YMCA School Age Child Care at Princess Anne Family YMCA

8VAC20-780-500-A

“Based upon observation, the facility has not ensured that children's hands are washed before and after eating. Evidence: The group of 31 children ages 8 and 9 years were observed finishing lunch. None of the children washed their hands with soap and water or cleansing wipes after eating lunch. The children were taken directly from the interactive zone to the gymnasium where the children put away their lunch bags and lined up for the next activity.”

8VAC20-780-340-A

“Based upon observation, the facility has not ensured that when staff are supervising children, they ensure their care, protection and guidance. Evidence: 1. A group of 31 children, ages 8 and 9 years, were observed eating lunch in the Interactive Zone. Of the six staff on duty with the children, two female staff were at the front of the room talking with each other and three male staff were sitting together over by the window sill talking with each other. Only one staff was near the children who were eating as he was sweeping under a table. Children were observed getting up from their places at the tables and running up to talk to the staff and running back to their seats. Five of the six staff did not voluntarily interact or actively supervise the children during the lunch period. 2. After eating, the group of 8 and 9 year old children went to the gym to put away their lunch bags. These children were observed running into and across/around the gym, pushing, shoving, screaming and running through the groups of younger children who were seated on the gym floor with a craft project. The noise level in the gym was such that the children could not hear the staff who were shouting in an effort to calm the chaos and get the children to line up at the door. 3. Once the children were lined up at the gym door, they remained standing in line for ten minutes while waiting to have access to the Mind/Body room. As the children were waiting, they were pushing and shoving each other and getting in and out of line. 4. There was no evidence of a planned routine for the grouping of 31 eight and nine year old children.”

8VAC20-780-560-L

“Based upon observation, the facility has not ensured that staff sit with the children during meal times. Evidence: Thirty-one children ages 8 and 9 years were observed eating lunch in the interactive zone with 6 staff. None of the six staff were sitting at the tables with the children.”

8VAC20-780-500-A

“Repeat violation Based upon observation, the facility has not ensured that children's hands are washed after eating. Evidence: The children were observed eating lunch. When children finished, they were interacting with friends and other activities with other children with only occasional reminders to go wash their hands. Children were observed getting up from the table, interacting with other children and sitting back down at the table. There was no structure or means to ensure that all children washed their hands.”

8VAC20-780-510-L

“Based upon staff interview, the facility has not ensured that medication are kept in a locked place using a safe locking method that prevents access by children. Evidence: When asked about children's medication, staff responded that child 1 had an inhaler in her bag. It was confirmed that child 1's inhaler was in her bag in her bin.”

8VAC20-780-510-G

“Based upon observation, the facility has not ensured that medication is labeled with the child's name, the name of the medication, the dosage amount and the time or times to be given (prescription label). Evidence: The albuterol to be administered to child 1 was not labeled with the child's name, dosage amount and the time(s) to be given.”

8VAC20-780-560-L

“Based upon observation, the facility has not ensured that staff sit with the children during meal times. Evidence: The children were observed eating lunch. Staff were walking around the tables where children were eating or standing still and watching the children eat. Staff 2 was walking around eating from a snack bag.”

8VAC20-780-70

“Based upon review of records, the facility has not ensured that staff records include all required information. Evidence: According to the program administrator, staff 2 is a program leader. The record for staff 2 did not indicate that staff 2 is a program leader, nor did it contain documentation of the program leader qualifications.”

8VAC20-780-160-A

“Based upon review of records, the facility has not ensured that each staff member has submitted documentation of a negative tuberculosis screening obtained prior to being on duty with the children. Evidence: Staff 4 was hired on 5/10/2023. The tuberculosis screening was not obtained until 5/24/2023.”

