Tuckaway-Ellwood House Child Development Center

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

“Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. In a school age bathroom, a floor tile was observed that was not secured to the floor which posed a tripping hazard. In a second school age bathroom, an area of the wall by a toilet was broken. Small pieces of the wall and wall dust were observed on the ground. In the infant classroom, an area of the wall by the back playground door was observed that was cracked and broken. A small pile of wall dust was observed in the corner. A piece of the baseboard in the infant room that measured approximately four inches was missing which exposed a gap behind the drywall that the infants could potentially access with their hands. 2. Administration acknowledged that the areas noted required maintenance.”

8VAC20-780-60-A

“Based on a review of five child records and interview, the center not ensure that two records contained the required information. Evidence: 1. The records of child #4 (date of enrollment: 6/3/2024) and child #5 (date of enrollment: 8/21/2023) were missing two emergency contact addresses. Child records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the contact addresses were missing.”

8VAC20-780-40-M

“Based on observation and interview, the center did not ensure to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list must be dated and kept confidential in each room or area where children are present. Evidence: 1. An allergy list was not posted or accessible in two of the four year old classrooms. Staff stated they did not have a copy. 2. Administration acknowledged the list was missing.”

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

“Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. In a school age bathroom, a floor tile was observed that was not secured to the floor which posed a tripping hazard. In a second school age bathroom, an area of the wall by a toilet was broken. Small pieces of the wall and wall dust were observed on the ground. In the infant classroom, an area of the wall by the back playground door was observed that was cracked and broken. A small pile of wall dust was observed in the corner. A piece of the baseboard in the infant room that measured approximately four inches was missing which exposed a gap behind the drywall that the infants could potentially access with their hands. 2. Administration acknowledged that the areas noted required maintenance.”

8VAC20-780-60-A

“Based on a review of five child records and interview, the center not ensure that two records contained the required information. Evidence: 1. The records of child #4 (date of enrollment: 6/3/2024) and child #5 (date of enrollment: 8/21/2023) were missing two emergency contact addresses. Child records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the contact addresses were missing.”

8VAC20-780-40-M

“Based on observation and interview, the center did not ensure to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list must be dated and kept confidential in each room or area where children are present. Evidence: 1. An allergy list was not posted or accessible in two of the four year old classrooms. Staff stated they did not have a copy. 2. Administration acknowledged the list was missing.”

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

“Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. In a school age bathroom, a floor tile was observed that was not secured to the floor which posed a tripping hazard. In a second school age bathroom, an area of the wall by a toilet was broken. Small pieces of the wall and wall dust were observed on the ground. In the infant classroom, an area of the wall by the back playground door was observed that was cracked and broken. A small pile of wall dust was observed in the corner. A piece of the baseboard in the infant room that measured approximately four inches was missing which exposed a gap behind the drywall that the infants could potentially access with their hands. 2. Administration acknowledged that the areas noted required maintenance.”

8VAC20-780-60-A

“Based on a review of five child records and interview, the center not ensure that two records contained the required information. Evidence: 1. The records of child #4 (date of enrollment: 6/3/2024) and child #5 (date of enrollment: 8/21/2023) were missing two emergency contact addresses. Child records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the contact addresses were missing.”

8VAC20-780-40-M

“Based on observation and interview, the center did not ensure to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list must be dated and kept confidential in each room or area where children are present. Evidence: 1. An allergy list was not posted or accessible in two of the four year old classrooms. Staff stated they did not have a copy. 2. Administration acknowledged the list was missing.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In the three year old classroom, a bottle of Windex and a bottle of carpet cleaner were observed in an unlocked cabinet. In the school age room, three cans of spray paint were observed on a table. 2. Administration acknowledged that the paint and cleaners were not locked.”

8VAC20-780-280-B

“Based on observation and interview, the center did not ensure that hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In the three year old classroom, a bottle of Windex and a bottle of carpet cleaner were observed in an unlocked cabinet. In the school age room, three cans of spray paint were observed on a table. 2. Administration acknowledged that the paint and cleaners were not locked.”

8VAC20-780-60-A-8

“Based on a review of records and interview, the center did not ensure to obtain a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 1. Emergency medications and allergy care plans were reviewed for two children on 10/30/2023. The record of one child (date of enrollment: 8/21/2023) indicated that the child had a diagnosed food allergy. The record did not contain a written care plan. 2. Administration acknowledged that they had not obtained the plan.”

