VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Faith Life Tabernacle
420 Steadmand Ave
Richmond, VA 23222
(804) 321-1333

VDSS Contact: Florence Martus (804) 389-0157

Inspection Date: Dec. 12, 2019 , Jan. 9, 2020 and Jan. 23, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-665 ADMINISTRATION 22VAC40-665 STAFF QUALIFICATIONS & TRAINING 22VAC40-665 STAFFING & SUPERVISION 22VAC40-665 PROGAMS 22VAC40-665 SPECIAL CARE PROVISIONS & EMERGENCIES

Technical Assistance:

N/A

Comments:

The licensing inspector initiated an unannounced subsidy complaint inspection on December 2, 2019 and completed the inspection on February 10, 2020 in response to a complaint received by the department on November 26, 2019. The allegations in the complaint involved supervision of children and a child?s injury. The licensing inspector and officials from local agencies met and conducted interviews with involved parties on December 12, 2019. The licensing inspector and officials from local agencies were on site on December 12, 2019 from approximately 11:00 AM until 12:30 PM. During the inspection, interviews with staff were completed, documentation was reviewed and classroom observations were conducted. In addition, the licensing inspector and officials from other local agencies conducted additional interviews on December 19, 2019, January 9, 2020 and January 23, 2020 off site. Additional documentation was reviewed on February 10, 2020 off site. The preponderance of the evidence gathered during the investigation supports the allegation and therefore the complaint is determined valid. See the violation notice for additional details. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and returned it to me within five business days from today. 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 preventive measure(s). If you have any questions about this inspection, please contact the licensing inspector at (804) 662-9790.

Violations:

