioning from playing to snack and the tables were not sanitized before the children were served snack.”

8VAC20-780-510-P

“Based on review of 10 medications and authorizations, the center did not ensure that when an authorization for medication expired, that parents were notified that the medication needed to be picked up within 14 days or the parent must renew the authorization; and that medications that were not picked up by the parent within 14 days were disposed of by the center. Evidence: 1. The parent and doctor long-term authorization for an emergency medication for Child F expired on 8/12/23. The emergency medication was observed onsite on 5/30/24. 2. The parent long-term authorization for a second emergency medication for Child F expired on 3/21/24. The emergency medication was observed onsite on 5/30/24.”

8VAC20-780-200-A

“Based on interview, the center did not have a qualified program director or a qualified back-up program director who met one of the director qualifications who was on site at least 50% of the center's hours of operation. Evidence: Staff #2 is being referred to as the Director by the center, but the staff does not meet the director qualifications at this time.”

8VAC20-780-80-A

“(REPEAT VIOLATION) Based on observation and review of documentation, the center did not ensure that a written record of attendance that documented the arrival and departure of each child in care as it occurred was maintained for each group of children. Evidence: On 12/14/23 at approximately 9:37am, there were 10 children in care in the ?Threes? classroom. The written attendance did not contain documentation of any children in care and the online attendance contained documentation of only six children in care.”

8VAC20-780-530-A-1

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in CPR.”

8VAC20-780-530-A-2

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in first aid. Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in first aid.”

8VAC20-780-260-B

“Based on review of documentation and interview, the center did not provide annual approval from the health department. Evidence: The most recent health inspection provided from the center was dated 11/30/22 and the owner confirmed that was the most recent completed health inspection.”

8VAC20-780-560-F

“Based on observation and review of documentation, the center did not ensure that when they provide meals or snacks, that they followed the most recent age-appropriate nutritional requirements of the Child and Adult Care Food Program (CACFP) of the United States Department of Agriculture (USDA). Evidence: Snack served to some classes on 12/14/23 consisted of a banana and water. On the menu for December, water was listed as the second component of a snack 15 times. The USDA does not recognize water as a component for snacks and requires two other components when water is served. Fruit snacks were also listed as a component for snack and fruit snacks are not considered a credible component by the USDA.”

8VAC20-780-510-E

“(REPEAT VIOLATION) Based on review of 12 medications and medication authorization forms, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days, or long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: 1. One medication authorization form from the parent of Child A was dated 9/26/23. The doctor’s authorization was documented as expiring on 10/31/23. Without the extended authorization from the doctor, the parent’s authorization was also expired. The medication authorization form for a second medication for Child A was dated 10/27/22 by the parent and 10/31/22 by the doctor and the authorization was documented as expiring on 10/31/23. 2. Three medication authorization forms from the parent of Child C did not contain dates that the forms were signed by the parent, in order to determine duration of authorization.”

8VAC20-780-200-A

“Based on interview, the center did not have a qualified program director or a qualified back-up program director who met one of the director qualifications who was on site at least 50% of the center's hours of operation. Evidence: Staff #2 is being referred to as the Director by the center, but the staff does not meet the director qualifications at this time.”

8VAC20-780-80-A

“(REPEAT VIOLATION) Based on observation and review of documentation, the center did not ensure that a written record of attendance that documented the arrival and departure of each child in care as it occurred was maintained for each group of children. Evidence: On 12/14/23 at approximately 9:37am, there were 10 children in care in the ?Threes? classroom. The written attendance did not contain documentation of any children in care and the online attendance contained documentation of only six children in care.”

8VAC20-780-530-A-1

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in CPR.”

8VAC20-780-530-A-2

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in first aid. Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in first aid.”

8VAC20-780-260-B

“Based on review of documentation and interview, the center did not provide annual approval from the health department. Evidence: The most recent health inspection provided from the center was dated 11/30/22 and the owner confirmed that was the most recent completed health inspection.”

