VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Children's Center- Executive Court
300 Executive Court
Suffolk, VA 23434
(757) 538-2523

Current Inspector: Melinda Popkin (757) 802-5281

Inspection Date: Sept. 13, 2022

Complaint Related: Yes

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Staff Qualifications and Training. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies

Technical Assistance:

There may be times when verbal redirection is not appropriate to the circumstances. It may be helpful to discuss and provide training to staff so that they are able to determine when and how they may need to physically intervene to preserve the safety of a child or children and can do so within the guidelines that your program deems acceptable.

Comments:

A complaint investigation was initiated on 9/1/2022 regarding a complaint that was received by the department on 8/31/2022. An on site inspection was conducted on 9/13/2022. The inspector reviewed compliance in the areas of of administration, Staff Qualifications and Training, Physical Plant, Staffing and Supervision, Programs and Special Care Provisions and Emergencies. Video footage was reviewed, three staff were interviewed, documentation to include an incident report and policies and procedures for the center were reviewed. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program. The Complaint was deemed to be Valid.

Violations:

Standard #:	8VAC20-780-80-B-2
Complaint related:	Yes
Description:	Based on interviews and a review of documentation, the center did not inform the department of an injury to a child that occurred while the child was under the supervision of the center and required outside medical attention. Evidence: A two year old child (child #1) was injured while in care at the center on 8/26/2022 and required outside medical attention to close a cut on child #1?s scalp. Staff #1 stated during the interview on 9/13/2022 that following the injury, she spoke with the child?s family to arrange for him to be picked up and advised them to ?take him to the hospital just to be checked out?. Staff #1 went on to say that she has been certified in First Aid and CPR for 17 years and knows that when a child sustains a head injury ?it is best to have them checked by a doctor?. Despite staff advising the family to seek medical attention, the center did not notify the Department or the assigned inspector of child #1?s injury. Injuries requiring outside medical attention must be reported to the department's representative as soon as practical, but not to exceed two business days, of the injury occurring.
Plan of Correction:	The following written plan of correction was received by the department on 10/21/2022: "When the incident happened on 8.26.22, management was unaware to report serious injuries to VDOE portal. Management now understands and has updated our procedures to report serious injuries to the VDOE Portal or licensing inspector."
Standard #:	8VAC20-780-340-A
Complaint related:	Yes
Description:	Based on a review of documentation, video footage, and interviews, staff did not always supervise children in a manner that ensures their care, protection and guidance. Evidence: On 8/26/2022 at approximately 11:00 a.m., a two-year-old child (child #1) fell from standing position in the basket of a push toy located on the outdoor play area. The fall resulted in a cut on the back of child #1?s head which required outside medical care (surgical glue for closure of the wound). Camera footage of the outdoor area on 8/26/2022 was viewed on site, by the inspector, on 9/13/2022. The footage showed child #1 attempting to climb into the basket of a grocery cart push toy. Using a digital timer, the licensing inspector observed that approximately 23 seconds passed from the time that child #1 placed his foot into the basket of the push toy and began climbing into it when another child approached the basket, tried to push it, and child #1 fell to the ground. Two staff (staff #1 and staff #2) were in the vicinity of approximately 6 to 8 feet from child #1 and did not intervene. Further video footage showed that after child #1 fell to the ground both staff (#1 and #2) looked at child #1. Neither staff moved toward child #1, following his fall, to assess for injury or comfort the crying child. It was not until child #1 walked over and stood directly in front of staff #1, approximately 26 seconds later, that staff #1 attended to the child. At that point, after noticing blood on child #1?s hand when he moved it from his head, staff #1 moved quickly, in a sudden motion, to examine child #1?s head. Staff #2 said that when she ?saw he had fallen? I went to go [to him], but then he attempted to get up and seemed okay. Then [staff #1] saw the blood on his hand?. When staff #2 was asked why she did not go to child #1 immediately after he fell she stated that they ?don?t force yourself? on children. ?I was going to say `Come here?. I did not know his head had been hit.? 8VAC20-780-400-B. Based on interviews and viewing of video footage, the center staff did not always ensure that behavioral guidance was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. On 8/26/2022, a two year old child climbed into the basket of a toy shopping cart, stood up in the basket and then fell, striking his head and incurring a cut on his scalp. During interviews at the center on 9/13/2022, staff #1, stated that she heard a third staff member yelling from the deck area across the playground for child #1 to get down from the toy when he was standing in it. Staff #1 described seeing another child push the toy shopping cart while this other child ?Kept saying? to child #1, ?No [child#1]! Stop [child #1]!? Staff #1 stated that child #1?s ?foot got stuck and the whole basket fell?. The inspector asked staff #1 why she did not remove child #1 from the basket when she observed him standing in it. Staff #1 replied ?He is one that will continue to do it, regardless, until he wants to stop. I am pretty sure we also said to get out?. During an interview on the same day, staff #2 stated ?I think he climbed in [the cart]. When I turned around and saw him ? I started laughing and said `why don?t you get down? You can?t??? and ?before I knew it, he fell. I assume he was trying to get out?.
Plan of Correction:	The following written plan of correction was received by the department on 10/21/2022: "Staff 1 and 2 will be retrained on supervising children in their care. Staff 1 a and 2 will be in close proximity to the children and will be attentive and notice the children?s cues, and are aware of when children have difficulties and will provide comfort and assurance to the children."
Standard #:	8VAC20-780-400-B
Complaint related:	Yes
Description:	Based on interviews and viewing of video footage, the center staff did not always ensure that behavioral guidance was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. On 8/26/2022, a two year old child climbed into the basket of a toy shopping cart, stood up in the basket and then fell, striking his head and incurring a cut on his scalp. During interviews at the center on 9/13/2022, staff #1, stated that she heard a third staff member yelling from the deck area across the playground for child #1 to get down from the toy when he was standing in it. Staff #1 described seeing another child push the toy shopping cart while this other child ?Kept saying? to child #1, ?No [child#1]! Stop [child #1]!? Staff #1 stated that child #1?s ?foot got stuck and the whole basket fell?. The inspector asked staff #1 why she did not remove child #1 from the basket when she observed him standing in it. Staff #1 replied ?He is one that will continue to do it, regardless, until he wants to stop. I am pretty sure we also said to get out?. During an interview on the same day, staff #2 stated ?I think he climbed in [the cart]. When I turned around and saw him ? I started laughing and said `why don?t you get down? You can?t??? and ?before I knew it, he fell. I assume he was trying to get out?.
Plan of Correction:	The following written plan of correction was received by the department on 10/21/2022: "Staff 1 and 2 will be retrained in Behavior Management. Staff 1 and 2 will communicate and use specific age-appropriate reminders to effectively address problem behaviors and resolve conflicts. Staff 1 and 2 will use effective redirection to support children?s behavior."