VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Children of America - Doc Stone, LLC
75 Dunn Drive
Stafford, VA 22556
(540) 657-4567

Current Inspector: Angela Dudek (804) 629-8167

Inspection Date: April 22, 2024

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 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 the following: 8VAC20-780-160A TB tests/screenings should be completed within 30 days prior to the first day of employment.

Comments:

An unannounced monitoring inspection was conducted on 04/22/2024 from 10:00am to 2:05pm with the Director. There were 88 children ages 3 months to age 5 years old supervised by 16 staff. The physical plant, outdoor playground area, programming, attendance, menus, 5 staff records, 5 children?s records, 11 medications with corresponding authorization records, 1 allergy care plan, emergency drills, emergency supplies, and policies were reviewed. Children were observed participating in feeding, art, literacy activities and outside play. Handwashing procedures were also observed. There was an adequate number of staff present with current certification in Medication Administration Training (MAT) and Daily Health Observation (DHO) training. Areas of non-compliance are identified in the Violation Notice. Missing background checks must be sent no later than 10 days from the date of inspection. 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 of each page to me via email by 5pm on 5/3/24. Please email me at angela.dudek@doe.virginia.gov with any questions.

Violations:

Standard #:	22.1-289.035-B-4
Description:	Based on review of 5 staff records, the center did not obtain the results of a criminal history record check and a central registry check from all states in which staff members have resided within the last five years prior to employment. Evidence: The record for Staff #1 (date of hire 3/25/24) did not contain documentation of a completed criminal history record check from all states where they resided within the last five years prior to employment.
Plan of Correction:	Ensure that all staff receive a criminal history background check from all states where they have resided prior to enrollment.
Standard #:	8VAC20-780-130-E
Description:	Based on review of five child records, the provider did not obtain documentation of updated immunizations once every six months for children under the age of two years. Evidence: 1)The record for Child #2 (2 years old) did not contain documentation of updated immunizations once every six months for children under the age of two years. The most recent immunizations on file were dated 6/30/23 when the child was 15 months old. 2) The record for Child #3 (9 months old) did not contain documentation of updated immunizations once every six months for children under the age of two years. The most recent immunizations on file were dated 8/24/23 when the child was 2 months old.
Plan of Correction:	Ensure that all children's records contain documentation of updated immunizations every six months for children under 2 years.
Standard #:	8VAC20-780-60-A-8
Description:	(Repeat Violation) Based on review of 5 child records, the Center did not ensure they had a written care plan for each child with a diagnosed food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: The record for Child #1 did not contain an allergy care plan for their physician diagnosed food allergy.
Plan of Correction:	Ensure that all children's records contain an updated allergy care plan for children that have allergies.
Standard #:	8VAC20-780-80-A
Description:	Based on review of the written attendance record and interview with staff, the center did not ensure they maintained a written record of daily attendance for each group of children documenting the arrival and departure of each child in care as it occurs. Evidence: During inspection in the Infant A classroom (ages 3-4 months), there were 4 children present, but the written record reflected there were 5 children present.
Plan of Correction:	Ensure that the written record in each classroom reflects the correct number of children present.
Standard #:	8VAC20-780-340-A
Description:	Based on interviews, the center did not ensure the care, protection and guidance of all children in care. Evidence: 1)During inspection in the Infant B classroom, Child #2 (age 9 months) was laying awake in a crib and swaddled in a blanket that was tied in a knot around them. 2)In the Infant B classroom, Child #3 (age 9 months) was asleep in a crib with a rolled blanket under the mattress under their head which violates recommended safe sleep practices from the America Academy of Pediatrics guidelines (AAP). 3)In the Infant B classroom, 5 children (ages 7 months to 9 months) were swaddled in blankets in their cribs. Safe sleep recommendations from the AAP state that children should not be swaddled once they begin trying to roll over. The children had signs on their cribs that stated they could roll over.
Plan of Correction:	Ensure that children that are swaddled are swaddled in an approved blanket and that no children that can roll over are swaddled. Ensure that doctor's note specifically allow a crib wedge for sleeping for infants that require to sleep at a 45 degree angle.
Standard #:	8VAC20-780-370-1
Description:	Based on observation, the Center did not ensure that infants placed in their crib were placed on their back (supine). Evidence: In the Infant A classroom, (ages 3-4 months), Child #4 (age 4 months) was sleeping on their belly. There was a sign on their crib that stated they could not roll over.
Plan of Correction:	Ensure that all infants are placed on their back and signs are updated.
Standard #:	8VAC20-780-420-E-3
Description:	Based on review of 5 child records, the center did not ensure annually that parent confirmation of the required information in the child record is up to date. Evidence: The files for Child #2 and Child #5 did not have documentation that the parent had confirmed the updated record annually. Child #2?s record was last updated 11/23/22 and Child #5?s record was last updated on 1/24/22.
Plan of Correction:	Ensure that all childrens records are updated annually and reviewed by each family.
Standard #:	8VAC20-780-560-G
Description:	Based on observation, the center did not ensure that food brought from home was clearly dated and labeled in a way that identifies the owner. Evidence: In the Infant B classroom, 3 packages of food that had been brought from home were stored in the refrigerator and were not labeled with a name and date.
Plan of Correction:	Ensure that food from home is labeled with a name and date when stored in the refrigerator.
Standard #:	8VAC20-780-570-A
Description:	Based on observation, the Center did not ensure that when a child is placed in an infant seat or high chair, the protective belt was fastened securely. Evidence: In the Infant C classroom, a child (15 months old) was placed in a high chair seat and the safety belt was not fastened.
Plan of Correction:	Ensure that all infants are fastened securely with their protective safety belts.