8VAC20-780-80-A

“Based upon staff interview and review of documentation, the facility has not ensured that for each group of children, a written record of daily attendance that documents the arrival and departure of each child in care as it occurs is maintained. Evidence: The children were all together in one large grouping. Staff 1 was asked how many children were in care. Staff 1 responded that there were 53 children in care. The written record of attendance indicated 50 children in care. One child was signed in on the wrong day and two other children had not been checked into care.”

8VAC20-780-550-P

“Repeat violation Based upon a review of injury records, the facility has not ensured that the written records of children's injuries include all required information. Evidence: An injury record dated 3/6/2024 for child 5 documented that the parent was informed of the injury on 3/5/2024.”

8VAC20-780-340-B

“Based upon staff interview, the facility has not ensured that during the center's hours of operation, one adult on the premises shall either be the administrator or an adult appointed by the license as the person in charge. Evidence: Upon arrival of the inspector, the inspector was told by staff 6 that staff 1 was in charge. Staff 1 stated that she was not in charge and that staff 7 was in charge and that she was at another location.”

8VAC20-780-340-D

“Based upon review of records, the facility has not ensured that each program leader supervises no more that two aides. Evidence: At the start of the inspection, there were 6 staff on duty of whom only 1 was identified by the program administrator as a program leader. A second program leader arrived from break during the inspection. This brought the ratio of program leaders to aides to 2 program leaders and 5 aides.”

8VAC20-780-510-B

“Repeat violation Based upon observation and review of records, the facility has not ensured that prescription medication is given to a child only with written parental authorization. Evidence: Staff 4 administered albuterol to child 1 during the inspection. There was no written parent authorization for the medication to be administered.”

8VAC20-780-500-A

“Repeat violation Based upon observation, the facility has not ensured that children's hands are washed after eating. Evidence: The children were observed eating lunch. When children finished, they were interacting with friends and other activities with other children with only occasional reminders to go wash their hands. Children were observed getting up from the table, interacting with other children and sitting back down at the table. There was no structure or means to ensure that all children washed their hands.”

8VAC20-780-510-L

“Based upon staff interview, the facility has not ensured that medication are kept in a locked place using a safe locking method that prevents access by children. Evidence: When asked about children's medication, staff responded that child 1 had an inhaler in her bag. It was confirmed that child 1's inhaler was in her bag in her bin.”

8VAC20-780-510-G

“Based upon observation, the facility has not ensured that medication is labeled with the child's name, the name of the medication, the dosage amount and the time or times to be given (prescription label). Evidence: The albuterol to be administered to child 1 was not labeled with the child's name, dosage amount and the time(s) to be given.”

8VAC20-780-560-L

“Based upon observation, the facility has not ensured that staff sit with the children during meal times. Evidence: The children were observed eating lunch. Staff were walking around the tables where children were eating or standing still and watching the children eat. Staff 2 was walking around eating from a snack bag.”

8VAC20-780-70

“Based upon review of records, the facility has not ensured that staff records include all required information. Evidence: According to the program administrator, staff 2 is a program leader. The record for staff 2 did not indicate that staff 2 is a program leader, nor did it contain documentation of the program leader qualifications.”

8VAC20-780-160-A

“Based upon review of records, the facility has not ensured that each staff member has submitted documentation of a negative tuberculosis screening obtained prior to being on duty with the children. Evidence: Staff 4 was hired on 5/10/2023. The tuberculosis screening was not obtained until 5/24/2023.”

8VAC20-780-80-A

“Based upon staff interview and review of documentation, the facility has not ensured that for each group of children, a written record of daily attendance that documents the arrival and departure of each child in care as it occurs is maintained. Evidence: The children were all together in one large grouping. Staff 1 was asked how many children were in care. Staff 1 responded that there were 53 children in care. The written record of attendance indicated 50 children in care. One child was signed in on the wrong day and two other children had not been checked into care.”

8VAC20-780-550-P

“Repeat violation Based upon a review of injury records, the facility has not ensured that the written records of children's injuries include all required information. Evidence: An injury record dated 3/6/2024 for child 5 documented that the parent was informed of the injury on 3/5/2024.”

