VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Milestones Child Development Center
700 Fernwood Farms Road
Chesapeake, VA 23320
(757) 548-3300

Current Inspector: Heather Harrell (757) 334-4329

Inspection Date: Jan. 18, 2023

Complaint Related: No

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 8VAC20-780 Special Services. 8VAC20-770 Background Checks (8VAC20-770) 20 Access to minor?s records 22.1 Background Checks Code, Carbon Monoxide 63.2 Child Abuse & Neglect

Comments:

A renewal inspection was conducted on 1/18/23 from 10:25am until 1:30pm. At the time of the inspection, there were 53 children in care with 13 staff present. A sample of 5 children's records and 6 staff records were reviewed. Children were observed participating in learning activities, playing on the playground and eating lunch. Handwashing and restroom procedures were also observed. First aid and emergency supplies, the emergency preparedness plan, documentation of emergency practice drills, medication and required center postings were reviewed. Information gathered during the inspection determined non-compliance with applicable standards or law. Violations were documented on the violation notice issued to the program and discussed with the center director during the exit interview.

Violations:

Standard #:	22.1-289.035-A
Description:	Based on record review and interview, the center did not ensure that all employees shall undergo a background check every five years after the initial check is completed. Evidence: 1. The most recent central registry search result for staff 1 is dated 8/2/17. Staff 1 was due for an updated central registry search in August 2022. 2. The center director confirmed that the central registry search results for staff 1 is expired.
Plan of Correction:	The center responded with the following: An updated central registry search will be completed for staff 1. Once received, the results will be placed in staff 1's record and forwarded to the licensing inspector. Going forward, center management will ensure repeat central registry search requests are completed every 5 years.
Standard #:	22.1-289.035-B-2
Description:	Based on record review and interview, the center did not ensure that the results of a national fingerprint search are received for each staff member before employment. Evidence: 1. The record for staff 4 (date of hire: 12/12/22) contains results of a national fingerprint search dated 12/14/22, which is after her first day of employment. 2. The center director confirmed that staff 4 began employment at the center prior to receiving the results of her national fingerprint search.
Plan of Correction:	The center responded with the following: Going forward, center management will ensure new staff do not begin employment until the results of the fingerprint search are received.
Standard #:	22.1-289.035-B-4
Description:	Based on record review and interview, it was determined that the center did not ensure that a copy of the results of a search of the child abuse and neglect registry is obtained from any state in which the individual has resided in the preceding five years. Evidence: 1. Staff 3 has a hire date of 8/29/22. Staff 3 indicated on her sworn statement or affirmation that she has resided in the state of New Jersey within the past five years. The results of a search of the child abuse and neglect registry were not available for staff 3 from the state of New Jersey. 2. The center director confirmed that the required out-of-state background check was not completed for staff 3.
Plan of Correction:	The center responded with the following: The New Jersey central registry search for staff 3 will be requested. Once received, the results will be placed in staff 3's record and forwarded to the licensing inspector. Going forward, center management will ensure out-of-state background checks are completed within the required timeframes.
Standard #:	8VAC20-770-60-C-2
Description:	Based on record review and interview, the center did not ensure that an employee of a licensed or registered child day program must be denied continued employment or volunteer service if the licensed child day program does not have a central registry finding within 30 days of employment. Evidence: 1. The records for staff 2 (date of hire: 10/25/22) and staff 3 (date of hire: 8/29/22) do not contain documentation of a central registry finding. 2. The center director confirmed that the records for staff 2 and staff 3 are lacking documentation of a central registry finding.
Plan of Correction:	The center responded with the following: The central registry searches for staff 2 and staff 3 will be requested again and once received, the results will be placed in their records and forwarded to the licensing inspector. Going forward, center management will ensure staff central registry searches are followed up on if not received within 30 days of being requested.
Standard #:	8VAC20-780-160-A
Description:	Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and before coming into contact with children. Evidence: 1. The record for staff 3 (date of hire: 8/29/22) does not contain documentation of a negative tuberculosis screening. 2. The record for staff 6 (date of hire: 11/18/22) contains documentation of a negative tuberculosis screening dated 11/20/22, which is after her date of hire. 3. The center director confirmed that the tuberculosis screenings for staff 3 and staff 6 were not completed within the required timeframes.
Plan of Correction:	The center responded with the following: Staff 3 will obtain a TB screening as soon as possible. Going forward, the center will ensure new staff obtain TB screenings by their first day of employment and before coming in contact with children.
Standard #:	8VAC20-780-60-A-8
Description:	Based on record review and interview, the center did not ensure that children's records contain 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. Child 2 is identified on the center's written allergies, sensitivities and dietary restrictions list as having a diagnosed food allergy and has an emergency medication being stored at the center. The center does not have a written allergy care plan for child 2. 2. The center director confirmed that the center does not have a written allergy care plan for child 2's diagnosed food allergy.
Plan of Correction:	The center responded with the following: Center management will contact the parent of child 2 and request a written allergy care plan from the child's physician. Going forward, center management will ensure that each child with a diagnosed food allergy has a written allergy care plan located in their case record.