Standard #:	22VAC40-665-500-A
Description:	Based on interviews and documentation review, the vendor did not ensure compliance with the standards in this part, the terms of the vendor agreement, and all relevant federal, state, or local laws and regulations. Evidence: 1. Child #1 (seven months old) was taken to a local emergency room on November 26, 2019 and November 30, 201 9 as a result of the child being dropped on the floor at the center by Staff #1 on November 26, 2019. 2. During an interview on December 12, 2019 Staff #3 stated "On November 26, 2019, I was told [Staff #1] was holding [Child #1] (seven months old) in the rocking chair in the nursery when [Staff #1] fell asleep and [Child #1] fell from her arms, hitting a musical toy". Staff #3 stated she was aware of [Staff #l] dozing off when she sat still in the same position and had been told instead of sitting in the chair, she needs to be moving around and sitting on floor. Staff #3 stated "l have seen [Staff #1] doze, not sleep-sleep. I have spoken to her about it but not but anything in writing". 3. During an interview on December 19, 2019, Staff #1 stated "l was sitting in the rocking chair, I had my left arm around [Child #1]'s stomach, I nodded off, heard a cry and [Child #1] fell off my lap. [Child #1]'s forehead hit the piano part of the walker and then hit the floor. I have nodded off before but this is the first time something like this happened- never dropped a kid". Staff #1 stated, "[Staff #3] said to move around, make myself busy, clean. [Staff #3] wrote a plan and I had to sign it". 4. During an interview on January 9, 2020, Witness #1 stated "On November 26, 201 9, I witnessed [Staff #1] fall asleep while holding [Child #1] in a rocking chair. She dropped [Child #1] while she fell asleep. I have observed [Staff #1] fall asleep regularly, on multiple occasions." 5. During an interview on January 23, 2020, Staff #2 stated, "[Staff #1] will nod off and come back. Probably happens every day. I think [Staff #1] is aware of it. I'm sure she has probably seen it." 6. The accident report dated November 26, 2019 stated, ?What occurred? Nodded and baby fell on the walker mat. Future action plan to prevent recurrence of the injury: don?t nod.? 7. Documentation dated November 26, 2019 stated, ?[Staff #1] fell asleep while holding a child and the child fell from her arms. You have 10 days to correct this behavior. If you feel that you might have a medical issue that is causing you to fall asleep, I recommend you get it check out?. 8. Item 12.6 of the subsidy vendor agreement states, ?All services provided by the Vendor pursuant to this Agreement shall be performed to the satisfaction of VDSS and the local department of social services, and in accordance with the applicable federal, state, and local laws, ordinances, rules and regulations.? Despite Staff #1 being known to fall asleep while working, the vendor continued to allow Staff #1 to care for infants, failing to protect children in her care to prevent injury, which does not meet the requirement of providing services to the satisfaction of the department and local DSS. During the December 19, 2019, Staff #1 stated she is still working in the nursery.
Plan of Correction:	Plan of Correction 1st Time - Verbal Notice: The first time a worker is noticed nodding or dozing off the Director will request to speak with the staff concerning the importance of the matter at hand. The Director will ask the worker if there is a reason or problem causing the nodding or dozing. The worker will be given a verbal notice and reminded of the consequences of repeating this inappropriate behavior. The meeting will be documented, noting what was discussed. 2nd Notice ? Written Disciplinary Notice Depending on the situation the worker may be remove from the current work area or dismissed from the center. If the worker will be continuing as an employee they will be required to get Doze Alert device to help them stay alert if the matter is not resolve through other means. A space at the center will be available to workers who may want to take a power nap during their designated break time to help them refresh themselves. When a child has a fall make sure that parent sign notification sheet acknowledging the incident and the state of the child upon pick up.
Standard #:	22VAC40-665-500-G
Description:	Based on staff interviews and documentation review, the vendor did not ensure religious exempt child day centers that are exempt from licensure in accordance with ? 63.2-1716 of the Code of Virginia maintained compliance with all requirements of ? 63.2-1716, when the vendor did not establish and implement procedures for appropriate supervision of all children in care to ensure safety of the children. Evidence: 1. Religious exempt child day centers are required to establish and implement procedures that require appropriate supervision of all children in care to ensure safety of the children. The vendor failed to implement these procedures when Child #1 (seven months old) was taken to a local emergency room on November 26, 2019 and was diagnosed at that time with a scalp hematoma and facial bruise after being dropped on the floor at daycare. 2. During an interview on December 12, 2019 Staff #3 stated ?On November 26, 2019, I was told [Staff #1] was holding [Child #1] (seven months old) in the rocking chair in the nursery when [Staff #1] fell asleep and [Child #1] fell from her arms, hitting a musical toy?. Staff #3 stated she was aware of [Staff#1] dozing off when she sat still in the same position and had been told instead of sitting in the chair, she needs to be moving around and sitting on the floor. 3. During an interview on December 19, 2019 Staff #1 stated ?I was sitting in the rocking chair, I had my left arm around [Child #1]?s stomach, I nodded off, heard a cry and [Child #1] fell off my lap. [Child #1]?s forehead hit the piano part of the walker and then hit the floor. I picked [Child #1] back up, patted her. I checked her cheek and eyes; didn?t see a mark. I filled out the accident report. I got [Child #1] an icepack. I have nodded off before but this is the first time something like this happened- never dropped a kid?. Staff #1 stated, ?