8VAC20-780-340-B

“Based upon staff interview, the facility has not ensured that during the center's hours of operation, one adult on the premises shall either be the administrator or an adult appointed by the license as the person in charge. Evidence: Upon arrival of the inspector, the inspector was told by staff 6 that staff 1 was in charge. Staff 1 stated that she was not in charge and that staff 7 was in charge and that she was at another location.”

8VAC20-780-340-D

“Based upon review of records, the facility has not ensured that each program leader supervises no more that two aides. Evidence: At the start of the inspection, there were 6 staff on duty of whom only 1 was identified by the program administrator as a program leader. A second program leader arrived from break during the inspection. This brought the ratio of program leaders to aides to 2 program leaders and 5 aides.”

8VAC20-780-510-B

“Repeat violation Based upon observation and review of records, the facility has not ensured that prescription medication is given to a child only with written parental authorization. Evidence: Staff 4 administered albuterol to child 1 during the inspection. There was no written parent authorization for the medication to be administered.”

8VAC20-780-260-A

“Based upon staff interview, the facility has not ensured that there is an annual fire inspection. Evidence: Staff 1 was unable to provided documentation of an annual fire inspection. The most recent documentation is dated 4/18/2022.”

8VAC20-780-260-B

“Based upon staff interview, the facility has not ensured that there is an annual health department inspection. Evidence: Staff 1 was unable to provided documentation of an annual health department inspection. The most recent documentation is from 2022.”

8VAC20-780-510-B

“Based upon review of medication documentation and staff interview, the facility has not ensured that there is written authorization from the parent for medication to be administered. Evidence: 1. There is albuterol and an EpiPen for administration to child 6 in an emergency. There was no written parent authorization for administration of either medicine. 2. Staff 1 acknowledged that there was not written parental authorization for the albuterol and the EpiPen.”

8VAC20-780-60-A-8

“Based upon review of children's records and staff interview, the facility has not ensured that they have obtained a written care plan for each child with a diagnosed food allergy. Evidence: 1. The record provided for child 7 included documentation of a food allergy for which Benadryl and an EpiPen were stored for emergency use. The record did not include a written allergy care/management plan. 2. Staff 1 verified that there was not a written care plan for child 7.”

8VAC20-790-600-D-2

“Based upon review of records and staff interview, the facility has not ensured that staff obtain certification in first aid within 90 days of employ. Evidence: 1. The record provided for staff 3, employed on 7/25/23, did not include documentation that first aid certification has been obtained. 2. The record provided for staff 4, employed on 7/27/22, did not include documentation that first aid certification has been obtained. 3. Staff 1 verified that neither staff 3 or staff 4 have first aid certification.”

8VAC20-790-600-D-1

“Based upon review of records and staff interview, the facility has not ensured that staff obtain certification in cardiopulmonary resuscitation (CPR) within 90 days of employ. Evidence: 1. The record provided for staff 3, employed on 7/25/23, did not include documentation that CPR certification has been obtained. 2. The record provided for staff 4, employed on 7/27/22, did not include documentation that CPR certification has been obtained. 3. Staff 1 verified that neither staff 3 or staff 4 have CPR certification.”

8VAC20-780-260-A

“Based upon staff interview, the facility has not ensured that there is an annual fire inspection. Evidence: Staff 1 was unable to provided documentation of an annual fire inspection. The most recent documentation is dated 4/18/2022.”

8VAC20-780-260-B

“Based upon staff interview, the facility has not ensured that there is an annual health department inspection. Evidence: Staff 1 was unable to provided documentation of an annual health department inspection. The most recent documentation is from 2022.”

8VAC20-780-510-B

“Based upon review of medication documentation and staff interview, the facility has not ensured that there is written authorization from the parent for medication to be administered. Evidence: 1. There is albuterol and an EpiPen for administration to child 6 in an emergency. There was no written parent authorization for administration of either medicine. 2. Staff 1 acknowledged that there was not written parental authorization for the albuterol and the EpiPen.”

