VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tender Loving, Building Two
103 West 35th Street
Norfolk, VA 23504
(757) 622-1502

Current Inspector: Nanette Roberts (757) 404-2322

Inspection Date: Oct. 22, 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:

The following topics were discussed with the owner: - upstairs carpeting that is currently being repaired to include the carpeting on the stairs - reminder regarding shelter-in-place drills - emergency contact persons for staff - resilient surfacing (mulch) over asphalt does not meet required fall zone surfacing for playground climbing equipment or equipment with moving parts. - current attendance counts

Comments:

An unannounced, mandated monitoring inspection was conducted today. The inspector arrived at 12:20 PM and departed at 2:10 PM. Twenty-five children were in care. Nap time and transition following nap time were observed. A sample size of five staff records and six children's records were reviewed. Medication administration and injury records were reviewed. An exit meeting was conducted with the owner/administrator prior to closure of the inspection.

Violations:

Standard #:	22VAC40-185-280-B
Description:	Based upon observation and staff interview, the facility has not ensured that all hazardous substances are kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. The door to the kitchen was not locked. On the floor in the cleaning product storage area of the kitchen there was a container of Primoroso Sanitizer, a gallon of bleach and a container of sanitizing wipes, all labeled "warning, keep out of reach of children", 2. Staff 1 acknowledged that the kitchen door was not locking properly. 3. There was a container of hand lotion on the teacher desk in the PK2 (two year old children) classroom. The lotion was labeled "warning, keep out of reach of children". 4. Staff 7 verified the warning on the lotion.
Plan of Correction:	The facility responded with the following: 1. The lock on the kitchen door will be repaired. In the interim, a child proof knob cover was placed on the kitchen door. 2. The lotion was moved to the locked staff break room during the inspection. All staff will be reminded that personal products that are potentially hazardous to children must be kept locked.
Standard #:	22VAC40-185-280-G
Description:	Based upon observation and staff interview, the facility has not ensured that when hazardous substances are not kept in original containers, the substitute containers clearly indicate their contents. Evidence: 1. There was a spray bottle of purple fluid and a spray bottle of pink fluid in the wall hung cabinet in the children's bathroom. There was also a spray bottle of pink fluid in the wall hung cabinet in the second children's bathroom. None of the three bottles were labeled as to the contents. 2. Staff 7 identified the contents as Lysol cleaner and Primoroso sanitizer.
Plan of Correction:	The facility responded with the following: The spray bottles were labeled during the inspection. All staff will be reminded that all substitute containers must be clearly labeled as to the contents of the bottles.
Standard #:	22VAC40-185-510-A
Description:	Based upon review of medication administration, policies and staff interview, the facility has not ensured that medication is given according to the center's written medication policy. Evidence: 1. The facility policy requires written parental permission to include duration of authorization for any medication to be administered to the children. There was an albuterol inhaler stored for administration to child 7 for which there was no parent authorization or duration of authorization.. There was an albuterol inhaler stored for administration to child 8 for which there was no written parent authorization or duration of authorization. 2. Staff 1 verified that written parental permissions were not on file for the albuterol for child 7 or child 8.
Plan of Correction:	The facility responded with the following: All staff will be notified that the asthma allergy action plans are not parent authorizations for TLELC to administer the medication. All parents will be required to complete a medication authorization form specifying permission for TLELC to administer the medication.
Standard #:	22VAC40-185-510-N
Description:	Based upon observation and staff interview, the facility has not ensured that when medication expires, the parent is notified that the medication must be picked up within 14 days or the medication is disposed of by the center. Evidence: 1. There was a bottle of cephalexin labeled for administration to child 6 in the refrigerator. The medication expired on 6/17/2019. 2. Staff 1 acknowledged that the medication was not returned to the parent or disposed.
Plan of Correction:	The facility responded with the following: The medication was disposed of during the inspection. In the future, administration will ensure that all medication is returned to the parent within 14 days after expiration of the parent authorization or expiration of the medicine.