8VAC20-780-560-F

“Based on observation and review of documentation, the center did not ensure that when they provide meals or snacks, that they followed the most recent age-appropriate nutritional requirements of the Child and Adult Care Food Program (CACFP) of the United States Department of Agriculture (USDA). Evidence: Snack served to some classes on 12/14/23 consisted of a banana and water. On the menu for December, water was listed as the second component of a snack 15 times. The USDA does not recognize water as a component for snacks and requires two other components when water is served. Fruit snacks were also listed as a component for snack and fruit snacks are not considered a credible component by the USDA.”

8VAC20-780-510-E

“(REPEAT VIOLATION) Based on review of 12 medications and medication authorization forms, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days, or long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: 1. One medication authorization form from the parent of Child A was dated 9/26/23. The doctor’s authorization was documented as expiring on 10/31/23. Without the extended authorization from the doctor, the parent’s authorization was also expired. The medication authorization form for a second medication for Child A was dated 10/27/22 by the parent and 10/31/22 by the doctor and the authorization was documented as expiring on 10/31/23. 2. Three medication authorization forms from the parent of Child C did not contain dates that the forms were signed by the parent, in order to determine duration of authorization.”

8VAC20-780-200-A

“Based on interview, the center did not have a qualified program director or a qualified back-up program director who met one of the director qualifications who was on site at least 50% of the center's hours of operation. Evidence: Staff #2 is being referred to as the Director by the center, but the staff does not meet the director qualifications at this time.”

8VAC20-780-80-A

“(REPEAT VIOLATION) Based on observation and review of documentation, the center did not ensure that a written record of attendance that documented the arrival and departure of each child in care as it occurred was maintained for each group of children. Evidence: On 12/14/23 at approximately 9:37am, there were 10 children in care in the ?Threes? classroom. The written attendance did not contain documentation of any children in care and the online attendance contained documentation of only six children in care.”

8VAC20-780-530-A-1

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in CPR.”

8VAC20-780-530-A-2

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in first aid. Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in first aid.”

8VAC20-780-260-B

“Based on review of documentation and interview, the center did not provide annual approval from the health department. Evidence: The most recent health inspection provided from the center was dated 11/30/22 and the owner confirmed that was the most recent completed health inspection.”

8VAC20-780-560-F

“Based on observation and review of documentation, the center did not ensure that when they provide meals or snacks, that they followed the most recent age-appropriate nutritional requirements of the Child and Adult Care Food Program (CACFP) of the United States Department of Agriculture (USDA). Evidence: Snack served to some classes on 12/14/23 consisted of a banana and water. On the menu for December, water was listed as the second component of a snack 15 times. The USDA does not recognize water as a component for snacks and requires two other components when water is served. Fruit snacks were also listed as a component for snack and fruit snacks are not considered a credible component by the USDA.”

8VAC20-780-510-E

“(REPEAT VIOLATION) Based on review of 12 medications and medication authorization forms, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days, or long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: 1. One medication authorization form from the parent of Child A was dated 9/26/23. The doctor’s authorization was documented as expiring on 10/31/23. Without the extended authorization from the doctor, the parent’s authorization was also expired. The medication authorization form for a second medication for Child A was dated 10/27/22 by the parent and 10/31/22 by the doctor and the authorization was documented as expiring on 10/31/23. 2. Three medication authorization forms from the parent of Child C did not contain dates that the forms were signed by the parent, in order to determine duration of authorization.”

8VAC20-780-200-A

“Based on interview, the center did not have a qualified program director or a qualified back-up program director who met one of the director qualifications who was on site at least 50% of the center's hours of operation. Evidence: Staff #2 is being referred to as the Director by the center, but the staff does not meet the director qualifications at this time.”

8VAC20-780-80-A

“(REPEAT VIOLATION) Based on observation and review of documentation, the center did not ensure that a written record of attendance that documented the arrival and departure of each child in care as it occurred was maintained for each group of children. Evidence: On 12/14/23 at approximately 9:37am, there were 10 children in care in the ?Threes? classroom. The written attendance did not contain documentation of any children in care and the online attendance contained documentation of only six children in care.”

