VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Toddler Town, Inc.
12465 Maple Street
Ashland, VA 23005
(804) 798-2028

Current Inspector: Cindy Horne (804) 297-4469

Inspection Date: June 24, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-185 ADMINISTRATION. 22VAC40-185 STAFF QUALIFICATIONS AND TRAINING. 22VAC40-185 PHYSICAL PLANT. 22VAC40-185 STAFFING AND SUPERVISION. 22VAC40-185 PROGRAMS. 22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES. 22VAC40-185 SPECIAL SERVICES. 22VAC40-191 Background Checks (22VAC40-191)

Technical Assistance:

*Reference documentation form **Staff Orientation form ***Phase 2 training

Comments:

An unannounced focused monitoring inspection was conducted with the center director and center staff on June 24, 2019 to determine compliance with the provisional license. The following ratios were observed: six infants with two staff, three 2 year olds with one staff, eight 4 year olds with one staff, twelve 3 and 4 year olds with two staff, and 23 school age children with two staff. The children were engaged in a variety of activities including outdoor play, eating lunch, preparing for rest, and heading out for a field trip. Lunch served today: macaroni and cheese, green beans, mixed fruit cup, and milk. Five staff files and nine children's files were reviewed - please see Supplemental Summary for missing items. One medication for one child was reviewed; three staff are certified in Medication Administration Training. The last fire inspection was conducted 4/25/2019. Time of today's inspection: 10:00 a.m. to 2:30 p.m. Please call me if you have any questions at 804-662-9766 or e-mail tara.barton@dss.virginia.gov.

Violations:

Standard #:	22VAC40-185-130-B
Description:	Based on review of nine children's files, the facility failed to have documentation of additional immunizations every six months for children under the age of two years. Evidence: the last documented immunization record for Child 5, age 2 1/2, was conducted on 2/14/2018.
Plan of Correction:	We are requesting updated records from parents due ASAP.
Standard #:	22VAC40-185-140-A
Description:	Based on review of nine children's records, the facility failed to have documentation of a physical for each child before the child's attendance or within one month after attendance.. Evidence: Child 4 (date of enrollment 2/2019) and Child 5 (date of enrollment 11/2/2018) did not have a physical on file.
Plan of Correction:	We sent home forms requesting parents and giving them a certain time frame to bring it in.
Standard #:	22VAC40-185-60-A
Description:	Based on review of five children's files, the facility failed to have documentation of the physician's phone number in each child's file. Evidence: The enrollment form for each child does not have a designated place for the parent to write the child's physician's phone number. The physician's phone number is not listed in each child's file.
Plan of Correction:	We have requested each child's parent for the physician's phone number and address on appropriate place.
Standard #:	22VAC40-185-70-A
Description:	Based on review of four staff files, the facility failed to have all requirements in each file. Evidence: there was no documentation of two references as to character and reputation as well as competency prior to hire in the files of Staff A, Staff B, Staff C, or Staff D. There was no documentation of orientation training on file for Staff A, Staff B, Staff C, or Staff D. There was no documentation in the file that Staff A has the education or experience required for the job position.
Plan of Correction:	We are making sure staff files have proper documents in them.
Standard #:	22VAC40-185-270-A
Description:	Based on observation, the facility failed to maintain all areas inside and outside of the center in a clean, safe, and operable condition. Evidence: 1. There are three panels of fencing on the school age playground that are missing in three separate places. The panels were down in two spots along the long fence near the basketball court and in between the field and the playground. 2. There are several fence post caps missing on the fence between the Toddler playground and the basketball court, creating jagged, sharp edges. 3. There is a black cloth material surrounding the sandbox that is loose and uncovered, creating a tripping hazard. 4. There was animal feces on the preschool playground. 5. In the boys school age bathroom, there was a cracked toilet tank cover, with half of it missing. 6. There were several pieces of siding missing from the main building on the side of the twos playground.
Plan of Correction:	We are currently working on having new fencing put in. We have been told by the company they are about three weeks out. It should be started around the end of July.
Standard #:	22VAC40-185-280-B
Description:	Based on observation, the facility failed to have all hazardous substances such as cleaning materials in a locked place using a safe locking method. Evidence: An aerosol can of Lysol was in an unlocked cabinet in the school age room and in an unlocked cabinet in the pre-K classroom. A bottle of bleach water solution, Pine Sol, and an aerosol can of Lysol were in an upper cabinet, unlocked, in the twos room.
Plan of Correction:	Removal of all cleaning products and making sure all cabinets are unlocked and things are stored in the locked cabinet.
Standard #:	22VAC40-185-330-B
Description:	Based on observation, the facility failed to have sufficient resilient surfacing under equipment with climbing apparatus or in the fall zones as required. Evidence: 1. There was grass under a 3 foot slide on the toddler playground. 2. There was 2 to 3 inches of pea gravel in the fall zones of the older school age play equipment. 3. There was bare sand/dirt under the playground swing bar on the preschool playground. 4. There was sufficient mulch directly under the slides on the preschool playground equipment, but not in all fall zones surrounding the equipment.
Plan of Correction:	Ordered resilient surfacing and have started spraying grass in mulch and having pea gravel moved to proper depth for areas.
Standard #:	22VAC40-185-500-A
Description:	Based on observation, the facility failed to have children wash their hands with soap and water or disposable wipes after eating meals. Evidence: the school age children did not wash their hands or use disposable wipes after eating lunch today, June 24, 2019.
Plan of Correction:	Have children make sure hands are washed before and after eating.
Standard #:	22VAC40-185-510-D
Description:	Based on review of one medication, the facility failed to have written parental medication authorization to administer one child's medication. Evidence: the long term medication authorization form for one child's emergency medication expired 6/18/2019.
Plan of Correction:	Removed medication and no medication is on site as of now.
Standard #:	22VAC40-185-570-A
Description:	Based on observation, the facility failed to use the protective belt when a child is placed in an infant feeding table. Evidence: six infants were sitting at an infant feeding table without being strapped in by the protective safety belt. Only two belts were available; the others were being washed.
Plan of Correction:	We replaced belts in seats for children.