8VAC20-780-60-A

“Based on a review of five child records and interview, the center did not ensure that a record was kept for one child that contained the required information. Evidence: 1. The record of child #5 (date of attendance: 9/18/2023) did not contain complete emergency contact information to include the contacts' addresses. Child records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the record was incomplete.”

8VAC20-780-60-A-8

“Based on a review of records and interview, the center did not ensure to obtain a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: 1. Emergency medications and allergy care plans were reviewed for two children on 10/30/2023. The record of one child (date of enrollment: 8/21/2023) indicated that the child had a diagnosed food allergy. The record did not contain a written care plan. 2. Administration acknowledged that they had not obtained the plan.”

8VAC20-780-60-A

“Based on a review of five child records and interview, the center did not ensure that a record was kept for one child that contained the required information. Evidence: 1. The record of child #5 (date of attendance: 9/18/2023) did not contain complete emergency contact information to include the contacts' addresses. Child records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the record was incomplete.”

8VAC20-780-70

“Based on record review, the center did not ensure one of five staff records contained all of the required documentation. Evidence: 1. The record of staff #5 (employment date: 7/1/2019) did not have documentation of the following: two or more references, orientation training and child abuse and neglect training.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. The outside fence near the blacktop on the playground is leaning, presenting a falling hazard.”

8VAC20-780-330-B

“The center did not ensure that playground equipment had resilient surfacing that complies with the minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials. Evidence: The preschool slides, toddler slides and the ground underneath and around the swing set seats had approximately 0 - 5 inches of a resilient material. The equipment required a minimum of 6 inches of resilient material underneath and around the swing set seats, slides and in the fall zones.”

8VAC20-780-550-P

“Based on record review, the center did not ensure to maintain written injury records with all required documentation. Evidence: 1. Four of five injury records reviewed did not contain documentation of the date and time when the parents were notified. 2. Three of five injury records did not contain documentation of how the parents were notified.”

8VAC20-780-70

“Based on record review, the center did not ensure one of five staff records contained all of the required documentation. Evidence: 1. The record of staff #5 (employment date: 7/1/2019) did not have documentation of the following: two or more references, orientation training and child abuse and neglect training.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. The outside fence near the blacktop on the playground is leaning, presenting a falling hazard.”

8VAC20-780-330-B

“The center did not ensure that playground equipment had resilient surfacing that complies with the minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials. Evidence: The preschool slides, toddler slides and the ground underneath and around the swing set seats had approximately 0 - 5 inches of a resilient material. The equipment required a minimum of 6 inches of resilient material underneath and around the swing set seats, slides and in the fall zones.”

8VAC20-780-550-P

“Based on record review, the center did not ensure to maintain written injury records with all required documentation. Evidence: 1. Four of five injury records reviewed did not contain documentation of the date and time when the parents were notified. 2. Three of five injury records did not contain documentation of how the parents were notified.”

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

“Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children. Evidence: During the 12/05/22 inspection, the following was determined: 1. Staff #1 reported that on 12/01/2022, staff #1 was left alone to supervise 9 infant children in the Baby Birds 2 classroom for about 10-20 minutes while staff #2 supervised one sleeping infant in the Baby Birds 1 classroom. Staff #1 also stated that the center director was initially in the infant classroom to help with coverage but eventually left the classroom for about 10 to 20 minutes with one infant child to handle another task. 2. The center director reported that on 12/01/2022, the center director left the infant classrooms to finish emails while supervising one infant child. 3. Staff #2 reported that on 12/01/2022, staff #2 remained in the baby birds 1 classroom with a sleeping infant while the other 9 infants were located in the baby birds two classroom.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was refrigerated, dated and labeled with the child’s name. Evidence: The Baby Birds classroom's refrigerator contained 5 unlabeled infant bottles.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that staff wash their hands with soap and running water before and after a diaper change. Evidence: A Chickadees classroom teacher was observed diapering several children without washing their hands before and after each child.”

