VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Adventureland - Hylton Boys and Girls Club
5070 Dale Boulevard
Woodbridge, VA 22193
(703) 670-3311

Current Inspector: Angela Dudek (804) 629-8167

Inspection Date: Jan. 27, 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. 8VAC20-820 THE LICENSE. 8VAC20-820 THE LICENSING PROCESS. 8VAC20-820 HEARINGS PROCEDURES. 8VAC20-770 Background Checks (8VAC20-770) 20 Access to minor?s records 22.1 Background Checks Code, Carbon Monoxide 32.1 Report by person other than physician 63.2 Child Abuse & Neglect

Technical Assistance:

Provided consultation on: 8VAC20-780-560G All food from home including water bottles, need to be labeled with name and date.

Comments:

An unannounced monitoring inspection was conducted on 01/01/2023 from 1:10pm to 3:30pm. There were 23 children ages 6 years old to age 10 years old supervised by 3 staff. The physical plant, outdoor play area, programming, attendance, menus, 2 staff records, 1 volunteer record, 3 children?s records, 1 medication with corresponding authorization records, emergency drills, injury reports, emergency supplies, and policies were reviewed. Children were observed participating having snack and playing in the gym. Handwashing procedures were also observed. There was an adequate number of staff present with current certification in Medication Administration Training (MAT), CPR and First Aid, and Daily Health Observation (DHO) training. Areas of non-compliance are identified in the Violation Notice. Please complete the columns for "Plan of Correction" and "Date to be Corrected" for each violation cited on the Violation Notice, and then return a signed and dated copy to the licensing office by 5pm on 2/22/2023. Please email me at angela.dudek@doe.virginia.gov with any questions.

Violations:

Standard #:	22.1-289.035-B-2
Description:	Based on review of 2 Staff records, 1 Volunteer record, and interview with staff, the center did not obtain documentation of the results of a national fingerprint background check prior to hire or volunteer work starting. Evidence: The record for Volunteer #1 (date of volunteer work starting 1/19/23), did not contain documentation of a fingerprint background check completed prior to their date of hire or volunteer work starting.
Plan of Correction:	The listed volunteer is no longer working with the program.
Standard #:	8VAC20-770-60-B
Description:	Based on review of 2 Staff records, 1 Volunteer record, and interview with staff, the center did not obtain documentation of a completed sworn disclosure statement for each staff/volunteer prior to date of hire or beginning to volunteer. Evidence: The record for Volunteer #1 (date of volunteer work starting 1/19/23) did not contain documentation of a completed sworn disclosure statement.
Plan of Correction:	The listed volunteer is no longer working with the program.
Standard #:	8VAC20-770-60-C-2
Description:	Based on review of 2 Staff records, 1 Volunteer record, and interview with staff, the center did not obtain documentation that a central registry search was completed by the end of the 30th day of employment or volunteering. Evidence: The record for Volunteer #1 (date of volunteer work starting 1/19/23) did not contain documentation that a central registry search was completed within 30 days of hire or volunteer work starting. There were no Central registry results in the file. No documentation of follow up was in the file.
Plan of Correction:	The listed volunteer is no longer working with the program.
Standard #:	8VAC20-780-160-A
Description:	Based on review of 2 Staff records, 1 Volunteer record and interview with staff, the center did not obtain documentation of a negative tuberculosis (TB) test or screening for staff at the time of employment or beginning to volunteer and prior to contact with children that was completed within the last 30 days. Evidence: The file for Volunteer #1 (date of volunteer work starting 1/19/23) did not contain documentation of a negative tuberculosis (TB) test or screening within the last 30 days prior to date of hire or beginning to volunteer. The TB test on file was dated 3/7/2022.
Plan of Correction:	The listed volunteer is no longer working with the program.
Standard #:	8VAC20-780-70
Description:	Based on review of 2 staff records, 1 Volunteer record and interview with staff, the center did not obtain all the required documentation for staff/volunteer records. Evidence: 1)The center did not have documentation for Volunteer #1 that 2 or more references as to character and reputation as well as competency were checked before volunteering. 2) The center did not have documentation for Volunteer #1 of the name, address and phone number of a person to be notified in an emergency.
Plan of Correction:	The listed volunteer is no longer working with the program.