8VAC20-780-530-A-1

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in CPR.”

8VAC20-780-530-A-2

“Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in first aid. Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in first aid.”

8VAC20-780-260-B

“Based on review of documentation and interview, the center did not provide annual approval from the health department. Evidence: The most recent health inspection provided from the center was dated 11/30/22 and the owner confirmed that was the most recent completed health inspection.”

8VAC20-780-560-F

“Based on observation and review of documentation, the center did not ensure that when they provide meals or snacks, that they followed the most recent age-appropriate nutritional requirements of the Child and Adult Care Food Program (CACFP) of the United States Department of Agriculture (USDA). Evidence: Snack served to some classes on 12/14/23 consisted of a banana and water. On the menu for December, water was listed as the second component of a snack 15 times. The USDA does not recognize water as a component for snacks and requires two other components when water is served. Fruit snacks were also listed as a component for snack and fruit snacks are not considered a credible component by the USDA.”

8VAC20-780-510-E

“(REPEAT VIOLATION) Based on review of 12 medications and medication authorization forms, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days, or long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: 1. One medication authorization form from the parent of Child A was dated 9/26/23. The doctor’s authorization was documented as expiring on 10/31/23. Without the extended authorization from the doctor, the parent’s authorization was also expired. The medication authorization form for a second medication for Child A was dated 10/27/22 by the parent and 10/31/22 by the doctor and the authorization was documented as expiring on 10/31/23. 2. Three medication authorization forms from the parent of Child C did not contain dates that the forms were signed by the parent, in order to determine duration of authorization.”

8VAC20-780-550-P Complaint related: No

“Based on review of documentation and interview, the center did not maintain a written record of children's serious and minor injuries in which entries were made the day of occurrence and included the following: 1. Date and time of injury; 2. Name of injured child; 3. Type and circumstance of the injury; 4. Staff present and treatment; 5. Date and time when parents were notified; 6. Any future action to prevent recurrence of the injury; 7. Staff and parent signatures or two staff signatures; and 8. Documentation on how parent was notified. Evidence: Interview revealed that prior to October 18, 2023, when an injury occurred at the center, staff would send a message through their app to notify parents of an injury. There was no written record kept that contained the required documentation.”

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

“Based on review of documentation and interview, children’s records were not made available to a parent on request, unless otherwise ordered by the court. Evidence: On 11/13/23, the parent of two enrolled children requested copies of the two children’s records from the center, and provided a court order to show they were entitled to the documentation. The center refused to give the parent copies of the records.”

8VAC20-780-80-B-2 Complaint related: No

“Based on interview, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: Interview revealed that on October 5, 2023, at approximately 8:30am, Child A, a two-year-old, tripped and hit their forehead on a table, leaving a large lump and bruise. The center called the child’s parent at approximately 8:39am and the child was taken to the emergency room for evaluation. The center did not report the injury requiring outside medical treatment to the department.”

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

“Based on review of documentation and interview, children’s records were not made available to a parent on request, unless otherwise ordered by the court. Evidence: On 11/13/23, the parent of two enrolled children requested copies of the two children’s records from the center, and provided a court order to show they were entitled to the documentation. The center refused to give the parent copies of the records.”

8VAC20-780-80-B-2 Complaint related: No

“Based on interview, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: Interview revealed that on October 5, 2023, at approximately 8:30am, Child A, a two-year-old, tripped and hit their forehead on a table, leaving a large lump and bruise. The center called the child’s parent at approximately 8:39am and the child was taken to the emergency room for evaluation. The center did not report the injury requiring outside medical treatment to the department.”

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

“Based on review of documentation and interview, children’s records were not made available to a parent on request, unless otherwise ordered by the court. Evidence: On 11/13/23, the parent of two enrolled children requested copies of the two children’s records from the center, and provided a court order to show they were entitled to the documentation. The center refused to give the parent copies of the records.”