8VAC20-780-60-A-8

“Based upon review of children's records and staff interview, the facility has not ensured that they have obtained a written care plan for each child with a diagnosed food allergy. Evidence: 1. The record provided for child 7 included documentation of a food allergy for which Benadryl and an EpiPen were stored for emergency use. The record did not include a written allergy care/management plan. 2. Staff 1 verified that there was not a written care plan for child 7.”

8VAC20-790-600-D-2

“Based upon review of records and staff interview, the facility has not ensured that staff obtain certification in first aid within 90 days of employ. Evidence: 1. The record provided for staff 3, employed on 7/25/23, did not include documentation that first aid certification has been obtained. 2. The record provided for staff 4, employed on 7/27/22, did not include documentation that first aid certification has been obtained. 3. Staff 1 verified that neither staff 3 or staff 4 have first aid certification.”

8VAC20-790-600-D-1

“Based upon review of records and staff interview, the facility has not ensured that staff obtain certification in cardiopulmonary resuscitation (CPR) within 90 days of employ. Evidence: 1. The record provided for staff 3, employed on 7/25/23, did not include documentation that CPR certification has been obtained. 2. The record provided for staff 4, employed on 7/27/22, did not include documentation that CPR certification has been obtained. 3. Staff 1 verified that neither staff 3 or staff 4 have CPR certification.”

8VAC20-780-550-P Complaint related: Yes

“Based upon review of documentation and staff interview, the facility has not ensured that a written record is maintained of children's serious and minor injuries that includes all required documentation. Evidence: 1. A provided injury report dated 2/13/2023 for child 1, does not include the time facility staff notified the parent of the child's injury. 2. A provided injury report dated 2/13/2023 for child 1, indicates that staff 1 and 2 as staff present at the time of the injury. Staff interviews revealed that , although staff 1 and 2 were in the building at the time of the injury, staff 3 and 4 were the actual staff present and directly supervising the child at the time of the injury. 3. An injury report dated 2/16/2023 for child 1, indicates that staff 1 and 5 as staff present at the time of the incident. Staff interviews revealed that, although staff 1 was in the building at the time of the incident, staff 3 and staff 5 were the actual staff present and directly supervising the children at the time of the incident.”

8VAC20-780-130-A

“Based upon review of children's records and staff interview, the facility has not ensured that each child has received the immunizations required by the State Board of Health before the child attends the center. Evidence: 1. Child 4 began attending on 9/6/2022. The record did not include documentation of the required immunizations. 2. Staff 1 acknowledged that the record for child 4 did not include documentation of immunizations.”

8VAC20-770-60-C-2

“Based upon review of staff records and staff interview, the facility has not ensured that results of child protective services central registry search is obtained within 30 days of employment or the employee is denied continued employment. Evidence: 1. The record provided for staff 3, employed on 6/21/2022, and still employed, did not include the results of a central registry search. 2. Staff 1 acknowledged that the results of a central registry search were not available for review.”

22.1-289.035-B-4

“Based upon review of staff records, the facility has not ensured that the results of a fingerprint check, a child protective services central registry search and a sex offender search has been obtained from state other than Virginia in which an applicant for employment has lived within the past five years have been obtained. Evidence: 1. Results of a central registry search for the state of North Carolina have not been obtained for staff 2, employed since 6/13/2022. 2. Staff 1 acknowledged that out of state background checks from North Carolina had not been obtained for staff 2.”

8VAC20-780-240-A

“Based upon review of staff records and staff interview, the facility has not ensured that the Virginia Department of Education (VDOE)-sponsored ten hour orientation course is completed within 90 calendar days of employment. Evidence: 1. Staff 3 was hired on 6/21/2022 and staff 2 was hired on 6/3/2022. Neither record included documentation that either staff had completed the required ten hour VDOE-sponsored orientation course. 2. Staff 1 acknowledged that documentation of the completion of the required ten hour orientation course has not been received.”