8VAC20-780-500-B

“Based on observation, the center did not ensure the diapering surface was cleaned with soap and at least room temperature water and sanitized after each use. Evidence: Two teachers were observed diapering several children without cleaning and sanitizing the diapering surface after each use.”

8VAC20-780-330-B

“The center did not ensure that playground equipment had resilient surfacing that complies with the minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials. Evidence: The preschool slides, toddler slides and the ground underneath and around the swing set seats had about 0 - 5 inches of resilient material. The equipment required a minimum of 6 inches of resilient material underneath and around the swing set seats, slides and in the fall zones.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. There was a water hose several feet long, near the toddler playground presenting an entanglement and tripping hazard. 2. There was several pieces of food and drink dried on the wall and trashcan in the Green Birds classroom. 3. There was visible dirt buildup around the sink in the Green Birds classroom. 4. The Green Birds bathroom had feces on the wall and visible dirt buildup and residue on and around the toilet seat. 5. The Sparrows girls and boys bathrooms had visible dirt buildup and residue on and around the sinks. 6. The Sparrows bathroom has an area of the wall with loose shoe molding exposing a hole with crumbling drywall. 7. The outside fence near the blacktop on the playground is leaning presenting a falling hazard. 8. The red tricycle located on the preschool playground was missing both rubber handle bar guards presenting a puncture hazard.”

8VAC20-780-140-A

“Based on record review, the center did not ensure two of five children’s records contained documentation of the child’s physical examination by or under the direction of a physician before the child’s attendance or within 30 days of attendance. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of a physical examination dated 10/18/2022. 2. The record of child #2 (enrollment date: 10/25/2021) did not have documentation of a physical examination.”

8VAC20-780-130-A

“Based on record review, the center did not ensure three of five children’s records contained documentation of immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of immunizations dated 10/11/2022. 2. The record of child #2 (enrollment date: 10/25/2021) had documentation of immunizations dated 12/23/2021. 3. The record of child #3 (enrollment date: 9/07/2021) had documentation of immunizations dated 10/04/2021.”

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

“Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children. Evidence: During the 12/05/22 inspection, the following was determined: 1. Staff #1 reported that on 12/01/2022, staff #1 was left alone to supervise 9 infant children in the Baby Birds 2 classroom for about 10-20 minutes while staff #2 supervised one sleeping infant in the Baby Birds 1 classroom. Staff #1 also stated that the center director was initially in the infant classroom to help with coverage but eventually left the classroom for about 10 to 20 minutes with one infant child to handle another task. 2. The center director reported that on 12/01/2022, the center director left the infant classrooms to finish emails while supervising one infant child. 3. Staff #2 reported that on 12/01/2022, staff #2 remained in the baby birds 1 classroom with a sleeping infant while the other 9 infants were located in the baby birds two classroom.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was refrigerated, dated and labeled with the child’s name. Evidence: The Baby Birds classroom's refrigerator contained 5 unlabeled infant bottles.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that staff wash their hands with soap and running water before and after a diaper change. Evidence: A Chickadees classroom teacher was observed diapering several children without washing their hands before and after each child.”

8VAC20-780-500-B

“Based on observation, the center did not ensure the diapering surface was cleaned with soap and at least room temperature water and sanitized after each use. Evidence: Two teachers were observed diapering several children without cleaning and sanitizing the diapering surface after each use.”

8VAC20-780-330-B

“The center did not ensure that playground equipment had resilient surfacing that complies with the minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials. Evidence: The preschool slides, toddler slides and the ground underneath and around the swing set seats had about 0 - 5 inches of resilient material. The equipment required a minimum of 6 inches of resilient material underneath and around the swing set seats, slides and in the fall zones.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. There was a water hose several feet long, near the toddler playground presenting an entanglement and tripping hazard. 2. There was several pieces of food and drink dried on the wall and trashcan in the Green Birds classroom. 3. There was visible dirt buildup around the sink in the Green Birds classroom. 4. The Green Birds bathroom had feces on the wall and visible dirt buildup and residue on and around the toilet seat. 5. The Sparrows girls and boys bathrooms had visible dirt buildup and residue on and around the sinks. 6. The Sparrows bathroom has an area of the wall with loose shoe molding exposing a hole with crumbling drywall. 7. The outside fence near the blacktop on the playground is leaning presenting a falling hazard. 8. The red tricycle located on the preschool playground was missing both rubber handle bar guards presenting a puncture hazard.”

