VIRGINIA DEPARTMENT OF SOCIAL SERVICES

STEPS Head Start - Lunenburg
2401 Nottoway Boulevard
Victoria, VA 23974
(434) 696-1139

Current Inspector: Molly Muscat (804) 588-2367

Inspection Date: April 13, 2023

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 8VAC20-780 Special Services. 8VAC20-820 THE LICENSE. 8VAC20-770 Background Checks (8VAC20-770) 20 Access to minor?s records 63.2 Child Abuse & Neglect

Comments:

An unannounced inspection was conducted on April 13, 2023 from approximately 9:00 am to 11:00 am in response to a complaint that was received on April 4, 2023 in reference to an infant being forcefully shaken in a swing seat. A meeting was held with local agency on April 4, 2023. A follow up meeting was conducted on April 18, 2023 with Program Specialist. Documentation was reviewed, video footage was reviewed, and interviews were conducted. 1 staff record and 1 child record were reviewed. The preponderance of evidence gathered supports violation of standards. The complaint is considered valid. Please complete the plan of correction and ?date to be corrected? for each violation cited on the violation notice and return it to me within 5 business days from today, 04/27/2023. Please specify how the deficient practice will be or has been corrected. Your plan of correction should contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again, and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s).

Violations:

Standard #:	8VAC20-780-40-E
Complaint related:	Yes
Description:	Based on documentation review, interview, and observation the center failed to follow their own policies and procedures. Evidence: 1) Review of Procedure Number ED310 titled ?Guidance and Discipline? prohibits rough handling, shaking, yelling or raising voice, and use of restrictive environments such as infant swings. 2) Review of Procedure Number SAF527 titled ?Prevention of Shaken Baby Syndrome and Abusive Head Trauma? details ways to prevent abusive head trauma including ways to calm down if the staff member is frustrated. 3) Video footage revealed that staff #1 roughly shook the swing that child #1, age 7 months, was in. Video footage also shows staff #1 yelling at child #1. 4) Interviews revealed that staff #1 interacts with child #1, age 7 months, in this manner each day at nap time. Staff #1 stated ?I didn?t do anything different than I normally do every day?
Plan of Correction:	Policy ED310 prohibits the use of swings or restrictive environments for the purpose of discipline. The intent from the staff person was for sleep and not discipline. The staff person did violate the policy by shaking the swing and using a raised voice. The staff person has been terminated. As a result of the incident all Early Head Start staff have been resent a written copy of policies SAF527 and SAF526 regarding safe sleep practices and prevention of Shaken Baby Syndrome. Staff were given an opportunity to ask questions and have signed an acknowledgment of policy.
Standard #:	8VAC20-780-340-A
Complaint related:	Yes
Description:	Based on observation, and interview, the center failed to ensure when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: Video footage shows staff #1 yelling at child #1, age 7 months, and forcefully shaking the swing that the child is in. When interviewed, staff #1 stated "I didn't do anything different than I normally do every day."
Plan of Correction:	During annual pre-service training for the 2023-2024 program year the code of conduct will be reviewed with staff. On the spot coaching will occur as necessary, coaching support will be offered on an ongoing basis and regular classroom observation will be conducted.
Standard #:	8VAC20-780-370-1
Complaint related:	Yes
Description:	Based on interview, documentation review, and observation, the center failed to ensure that infants are provided with a flexible daily schedule based on their individual needs and that allows them sleep as needed. Evidence: Video footage showed staff #1 picking up child #1 off of the floor and putting them into the swing at 11:08 am. Child #1, age 7 months, was awake, making noises, flapping their arms, and later began crying. Child #1 remained in the swing for 45 minutes before falling asleep. Review of the child?s daily sheet, dated 3/29/23, indicated that child #1 fell asleep at 11:53 am. Interviews revealed that the child is placed in the swing each day to take a nap at the same time as the other children who range in age from 7 months to 24 months.
Plan of Correction:	Staff were in violation of STEPS policy EDU314 - Daily Activities for Infants - Infant Standards. The policy and expectation will be reviewed with staff during pre=service training.
Standard #:	8VAC20-780-370-5
Complaint related:	Yes
Description:	Based on documentation review, and observation, staff did not provide awake infants not playing on the floor or ground a change in play space at least every 30 minutes or more often as determined by the individual infant?s needs. Evidence: Video footage shows that child #1, age 7 months, was placed into the swing at 11:08 am. Child #1 was fully awake. Documentation review revealed that child #1 did not fall asleep until approximately 11:53 a.m. Child #1 was in the swing for 45 minutes before falling asleep.
Plan of Correction:	Staff were in violation of STEPS policy EDU314 - Daily Activities for Infants - Infant Standards. Which states "Awake infants not playing on the floor or ground a change in play space at least every 30 minutes or more often as determined by the individual infants needs." Site Administrator and staff will be retrained on the policy.
Standard #:	8VAC20-780-410-1
Complaint related:	Yes
Description:	Based on observation, the center failed to ensure that forbidden actions such as rough handling, and shaking were not used. Evidence: Video footage showed staff #1 forcibly placing a blanket on child #1, age 7 months, putting a pacifier in their mouth and grabbing the swing seat and shaking it forcefully.
Plan of Correction:	Training for the Site Administrator will be conducted June 5-9, 2023. During this in person training staff will be re-trained on proper infant safe sleep practices, the code of conduct, and expectations around staff supervision.
Standard #:	8VAC20-780-410-6
Complaint related:	Yes
Description:	Based on observation, the center failed to ensure that forbidden actions such as the use of verbal remarks which are demeaning to the child were not used. Evidence: Video footage showed staff #1 forcibly placing a blanket on child #1, age 7 months, putting a pacifier in their mouth and yelling repeatedly ??good night!? ?go to sleep!?, ?be quiet now!?
Plan of Correction:	In person training staff will be re-trained on proper infant safe sleep practices, the code of conduct, and supervision.
Standard #:	8VAC20-780-440-G
Complaint related:	Yes
Description:	Based on interview, and observation, the center failed to use a crib for children under 12 months of age. Evidence: Video footage showed staff #1 picking up child #1, age 7 months, off the floor and putting them into a swing. Interviews revealed that child #1 does not sleep in a crib and takes a nap daily in the swing.
Plan of Correction:	A crib is provided and designated for the infant. Staff will be reminded of the expectation that infants be placed in the crib to fall asleep during pre-service training.