8VAC20-780-140-A

“Based upon review of children's records and staff interview, the facility has not ensured that each child has a physical examination by or under the direction of a physician prior to attending or within 30 days after attending. Evidence: 1. Child 4 began attending on 9/6/2022. The record did not include documentation of a physical examination. 2. Staff 1 acknowledged that the results of a physical examination were not obtained for child 4.”

8VAC20-780-500-A

“Based upon observation, the facility has not ensured that children's hands are washed with soap and running water or disposable wipes before and after eating meals and snacks. Evidence: The children were observed as they finished eating lunch. Staff 4 was squirting the children's hands from a bottle labeled "sanitizer" before the children went to play. Hands were not washed with soap and water nor were the children given a disposable wipe.”

8VAC20-780-240-B

“Based upon review of staff records and staff interview, the facility has not ensured that staff have completed the orientation training to include all required components and topics prior to working alone with the children and no later than seven days of the date of assuming job responsibilities. Evidence: 1. There was no documentation to demonstrate that staff 2, hired on 6/13/2022, and staff 3, hired on 6/21/2022, had completed the required orientation training. 2. Staff 1 acknowledged that there was no documentation to verify the required orientation training of either staff 2 or staff 3.”

8VAC20-780-130-A

“Based upon review of children's records and staff interview, the facility has not ensured that each child has received the immunizations required by the State Board of Health before the child attends the center. Evidence: 1. Child 4 began attending on 9/6/2022. The record did not include documentation of the required immunizations. 2. Staff 1 acknowledged that the record for child 4 did not include documentation of immunizations.”

8VAC20-770-60-C-2

“Based upon review of staff records and staff interview, the facility has not ensured that results of child protective services central registry search is obtained within 30 days of employment or the employee is denied continued employment. Evidence: 1. The record provided for staff 3, employed on 6/21/2022, and still employed, did not include the results of a central registry search. 2. Staff 1 acknowledged that the results of a central registry search were not available for review.”

22.1-289.035-B-4

“Based upon review of staff records, the facility has not ensured that the results of a fingerprint check, a child protective services central registry search and a sex offender search has been obtained from state other than Virginia in which an applicant for employment has lived within the past five years have been obtained. Evidence: 1. Results of a central registry search for the state of North Carolina have not been obtained for staff 2, employed since 6/13/2022. 2. Staff 1 acknowledged that out of state background checks from North Carolina had not been obtained for staff 2.”

8VAC20-780-240-A

“Based upon review of staff records and staff interview, the facility has not ensured that the Virginia Department of Education (VDOE)-sponsored ten hour orientation course is completed within 90 calendar days of employment. Evidence: 1. Staff 3 was hired on 6/21/2022 and staff 2 was hired on 6/3/2022. Neither record included documentation that either staff had completed the required ten hour VDOE-sponsored orientation course. 2. Staff 1 acknowledged that documentation of the completion of the required ten hour orientation course has not been received.”

8VAC20-780-140-A

“Based upon review of children's records and staff interview, the facility has not ensured that each child has a physical examination by or under the direction of a physician prior to attending or within 30 days after attending. Evidence: 1. Child 4 began attending on 9/6/2022. The record did not include documentation of a physical examination. 2. Staff 1 acknowledged that the results of a physical examination were not obtained for child 4.”

8VAC20-780-500-A

“Based upon observation, the facility has not ensured that children's hands are washed with soap and running water or disposable wipes before and after eating meals and snacks. Evidence: The children were observed as they finished eating lunch. Staff 4 was squirting the children's hands from a bottle labeled "sanitizer" before the children went to play. Hands were not washed with soap and water nor were the children given a disposable wipe.”