8VAC20-780-140-A

“Based on record review, the center did not ensure two of five children’s records contained documentation of the child’s physical examination by or under the direction of a physician before the child’s attendance or within 30 days of attendance. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of a physical examination dated 10/18/2022. 2. The record of child #2 (enrollment date: 10/25/2021) did not have documentation of a physical examination.”

8VAC20-780-130-A

“Based on record review, the center did not ensure three of five children’s records contained documentation of immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of immunizations dated 10/11/2022. 2. The record of child #2 (enrollment date: 10/25/2021) had documentation of immunizations dated 12/23/2021. 3. The record of child #3 (enrollment date: 9/07/2021) had documentation of immunizations dated 10/04/2021.”

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

“Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children. Evidence: During the 12/05/22 inspection, the following was determined: 1. Staff #1 reported that on 12/01/2022, staff #1 was left alone to supervise 9 infant children in the Baby Birds 2 classroom for about 10-20 minutes while staff #2 supervised one sleeping infant in the Baby Birds 1 classroom. Staff #1 also stated that the center director was initially in the infant classroom to help with coverage but eventually left the classroom for about 10 to 20 minutes with one infant child to handle another task. 2. The center director reported that on 12/01/2022, the center director left the infant classrooms to finish emails while supervising one infant child. 3. Staff #2 reported that on 12/01/2022, staff #2 remained in the baby birds 1 classroom with a sleeping infant while the other 9 infants were located in the baby birds two classroom.”

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was refrigerated, dated and labeled with the child’s name. Evidence: The Baby Birds classroom's refrigerator contained 5 unlabeled infant bottles.”

8VAC20-780-500-A

“Based on observation, the center did not ensure that staff wash their hands with soap and running water before and after a diaper change. Evidence: A Chickadees classroom teacher was observed diapering several children without washing their hands before and after each child.”

8VAC20-780-500-B

“Based on observation, the center did not ensure the diapering surface was cleaned with soap and at least room temperature water and sanitized after each use. Evidence: Two teachers were observed diapering several children without cleaning and sanitizing the diapering surface after each use.”

8VAC20-780-330-B

“The center did not ensure that playground equipment had resilient surfacing that complies with the minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials. Evidence: The preschool slides, toddler slides and the ground underneath and around the swing set seats had about 0 - 5 inches of resilient material. The equipment required a minimum of 6 inches of resilient material underneath and around the swing set seats, slides and in the fall zones.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. There was a water hose several feet long, near the toddler playground presenting an entanglement and tripping hazard. 2. There was several pieces of food and drink dried on the wall and trashcan in the Green Birds classroom. 3. There was visible dirt buildup around the sink in the Green Birds classroom. 4. The Green Birds bathroom had feces on the wall and visible dirt buildup and residue on and around the toilet seat. 5. The Sparrows girls and boys bathrooms had visible dirt buildup and residue on and around the sinks. 6. The Sparrows bathroom has an area of the wall with loose shoe molding exposing a hole with crumbling drywall. 7. The outside fence near the blacktop on the playground is leaning presenting a falling hazard. 8. The red tricycle located on the preschool playground was missing both rubber handle bar guards presenting a puncture hazard.”

8VAC20-780-140-A

“Based on record review, the center did not ensure two of five children’s records contained documentation of the child’s physical examination by or under the direction of a physician before the child’s attendance or within 30 days of attendance. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of a physical examination dated 10/18/2022. 2. The record of child #2 (enrollment date: 10/25/2021) did not have documentation of a physical examination.”

8VAC20-780-130-A

“Based on record review, the center did not ensure three of five children’s records contained documentation of immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record of child #1 (enrollment date: 4/18/2022) had documentation of immunizations dated 10/11/2022. 2. The record of child #2 (enrollment date: 10/25/2021) had documentation of immunizations dated 12/23/2021. 3. The record of child #3 (enrollment date: 9/07/2021) had documentation of immunizations dated 10/04/2021.”