8VAC20-780-80-B-2 Complaint related: No

“Based on interview, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: Interview revealed that on October 5, 2023, at approximately 8:30am, Child A, a two-year-old, tripped and hit their forehead on a table, leaving a large lump and bruise. The center called the child’s parent at approximately 8:39am and the child was taken to the emergency room for evaluation. The center did not report the injury requiring outside medical treatment to the department.”

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

“Based on review of documentation and interview, children’s records were not made available to a parent on request, unless otherwise ordered by the court. Evidence: On 11/13/23, the parent of two enrolled children requested copies of the two children’s records from the center, and provided a court order to show they were entitled to the documentation. The center refused to give the parent copies of the records.”

8VAC20-780-80-B-2 Complaint related: No

“Based on interview, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: Interview revealed that on October 5, 2023, at approximately 8:30am, Child A, a two-year-old, tripped and hit their forehead on a table, leaving a large lump and bruise. The center called the child’s parent at approximately 8:39am and the child was taken to the emergency room for evaluation. The center did not report the injury requiring outside medical treatment to the department.”

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

“Based on review of documentation and interview, children’s records were not made available to a parent on request, unless otherwise ordered by the court. Evidence: On 11/13/23, the parent of two enrolled children requested copies of the two children’s records from the center, and provided a court order to show they were entitled to the documentation. The center refused to give the parent copies of the records.”

8VAC20-780-80-B-2 Complaint related: No

“Based on interview, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: Interview revealed that on October 5, 2023, at approximately 8:30am, Child A, a two-year-old, tripped and hit their forehead on a table, leaving a large lump and bruise. The center called the child’s parent at approximately 8:39am and the child was taken to the emergency room for evaluation. The center did not report the injury requiring outside medical treatment to the department.”

8VAC20-780-350-C

“(Repeat Violation) Based on observation and interview, the center did not ensure that when children were in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group applied to the entire group. Evidence: 1. On 8/10/23 at approximately 10:00am, five children were observed with one staff in the ?Ones? classroom. The youngest child in the group was 13-months-old and required a staff to child ratio of 1:4. 2. On 8/10/23 at approximately 10:05am, 16 children were observed with three staff in the ?Twos? classroom. The youngest child in the group was not yet two-years-old, and required a staff to child ratio of 1:5.”

8VAC20-780-160-A

“(Repeat Violation) Based on review of 12 staff records, the center did not obtain documentation of a tuberculosis (TB) test or screening for staff at the time of employment or prior to contact with children. Evidence: The TB test on record for Staff #12, with an employment date of 7/10/23, was dated 7/25/23.”

8VAC20-770-60-C-2

“(Repeat Violation) Based on review of 12 staff records, the center did not obtain the results of a search of the central registry ( CPS ) for staff members within 30 days of employment. Evidence: The record for Staff #2, with an employment date of 2/6/23, did not contain documentation of a CPS check. The record for Staff #3, with an employment date of 2/13/23, did not contain documentation of a CPS check. The record for Staff #8, with an employment date of 4/18/23, did not contain documentation of a CPS check. The record for Staff #11, with an employment date of 5/4/23, did not contain documentation of a CPS check. The record for Staff #12, with an employment date of 7/10/23, did not contain documentation of a CPS check.”

8VAC20-780-510-E

“Based on review of medication, medication authorizations, and interview, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days and long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: A sample of eight medications and authorizations were reviewed on 5/22/23. Of the eight medications and authorizations, five authorizations were expired as the parent authorization was beyond the 10 days and there was no written physician authorization on record.”

8VAC20-780-550-D

“Based on review of documentation and interview, the center did not implement a monthly practice evacuation drill. Evidence: The drill log did not contain documentation of a drill conducted in April 2023.”

8VAC20-780-140-A

“Based on review of five child records, the center did not obtain documentation of a physical examination for each child by or under the direction of a physician within 30 days after the first day of attendance. Evidence: The record for Child C, with a start date of 3/23/23, did not contain documentation of a physical.”