8VAC20-780-240-B

“Based upon review of staff records and staff interview, the facility has not ensured that staff have completed the orientation training to include all required components and topics prior to working alone with the children and no later than seven days of the date of assuming job responsibilities. Evidence: 1. There was no documentation to demonstrate that staff 2, hired on 6/13/2022, and staff 3, hired on 6/21/2022, had completed the required orientation training. 2. Staff 1 acknowledged that there was no documentation to verify the required orientation training of either staff 2 or staff 3.”

8VAC20-780-40-M

“Based upon review of records and staff interview, the facility has not ensured that a current list of all children's allergies, sensitivities and dietary restrictions is maintained, dated and kept confidential in each room or area where children are present. Evidence: Staff 1 stated that there were currently no children with allergies, food sensitivity or dietary restrictions. Review of children's records revealed that the parent of child 3 indicated an allergy to shellfish. Staff 1 stated that the parent said that the child had a reaction to shellfish after the child's physical examination and that it was not diagnosed. The facility did not have a written list to include this child with a food sensitivity.”

8VAC20-780-560-M

“Based upon observation, the facility has not ensured that children are not allowed to drink or eat while walking around. Evidence: 1. Child 6 was observed wrapping her snack in the paper towel provided and walk to the carpeted area while eating vegetable straws from the towel. She then sat down on the carpet and began playing with toys while eating. 2. Two female children were observed walking around with lollipops in their mouths.”

8VAC20-780-560-G

“Based upon observation, the facility has not ensured that when food is brought from home the food container is labeled in such a way to identify the owner and dated. Evidence: Children were observed bringing their lunch boxes from their book bags they had taken to elementary school to the snack tables and eating whatever food was in the lunch boxes. There was no mechanism in place to ensure that the lunch boxes were labeled with the children's names and the date.”

8VAC20-780-500-A

“Based upon observation, the facility has not ensured that children's hands are washed with soap and water or disposable wipes after eating. Evidence: The first shift of children arriving from the bus after school were served snack at long tables. Upon finishing snack the children got up and disposed of their paper towels and any leftover snack. Some children were observed going to get a disposable wipe from staff but other children were observed going straight to playing without cleaning their hands. A procedure to ensure that that all children's hands were cleaned after snack did not appear to be in place.”

8VAC20-780-480-B

“Based upon review of children's records, the facility has not ensured that that they maintain written permission from the parent of any child who participates in swimming that includes a statement from the parent advising of the child's swimming skills. Evidence: The record provided for child 4 included written parental permission for child 4 to participate in swimming, however the parent did not complete the child's swimming ability on the form.”

8VAC20-780-70

“Based upon review of staff records and staff interview, the facility has not ensured that staff records include all required documentation. Evidence: 1. The records provided for staff 5 and staff 7 did not include the hire dates. 2. Staff 1 verified that the hire dates were not written in the records of staff 5 and staff 7.”

8VAC20-780-240-B

“Based upon review of staff records and staff interview, the facility has not ensured that staff complete orientation training no later than seven days of the date of assuming job responsibilities. Evidence: 1. The record provided for staff 4 indicated a hire date of 11/26/2021. The record did not include any documentation to indicate that staff 4 had received the required orientation training. 2. The record provided for staff 7 who staff 1 said was employed in January 2022, did not include any documentation to indicate that staff 7 had received the required orientation training. 3. Staff 1 verified that there was no record of orientation training for staff 4 and staff 7.”

8VAC20-780-240-C

“Based upon review of staff records, the facility has not ensured that the orientation training of new staff includes all of the facility specific topics. Evidence: The documented orientation training in the records of staff 2, hired 3/7/22 and staff 3, hired 1/3/22, did not include prevention of sudden infant death syndrome and use of safe sleep practices; prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children and prevention of and response to emergencies due to food and other allergic reactions including: recognizing the symptoms of an allergic reaction; responding to allergic reactions; preventing exposure to the specific food and other substances to which the child is allergic; and preventing cross contamination.”