Standard #:	8VAC20-780-70
Description:	Based on record review and interview, the center did not ensure that staff records contain all the required information. Evidence: 1. Staff 2's (date of hire: 10/25/22) job title is documented in the record as program leader. The record for staff 2 does not contain documentation to demonstrate that she possesses the education and experience required for the job position of program leader. 2. Staff 3's (date of hire: 8/29/22) job title is documented in the record as program leader. The record for staff 2 does not contain documentation to demonstrate that she possesses the education and experience required for the job position of program leader. 3. Staff 5's (date of hire: 11/4/22) job title is documented in the record as program leader. The record for staff 5 does not contain documentation to demonstrate that she possesses the education required for the job position of program leader. 4. Staff 6's (date of hire: 11/18/22) job title is documented in the record as program leader. The record for staff 6 does not contain documentation to demonstrate that she possesses the education and experience required for the job position of program leader. The record for staff 6 also does not contain documentation that two or more references as to character and reputation as well as competency were checked before employment. 5. The center director confirmed that the records for staff 2, staff 3, staff 5 and staff 6 are lacking the above required information.
Plan of Correction:	The center responded with the following: The missing information for staff 2, staff 3, staff 5 and staff 6 will be obtained and placed in their staff records.
Standard #:	8VAC20-780-240-A
Description:	Based on record review and interview, the center did not ensure that all staff shall complete the Virginia Department of Education-sponsored orientation training within 90 calendar days of employment. Evidence: 1. The record for staff 3 (date of hire: 8/29/22) does not contain documentation of completing the Virginia Department of Education-sponsored orientation training. 2. The center director confirmed that staff 3 has not completed the required orientation training.
Plan of Correction:	The center responded with the following: Staff 3 will complete the required DOE sponsored training as soon as possible and the certificate will be placed in her record.
Standard #:	8VAC20-780-270-A
Description:	Based on observation and interview, the center did not ensure that areas and equipment of the center shall be maintained in a clean, safe and operable condition. Evidence: 1. The wooden shelving unit in the school-age classroom has multiple areas of chipped and peeling paint. 2. The center director confirmed that the shelving unit in the school-age classroom has chipped and peeling paint.
Plan of Correction:	The center responded with the following: Maintenance will be contacted to sand down and repaint the shelving unit in the school-age classroom.
Standard #:	8VAC20-780-280-B
Description:	Based on observation and interview, the center did not ensure that hazardous substances, such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In the waddler/toddler bathroom, there was toilet bowl cleaner and a spray disinfectant unlocked on the top of a cabinet above the toilet. 2. In the waddler room, there was gel hand sanitizer on the changing table and accessible to children in care. 3. In the toddler room, there was a can of disinfectant, a spray bottle of sanitizer and Clorox disinfecting mist on an unlocked cabinet shelf above the sink. 4. The center director confirmed that there were unlocked hazardous cleaning materials in the toddler and waddler classrooms and bathroom.
Plan of Correction:	The center responded with the following: The unlocked cleaning products were placed in locked cabinets during the inspection. Staff will be reminded that all hazardous substances, including cleaning products and hand sanitizer, should be kept locked except for when in use.
Standard #:	8VAC20-780-510-B
Description:	Based on interview and a review of medication, the center did not ensure that nonprescription medication shall be given to a child only with written authorization from the parent. Evidence: 1. Child 1 was administered Benadryl by center staff on 11/1/22 without written authorization from the parent. 2. The center director confirmed that there is no written parental authorization to administer Benadryl to child 1.
Plan of Correction:	The center responded with the following: The parent of child 1 will be contacted today and written authorization to administer medication will be obtained and placed in child 1's record. Going forward, center management will ensure that medication is not administered to children in care without written authorization from the parent.
Standard #:	8VAC20-780-510-E
Description:	Based on interview and a review of medication, the center did not ensure that the center's procedures for administering medication shall include written authorization from the child's physician and parent for long-term prescription drug use. Evidence: 1. Child 1 has an emergency medication being stored at the center. There is no written parental or physician authorization to administer this medication to child 1. 2. Child 2 has an emergency medication being stored at the center. There is no written parental or physician authorization to administer this medication to child 2. 3. The center director confirmed that child 1 and child 2 have emergency medications being stored at the center and that there is no written parental or physician authorization for the center to administer these medications to the children.
Plan of Correction:	The center responded with the following: The parents of child 1 and child 2 will be contacted today and written authorization to administer emergency medication from the parent and the physician will be requested. Once received, the written authorizations will be placed in each child's record. Going forward, the center will ensure that written authorization from the parent and physician is obtained for long-term prescription medication being stored at the center.
Standard #:	8VAC20-780-570-E
Description:	Based on observation and interview, the center did not ensure that prepared infant formula shall be dated. Evidence: 1. In the infant room, there were 6 bottles of formula in the refrigerator that were not dated. 2. The center director confirmed that the refrigerated bottled formula in the infant room were not dated.
Plan of Correction:	The center responded with the following: Going forward, the center will ensure all prepared infant formula is dated.