VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Toras Chaim
3110 Sterling Point Drive
Portsmouth, VA 23703
(757) 686-2480

VDSS Contact: Rene Old (757) 404-1784

Inspection Date: March 2, 2023

Complaint Related: No

Areas Reviewed:

8VAC20-790 Subsidy Program Vendor Requirements for Child Day Centers

Technical Assistance:

The following topics were discussed: - Orientation training and preservice training of staff. - Fitted sheets for cribs. Use of blankets - child must be able to breathe through the weave of the blankets. Use of small blankets. - Written permission to photograph children

Comments:

A subsidy health and safety (SHSI) initial inspection was conducted on 3/2/2023. There were 32 children present with 10 staff supervising. A Code of Virginia compliance inspection was also conducted on this date. Both inspections combined cover subsidy health and safety regulations. Only subsidy requirements that are not covered in Code of Virginia were reviewed during this supplemental inspection. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program.

Violations:

Standard #:	8VAC20-790-540-B
Description:	Based upon review of children's records, the facility has not ensured that each child's record includes all required information. Evidence: 1. The record provided for child 1 did not include the address of the person to be contacted in an emergency if the parent cannot be reached, the names of persons other than the custodial parent who are authorized to pick up the child and the child's proof of identity. 2. The record provided for child 2 did not include a person to be contacted in an emergency if a parent cannot be reached nor the child's proof of identity. 3. The record provided for child 3 did not include the address of the person to be contacted in an emergency if the parent cannot be reached. 4. The record provided for child 4 did not include the address of the person to be contacted in an emergency if the parent cannot be reached no the child's proof of identity. 5. The facility has stored epinephrine for emergency administration to child 6 and child 7. The facility did not have written parental permission for the epinephrine to be administered to either child.
Plan of Correction:	The facility responded with the following: We did not insist on addresses for emergency contacts since, as a small community, we all know where the key people live, and in an emergency, we would contact by phone, and not by a visit. We now have all of the addresses on our forms for the emergency contacts. Completed- All emergency contacts on all student records now have the addresses for the emergency contacts, and two viable contacts. A letter to receive birth certificates has gone home to all the children who did not have a copy in their files. The deadline was given as March 22, 2023. March 20 is parent conference night, and we can give a gentle reminder to bring the copy to conference night. Permission to administer epinephrine to child 6 and 7 are now in their records, and with their epinephrine pens. Written permission for child 6 and child 7 epinephrine pens are in Safety Sacks and in their records.
Standard #:	8VAC20-790-550-1
Description:	Based upon review of staff records, the facility has not ensured that each staff record includes the date of employment. Evidence: 1. The records provided for staff 2, 4, 10, 11 and 12 did not include the date of employment. 2. The record for staff 8 included only the month and year of employment.
Plan of Correction:	The facility responded with the following: We have gotten employee start dates from our bookkeeping company, and updated our spreadsheet and info sheet in their records.
Standard #:	8VAC20-790-630-A
Description:	Based upon observation, the facility has not ensured that areas and equipment of the center are maintained in a clean and safe condition. Evidence: 1. There are metal plates installed beside the toilets in the girls' bathroom. The plates are not securely attached enabling potential pinch points for fingers. 2. There is a tape remnant on the floor of the girls' bathroom. The area around and under the tape cannot be adequately cleaned/sanitized. 3. There is an area under the sink in the girls' bathroom where the plywood has splintered and cracked. 4. There were string blind cords within reach of the children in preschool classroom. 5. There was a broken plastic ball bin with sharp edges in the gymnasium. 6. There was a broken plastic chair with sharp edges in the gymnasium.
Plan of Correction:	The facility responded with the following: 1 - 3 Our handyman is going to reinforce the metal plates so that there isn't any space between it and the wall, remove the tape, and put a baseboard under the sinks. 4. The strings on the blinds are now secure. 5 - 6 The broken ball bin and chair (which was supposed to be moved days before by the custodian) were removed immediately when the inspector pointed them out.
Standard #:	8VAC20-790-640-A
Description:	Based upon observation, the facility has not ensured that hazardous substances are kept in locked places using safe locking methods that prevent access by children. Evidence: 1. There was a container of sanitizing wipes and three bottles of antibacterial hand soap, all with hazard warnings, on the sink counter in the girls' bathroom. 2. There was a container of antibacterial hand soap with a hazard warning on a shelf in the infant classroom.
Plan of Correction:	The facility responded with the following: 1. Removed from the bathroom. Ivory soap will be used as a backup when the dispenser soap isn't available. 2. This was removed, apparently it fell from the cabinet when a staff member retrieved something, and wasn't aware of it.
Standard #:	8VAC20-790-650-C-3
Description:	Based upon observation, the facility has not ensured that sinks located near the toilets are supplied with running warm water. Evidence: The hot water has been turned off at all sinks in the bathrooms used by the children.
Plan of Correction:	The facility responded with the following: Our handyman is slated to turn on the hot water at less than 120 degrees. Hot water will be turned on by the plumber when we install the sinks within 14 days.
Standard #:	8VAC20-790-720-C
Description:	Based upon review of injury records, the facility has not ensured that the written record of children's injuries includes all required information. Evidence: The injury record forms provided did not include a space to indicate the staff present at the time of the injury, the date and time the parent was notified and two signatures (either the signature of a staff person and the parent or a two staff signatures).
Plan of Correction:	The facility responded with the following: This injury report was updated in the presence of the inspector, using many of her suggestions.
Standard #:	8VAC20-790-760-B-3-a
Description:	Based upon observation, the facility has not ensured that the diapering areas have access to a sink with running warm water. Evidence: The diaper changing tables in both the infant and two year old classrooms do not have direct access to a sink with running warm water. Staff musty leave the classroom with the child to enter the hallway restrooms and these restrooms do not have warm water as the hot water has been turned off.
Plan of Correction:	The facility responded with the following: Each of these classrooms will have sinks with hot water installed.
Standard #:	8VAC20-790-770-A
Description:	Based upon review of medication, the facility has not ensured that prescription medication is administered only with written parent permission. Evidence: The facility has stored epinephrine for emergency administration to child 6 and child 7. The facility did not have written parental permission for the epinephrine to be administered to either child.
Plan of Correction:	The facility responded with the following: Medication permission slips went home with instructions that no medications will be given without competed forms. Children's medication is now stored in Safety Sacks. There was implied consent on the Life Threatening Allergy Management Plan that was signed by the child's doctor and parents. However, we now have the additional permission on our medication administration consent form. All medication permission slips are on file for those children who have prescription medication at school.