8VAC20-780-520-B

“Based on observation, the center did not ensure that used sunscreen is kept in the original container. Evidence: There were several clear bottles located throughout the center that contained sunscreen. The bottles were labeled "sunscreen". The bottles were not the original containers. The center representative stated that the center used the sunscreen in the clear bottles for children, with parent permission, last summer.”

8VAC20-780-500-B

“Based on observation, the center did not ensure diapering areas had sinks with running warm water not to exceed 120?F. Evidence: 1. The Baby Birds diapering area had a sink with hot running water that measured 139.5?F which presented a scalding hazard. 2. The Chickadees classroom diapering area sink did not having working warm running water.”

8VAC20-780-320-B

“Based on observation, the center did not ensure that sinks located near toilets are supplied with running warm water not to exceed 120?F. Evidence: The sink locate in the Yellow Birds classroom had running hot water that measured 136?F.”

8VAC20-780-160-A-1

“Based on record review, the center did not ensure three of four staff records contained documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. The record of staff #1 (start date: 12/7/21) had documentation of a negative tuberculosis screening dated 12/29/2021. 2. The record of staff #2 (start date: 12/20/21) had documentation of a negative tuberculosis screening dated 12/29/2021. 3. The record of staff #3 (start date: 2/15/22) had documentation of a negative tuberculosis screening dated 2/24/2022.”

22.1-289.035-B-4

“Based on record review, the center did not ensure one of three staff records contained documentation of criminal history record results, sex offender registry check results and a child abuse and neglect search request from any state in which the individual has resided in the past five years. Evidence: The record of staff #1 (start date: 12/7/2021) had documentation of out of state criminal history record results and sex offender registry check results dated 1/7/2021.”

8VAC20-780-270-A

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: 1. There was mouse feces in an unlocked cabinet in the yellow children's bathroom near the main entrance. The cabinet was within the reach of children in care. 2. The outside fence near the blacktop on the playground is leaning presenting a falling hazard. 3. There is a hole in the wall near the sinks in the green birds classroom exposing crumbling drywall. 4. There was a damp, warped and discolored wall with chipped/peeling plaster near the back storage area of the green birds classroom. The center representative stated that there was a leaking toilet that cause water damage in the classroom below. 5. There was an unlocked closet in the back of the green birds classroom which contained molded, damaged and deteriorating particle board. 6. There were two hanging cords connected to a surge protector located on top of a small refrigerator in the Baby Birds 1 room. The cords presented a falling or entanglement hazard if pulled. 7. There was visible dirt build up located on the vents in the sparrows classroom and bathroom which could affect the air quality for children and staff. 8. The girls and boys bathroom sinks, located in the Sparrows classroom, were pulling away from the wall exposing caulk and peeling paint. 9. The boys bathroom located in the Sparrows classroom had a sink and toilet with visible dirt build up and the bathroom had a strong urine smell. The bathroom floor was visibly dirty. 10. There was what seemed to be mold and dirt build up around the pipes of the sink within the reach of children in both bathrooms located in the Sparrows classroom. 11. A piece of the ceiling in the sparrows classroom was missing exposing rusted and damaged pipes and materials.”

8VAC20-780-280-B

“Based on observation, the center did not ensure hazardous substances such as cleaning materials were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was one cleaner located in an unlocked diapering cabinet in the Chickadees classroom, within the reach of children in care. 2. There were two cleaners located in an unlocked cabinet in the orange birds classroom. 3. There was one unlocked cleaner in the Green Birds supply room and two cleaners in an unlocked drawer next to the handwashing sinks in the Green Birds classroom. 4. There were cleaners located in an unlocked laundry closet in the Sparrows classroom.”

8VAC20-780-270-A Complaint related: No

“Based on observation, the center did not ensure areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition. Evidence: There were several areas in the center with chipped and peeling paint.”

22VAC40-665-520-B-11

“Based on record review, the center did not ensure to obtain a written allergy care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: The record of child #7 did not have documentation of a written allergy care plan for the child's documented diagnosed food allergy. The center representative stated that the center recently gave the allergy care plan back to the parent per the parent's request.”

22VAC40-665-520-B-11

“Based on record review, the center did not ensure to obtain a written allergy care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: The record of child #7 did not have documentation of a written allergy care plan for the child's documented diagnosed food allergy. The center representative stated that the center recently gave the allergy care plan back to the parent per the parent's request.”