22.1-289.035-B-2

“Based on review of 11 staff records, the center did not ensure that the results of a national fingerprint-based criminal history check were obtained prior to employment for four staff. Evidence: The record for Staff #5, with an employment date of 5/4/23, did not contain documentation of the results of a national fingerprint-based criminal history check. The fingerprints on record for Staff #1, with an employment date of 4/3/23, were dated 4/18/23. The fingerprints on record for Staff #2, with an employment date of 4/18/23, were dated 4/20/23. The fingerprints on record for Staff #3, with an employment date of 3/18/23, were dated 3/21/23.”

22.1-289.011-F

“Based on observation and interview, the center did not ensure that documents required by the Superintendent were posted in a conspicuous place on the licensed premises. Evidence: On 5/22/23 the most recent inspection was not posted on the licensed premises.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials, were kept in a locked place using a safe locking method. Evidence: On 5/22/23, two containers of disinfecting wipes were observed on a high, open shelf in the three-year-old classroom.”

8VAC20-780-350-C

“Based on observation and interview, the center did not ensure that when children were in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group applied to the entire group. Evidence: On 5/22/23, two staff were observed supervising 16 children in the two-year-old classroom. There were four children present in the classroom who will not turn two-years-old until July and August 2023. With these children present in the classroom, the required ratio was one staff to five children.”

8VAC20-780-440-G

“Based on observation and interview, the center did not ensure that cribs were used for children under 12 months of age. Evidence: On 5/22/23 a child who was reported to be 10-months-old was observed sleeping on a cot in the infant classroom.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that staff washed their hands with soap and running water after any contact with body fluids. Evidence: On 5/22/23, in the two-year-old classroom, staff were observed wiping children’s noses with tissue and then using hand sanitizer, but not washing hands with soap and running water.”

8VAC20-770-60-C-2

“Based on review of 11 staff records, the center did not obtain the results of a search of the central registry for eight staff within 30 days of employment. Evidence: The records for Staff #1, with an employment date of 4/3/23; Staff #2, with an employment date of 4/18/23; Staff #6, with an employment date of 3/6/23; Staff #7, with an employment date of 2/6/23; Staff #8, with an employment date of 2/13/23; Staff #9, with an employment date of 1/20/23; and Staff #11, with an employment date of 2/5/23 did not contain documentation of the results of a central registry check. The central registry check results on record for Staff #3, with an employment date of 3/18/23, were dated 5/3/23.”

8VAC20-780-160-A

“Based on review of five staff records, the center did not obtain documentation of a tuberculosis (TB) test or screening for staff at the time of employment or prior to contact with children. Evidence: The record for Staff #2 contained documentation of a start date of 4/18/23. The TB test on record for Staff #2 was dated 5/17/23. The record for Staff #5 contained documentation of a start date of 5/4/23. The TB test on record for Staff #5 was dated 5/8/23.”

22.1-289.035-B-4

“Based on review of five staff records and interview, the center did not obtain the results of a criminal history record check or sex offender registry check from all states in which staff members have resided within the past five years prior to employment, or the results of a central registry check from all states in which staff members have resided within the past five years within 30 days of employment. Evidence: The record for Staff #1, with an employment date of 4/3/23, contained documentation that the staff member had lived in the state of West Virginia within the past five years. There was no documentation of a sex offender registry check or a central registry check from West Virginia on record for Staff #1. The record for Staff #5, with an employment date of 5/4/23, contained documentation that the staff member had lived in the state of Illinois within the past five years. There was no documentation of a criminal history record check or central registry check from Illinois on record for Staff #5.”

8VAC20-780-510-E

“Based on review of medication, medication authorizations, and interview, the center did not follow the policy for administration of medication in that the duration of the parent’s authorization shall expire or be renewed after 10 work days and long-term medication authorization may be allowed with written authorization from the child’s physician and parent. Evidence: A sample of eight medications and authorizations were reviewed on 5/22/23. Of the eight medications and authorizations, five authorizations were expired as the parent authorization was beyond the 10 days and there was no written physician authorization on record.”