8VAC20-780-160-A

“Based upon review of staff records and staff interview, the facility has not ensured that each staff member has submitted documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. The record provided for staff 5, who staff 1 indicated was employed on 8/16/21, and who was on duty with the children during the inspection, did not include documentation of a negative tuberculosis screening. 2. The record provided for staff 7, who staff 1 indicated was hired in January 2022, and who drove the bus full of children during the inspection, did not include documentation of a negative tuberculosis screening. 3. Staff 1 verified that the records for staff 5 and staff 7 did not include tuberculosis screenings.”

8VAC20-770-60-C-2

“Based upon review of staff records and staff interview, the facility has not ensured that the results of a child protective services search are obtained for staff within 30 days of employment. Evidence: 1. The record provided for staff 4 indicated a hire date of 11/26/2021. The record did not include the results of a child protective services central registry search. 2. Staff 1 verified that results of a central registry search were not in the record for staff 4.”

8VAC20-770-60-B

“Based upon review of staff records and staff interview, the facility has not ensured that an employee is not employed without having completed a sworn disclosure or affirmation statement. Evidence: 1. The record provided for staff 7, who staff 1 stated was employed since January 2022, and who drove the bus load of children during the inspection, did not include a completed and signed sworn disclosure statement. 2. Staff 1 verified that the record did not contain a completed sworn disclsure statement for staff 7.”

22.1-289.035-B-4

“Based upon review of staff records, the facility has not ensured that they have obtained a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which an applicant/employee has resided in the preceding five years. Evidence: 1. According to the record provided, staff 2 lived in North Carolina within five years prior to employ. Results of a sex offender registry have not been obtained. Results of a child protective services central registry search were not requested. 2. Staff 1 verified that results of a sex offender registry search and child protective services central registry search have not been obtained from North Carolina for staff 2. 3. According to the record provided, staff 3 lived in Maryland within five years prior to employ. Results of a sex offender registry have not been obtained. Results of a child protective services central registry search have not been requested. 4. Staff 1 verified that results of a sex offender registry search and child protective services central registry search have not been obtained from Maryland for staff 2.”

8VAC20-780-40-M

“Based upon review of records and staff interview, the facility has not ensured that a current list of all children's allergies, sensitivities and dietary restrictions is maintained, dated and kept confidential in each room or area where children are present. Evidence: Staff 1 stated that there were currently no children with allergies, food sensitivity or dietary restrictions. Review of children's records revealed that the parent of child 3 indicated an allergy to shellfish. Staff 1 stated that the parent said that the child had a reaction to shellfish after the child's physical examination and that it was not diagnosed. The facility did not have a written list to include this child with a food sensitivity.”

8VAC20-780-560-M

“Based upon observation, the facility has not ensured that children are not allowed to drink or eat while walking around. Evidence: 1. Child 6 was observed wrapping her snack in the paper towel provided and walk to the carpeted area while eating vegetable straws from the towel. She then sat down on the carpet and began playing with toys while eating. 2. Two female children were observed walking around with lollipops in their mouths.”

8VAC20-780-560-G

“Based upon observation, the facility has not ensured that when food is brought from home the food container is labeled in such a way to identify the owner and dated. Evidence: Children were observed bringing their lunch boxes from their book bags they had taken to elementary school to the snack tables and eating whatever food was in the lunch boxes. There was no mechanism in place to ensure that the lunch boxes were labeled with the children's names and the date.”

8VAC20-780-500-A

“Based upon observation, the facility has not ensured that children's hands are washed with soap and water or disposable wipes after eating. Evidence: The first shift of children arriving from the bus after school were served snack at long tables. Upon finishing snack the children got up and disposed of their paper towels and any leftover snack. Some children were observed going to get a disposable wipe from staff but other children were observed going straight to playing without cleaning their hands. A procedure to ensure that that all children's hands were cleaned after snack did not appear to be in place.”