[Staff #3] said to move around, make myself busy, clean. [Staff #3] wrote a plan and I had to sign it?. 4. During an interview on January 9, 2020, Witness #1 stated ?On November 26, 2019, I witnessed [Staff #1] fall asleep while holding [Child #1] in a rocking chair. She dropped [Child #1] while she fell asleep. [Child #1] hit an excersaucer before hitting the floor. [Child #1] cried for a little bit. I am not sure if [Child #1] had any injuries. I have observed [Staff #1] fall asleep regularly, on multiple occasions. I am at the center once a week for some time now and [Staff #1] has fallen asleep just about each time I have been there. I was so concerned, I did not see [Staff #3] when I was leaving so I sent her an emailing letting her know what happened?. 5. During an interview on January 23, 2020, Staff #2 stated, ?I know of what happened but I didn?t see it. While in the nursery, I heard [Child #1] cry. [Staff #1] told me what happened. [Staff #1] said [Child #1] slipped out of hand and I caught her. She did not really hit the floor?. [Staff #1] evidently has a condition. She will nod off and come back. Probably happens every day. I think [Staff #1] is aware of it. I?m sure she has probably seen it.? 6. Documentation dated November 26, 2019 stated, ?[Staff #1] fell asleep while hold a child and the child fell from her arms. According to our handbook, during nap time workers are expected to clean, plan activities or engage with a child that is awoke, not take it as a break time?.
Plan of Correction:	I would like to first describe what happened on November 26, 2019. As well as share some information that happened before the date of the incident. Before the incident with the seven month old child #1, the child #1 had been out sick. According to a local health provider, Child #1 was admitted to a local hospital from 11/16/19 ? 11/17/19 for the second time per mother email. Child was seen at a pediatrics center on 11/19/19 and was given a notice that stated return to daycare on 11/19/19. Child #1 was cleared again on 11/25/19 to return to daycare on 11/26/19. I shared all this because the report states the child was taken to the ER on 11/26 & again on 11/30/19 for vomiting. It is recorded in the child's record that child #1 takes medicine for reflux. A few weeks before November 26, 2019, the mother told the Nursery workers that the child had fallen off the bed at home. The day this incident happened the child #1 was brought into the center at 11:27am by the mother. The other children in the room were just finishing lunch and preparing for naptime. The therapist arrived around 11:30am to start a private therapy session with child#2. The Director was covering another class in the building when the incident happened. When the Director returned to the office around 1'oclock, I saw a note from the Occupational Therapist who was there working with another child #2, asking me to call her. When I spoke with the therapist by phone, she informed me what happened. I asked her if she would write it up, what she saw and email it to me for my records. I did not receive an email. After speaking with the therapist, I went into the class area of the child #1 to check out the child and speak with the workers. I asked the staff #1 did she write up a report and did she take a picture of the child #1. Staff #1 said yes, pictures were taken, and she was still working the report. I then called the mother which was around 1 o'clock and left her a message on her voice mail. Because I could not reach her by phone, I emailed her with the pictures of the child at 1:27pm telling her I tried to reach her by phone to inform her that the child #1 had fallen. The mother called me back around 2:20pm and I then told her verbally what happened and that I tried to reach her by phone and email, she just responded ok. Mom came to pick the child up around 3pm. The Director was still in the nursery area when mom arrived. l, the director, spoke to mom and told her exactly what happened and asked her if she had any questions for me or staff #1, who was there to speak with mom if she had questions and she responded again no. At the time mom picked up the child #1, there were no bruises or swelling visible on the child. The child #1 was currently under the doctor's care for the left eye. Due to what was going on with the child #1 left eye, it was watery, puffy and a little red and had an eye ointment on it. The child returned the next day and mom still did not share that she had taken child #1 to the ER. Mom didn't ask or share any concerns regarding the incident. The next day, November 27, 2019, there were still no marks or bruises on the child. After everything settled down that day, l, the director, called staff #1 into the office and spoke with her regarding the incident. I told her that nodding off while at work is unacceptable. I reminded staff #1 that during naptime or when things get quiet in the room, she must be active doing something with a child or cleaning and preparing the evening activities. This is not something that was told to only one staff, this is our policy for every staff. During naptime l, the director, usually walk around during naptime and make sure each staff worker is during what they are suppose to be doing, because our bodies gets relaxed if we sit too long in one spot. Staff #1 was written up for the incident and was asked if she thought som
Standard #:	22VAC40-665-700-A
Description:	Based on interviews and documentation review, the vendor did not notify the parent immediately required emergency medical treatment and sustained a serious injury. Evidence: 1. On November 26, 2019, Staff #1 was sitting in a rocking chair, holding Child #1 (seven months old). Staff #1 stated she nodded off and dropped Child #1. Staff and a witness stated Child #1 hit her head on an excersaucer and then fell to the floor. 2. The completed accident report indicated the injury occurred at 12:30 PM. 3. The parent stated she was called by the center at approximately 2:20 PM. 4. An email from Staff #3 was sent the parent of Child #1 at 2:27 PM stating ?I tried to call you in referent to [Child #1] falling today. Please see the photos of her and if you have any other questions please feel free to call me back or talk with me upon pick up.? 5. Medical records indicated Child A was seen in a local emergency room on November 26, 2019 and November 30, 2019. The medical records stated Child A was diagnosed with a scalp hematoma and facial bruise.
Plan of Correction:	Not available online. Contact Inspector for more information.