8VAC20-780-550-D

“Based on review of documentation and interview, the center did not implement a monthly practice evacuation drill. Evidence: The drill log did not contain documentation of a drill conducted in April 2023.”

8VAC20-780-140-A

“Based on review of five child records, the center did not obtain documentation of a physical examination for each child by or under the direction of a physician within 30 days after the first day of attendance. Evidence: The record for Child C, with a start date of 3/23/23, did not contain documentation of a physical.”

22.1-289.035-B-2

“Based on review of 11 staff records, the center did not ensure that the results of a national fingerprint-based criminal history check were obtained prior to employment for four staff. Evidence: The record for Staff #5, with an employment date of 5/4/23, did not contain documentation of the results of a national fingerprint-based criminal history check. The fingerprints on record for Staff #1, with an employment date of 4/3/23, were dated 4/18/23. The fingerprints on record for Staff #2, with an employment date of 4/18/23, were dated 4/20/23. The fingerprints on record for Staff #3, with an employment date of 3/18/23, were dated 3/21/23.”

22.1-289.011-F

“Based on observation and interview, the center did not ensure that documents required by the Superintendent were posted in a conspicuous place on the licensed premises. Evidence: On 5/22/23 the most recent inspection was not posted on the licensed premises.”

8VAC20-780-280-B

“Based on observation, the center did not ensure that hazardous substances such as cleaning materials, were kept in a locked place using a safe locking method. Evidence: On 5/22/23, two containers of disinfecting wipes were observed on a high, open shelf in the three-year-old classroom.”

8VAC20-780-350-C

“Based on observation and interview, the center did not ensure that when children were in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group applied to the entire group. Evidence: On 5/22/23, two staff were observed supervising 16 children in the two-year-old classroom. There were four children present in the classroom who will not turn two-years-old until July and August 2023. With these children present in the classroom, the required ratio was one staff to five children.”

8VAC20-780-440-G

“Based on observation and interview, the center did not ensure that cribs were used for children under 12 months of age. Evidence: On 5/22/23 a child who was reported to be 10-months-old was observed sleeping on a cot in the infant classroom.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that staff washed their hands with soap and running water after any contact with body fluids. Evidence: On 5/22/23, in the two-year-old classroom, staff were observed wiping children’s noses with tissue and then using hand sanitizer, but not washing hands with soap and running water.”

8VAC20-770-60-C-2

“Based on review of 11 staff records, the center did not obtain the results of a search of the central registry for eight staff within 30 days of employment. Evidence: The records for Staff #1, with an employment date of 4/3/23; Staff #2, with an employment date of 4/18/23; Staff #6, with an employment date of 3/6/23; Staff #7, with an employment date of 2/6/23; Staff #8, with an employment date of 2/13/23; Staff #9, with an employment date of 1/20/23; and Staff #11, with an employment date of 2/5/23 did not contain documentation of the results of a central registry check. The central registry check results on record for Staff #3, with an employment date of 3/18/23, were dated 5/3/23.”

8VAC20-780-160-A

“Based on review of five staff records, the center did not obtain documentation of a tuberculosis (TB) test or screening for staff at the time of employment or prior to contact with children. Evidence: The record for Staff #2 contained documentation of a start date of 4/18/23. The TB test on record for Staff #2 was dated 5/17/23. The record for Staff #5 contained documentation of a start date of 5/4/23. The TB test on record for Staff #5 was dated 5/8/23.”