8VAC20-780-480-B

“Based upon review of children's records, the facility has not ensured that that they maintain written permission from the parent of any child who participates in swimming that includes a statement from the parent advising of the child's swimming skills. Evidence: The record provided for child 4 included written parental permission for child 4 to participate in swimming, however the parent did not complete the child's swimming ability on the form.”

8VAC20-780-70

“Based upon review of staff records and staff interview, the facility has not ensured that staff records include all required documentation. Evidence: 1. The records provided for staff 5 and staff 7 did not include the hire dates. 2. Staff 1 verified that the hire dates were not written in the records of staff 5 and staff 7.”

8VAC20-780-240-B

“Based upon review of staff records and staff interview, the facility has not ensured that staff complete orientation training no later than seven days of the date of assuming job responsibilities. Evidence: 1. The record provided for staff 4 indicated a hire date of 11/26/2021. The record did not include any documentation to indicate that staff 4 had received the required orientation training. 2. The record provided for staff 7 who staff 1 said was employed in January 2022, did not include any documentation to indicate that staff 7 had received the required orientation training. 3. Staff 1 verified that there was no record of orientation training for staff 4 and staff 7.”

8VAC20-780-240-C

“Based upon review of staff records, the facility has not ensured that the orientation training of new staff includes all of the facility specific topics. Evidence: The documented orientation training in the records of staff 2, hired 3/7/22 and staff 3, hired 1/3/22, did not include prevention of sudden infant death syndrome and use of safe sleep practices; prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children and prevention of and response to emergencies due to food and other allergic reactions including: recognizing the symptoms of an allergic reaction; responding to allergic reactions; preventing exposure to the specific food and other substances to which the child is allergic; and preventing cross contamination.”

8VAC20-780-160-A

“Based upon review of staff records and staff interview, the facility has not ensured that each staff member has submitted documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. The record provided for staff 5, who staff 1 indicated was employed on 8/16/21, and who was on duty with the children during the inspection, did not include documentation of a negative tuberculosis screening. 2. The record provided for staff 7, who staff 1 indicated was hired in January 2022, and who drove the bus full of children during the inspection, did not include documentation of a negative tuberculosis screening. 3. Staff 1 verified that the records for staff 5 and staff 7 did not include tuberculosis screenings.”

8VAC20-770-60-C-2

“Based upon review of staff records and staff interview, the facility has not ensured that the results of a child protective services search are obtained for staff within 30 days of employment. Evidence: 1. The record provided for staff 4 indicated a hire date of 11/26/2021. The record did not include the results of a child protective services central registry search. 2. Staff 1 verified that results of a central registry search were not in the record for staff 4.”

8VAC20-770-60-B

“Based upon review of staff records and staff interview, the facility has not ensured that an employee is not employed without having completed a sworn disclosure or affirmation statement. Evidence: 1. The record provided for staff 7, who staff 1 stated was employed since January 2022, and who drove the bus load of children during the inspection, did not include a completed and signed sworn disclosure statement. 2. Staff 1 verified that the record did not contain a completed sworn disclsure statement for staff 7.”

22.1-289.035-B-4

“Based upon review of staff records, the facility has not ensured that they have obtained a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which an applicant/employee has resided in the preceding five years. Evidence: 1. According to the record provided, staff 2 lived in North Carolina within five years prior to employ. Results of a sex offender registry have not been obtained. Results of a child protective services central registry search were not requested. 2. Staff 1 verified that results of a sex offender registry search and child protective services central registry search have not been obtained from North Carolina for staff 2. 3. According to the record provided, staff 3 lived in Maryland within five years prior to employ. Results of a sex offender registry have not been obtained. Results of a child protective services central registry search have not been requested. 4. Staff 1 verified that results of a sex offender registry search and child protective services central registry search have not been obtained from Maryland for staff 2.”