22.1-289.035-B-4

“Based on review of five staff records and interview, the center did not obtain the results of a criminal history record check or sex offender registry check from all states in which staff members have resided within the past five years prior to employment, or the results of a central registry check from all states in which staff members have resided within the past five years within 30 days of employment. Evidence: The record for Staff #1, with an employment date of 4/3/23, contained documentation that the staff member had lived in the state of West Virginia within the past five years. There was no documentation of a sex offender registry check or a central registry check from West Virginia on record for Staff #1. The record for Staff #5, with an employment date of 5/4/23, contained documentation that the staff member had lived in the state of Illinois within the past five years. There was no documentation of a criminal history record check or central registry check from Illinois on record for Staff #5.”

8VAC20-780-240-I

“Based on review of six staff records, the center did not ensure that documentation of orientation training was kept by the center in a manner that allowed for identification by individual staff member, was considered part of the staff member’s record, and included: 1. Name of staff; 2. Training topics; 3. Training delivery method; 3. The entity or individual who provided the training; and the date of the training. Evidence: There was no documentation of orientation training on record for Staff #1, Staff #2, Staff #3, Staff #4, or Staff #5.”

8VAC20-780-160-A

“Based on review of six staff records, the center did not ensure that each staff member submitted documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children. Evidence: 1. The record for Staff #6, with an employment date of 2/5/23, did not contain documentation of a TB screening. 2. The TB test on record for Staff #2, with an employment date of 2/6/23, was dated 2/10/23; the TB test on record for Staff #3, with an employment date of 2/13/23, was dated 3/2/23; and the TB test on record for Staff #4, with an employment date of 1/20/23, was dated 3/2/23.”

8VAC20-770-60-C-2

“Based on review of six staff records, the center did not obtain the results of a search of the central registry ( CPS ) within 30 days of employment for five staff members. Evidence: 1. There were no CPS results on record for Staff #2, with an employment date of 2/6/23; Staff #3, with an employment date of 2/13/23; Staff #4, with an employment date of 1/20/23; and Staff #6, with an employment date of 2/5/23. 2. The CPS results on record for Staff #5, with an employment date of 8/1/22, were dated 10/17/22.”

22.1-289.035-B-2

“Based on review of six staff records, the center did not obtain the results of a national, fingerprint-based criminal history record check prior to employment for four staff. Evidence: 1. The fingerprints on record for Staff #2, with an employment date of 2/6/23, were dated 2/27/23; the fingerprints on record for Staff #5, with an employment date of 8/1/22, were dated 8/22/22. 2. There were no fingerprints on record for Staff #3, with an employment date of 2/13/23; and Staff #6, with an employment date of 2/5/23.”

8VAC20-780-80-A

“Based on review of documentation, the center did not ensure that for each group of children, a record of attendance was maintained that documented the arrival and departure of each child in care as it occurred. Evidence: On 3/14/23 at approximately 11:26am the attendance record in the School Age class contained documentation of three children present. There were five children present at the time.”

8VAC20-780-570-B

“Based on observation and interview, the center did not ensure that bottles were not used while a child was in their designated sleeping location. Evidence: On 3/14/23 at approximately 10:50am, a 13-month-old infant was observed sleeping on their cot with a bottle in their mouth.”

8VAC20-780-500-B

“Based on observation, the center did not ensure that disposable diapers were disposed of 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: The trash cans in the Infant/Toddler diaper changing area and the hallway bathroom for children two-years-old and older were not foot-operated and required that the staff member touched the trashcan with their hand or the soiled diaper in order to dispose of it.”

8VAC20-780-540-C

“Based on observation, the first aid kit did not include all of the required items. Evidence: The first aid kit did not include triangular bandages or a thermometer.”

8VAC20-780-270-A

“Based on observation, the center did not ensure that areas of the center, inside and outside, were maintained in a safe condition. Evidence: The fence separating the large playground from the small playground had openings that allowed a small torso template (3-1/2 inch by 6-1/4 inch rectangle) to fit through but not a large head template (9 inch circle) to fit through, which presented a head entrapment hazard.”

8VAC20-780-540-E

“Based on observation and interview, the center did not obtain all of the required nonmedical emergency supplies. Evidence: The managers reported that there was neither a working, battery-operated flashlight nor a working, battery-operated radio available at the center.”