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Current Inspector:

Inspection Date: Jan. 17, 2019 and Feb. 7, 2019

Complaint Related: No

Areas Reviewed:
22VAC40-185 ADMINISTRATION.
22VAC40-185 STAFF QUALIFICATIONS AND TRAINING.
22VAC40-185 PHYSICAL PLANT.
22VAC40-185 STAFFING AND SUPERVISION.
22VAC40-185 PROGRAMS.
22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.
22VAC40-185 SPECIAL SERVICES.
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks (22VAC40-191)

Comments:
An unannounced monitoring inspection was completed on January 17, 2019 from approximately 1:00p.m. to 4:30p.m. and a review of the center's medication policies was completed off site on February 7, 2019. Twenty-three children were in care during the inspection. Staff and children, ages eighteen months to four years old, were observed in two groups with adequate staff ratios. Children and staff were observed engaging in activities to include instructional time, nap time, hand washing, toileting and snack time. The physical space, programs, equipment and materials, restrooms and the first aid and emergency supplies were inspected. Five children?s records, six staff records, annual fire and health inspections, fire drill, shelter in place and lock down drill logs, daily health observation and medication administration certifications, injury reports, daily attendance, liability insurance policy, medication authorizations and logs and required postings were reviewed. The Directors/Owners and Administrative Assistant were available for interview and the inspection, and one Director/Owner was present at the exit interview at which time inspection findings were reviewed and an Acknowledgement of Inspection form was signed and left with the licensee. There were nine citations for violations of the Standards for Child Day Centers. See the violation notice on the Department?s public web site for violations of the Standards. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return it within five business days of receipt. Specify how the deficient practice will be or has been corrected. The plan of correction should contain: 1) steps to correct the noncompliance with the standards, 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). The provider?s response for the ?plan of correction? was not received and will not appear on the Violation Notice.

Violations:
Standard #: 22VAC40-185-140-A
Description: Based on a review of children?s records, the licensee failed to obtain a physical for two of five children before the child?s attendance or within one month after attendance. Evidence: 1. Child #3 was enrolled at the child care center on October 29, 2018. 2. Child #3?s record contained a physical dated December 11, 2018. 2. Administrator #1 acknowledged the physical was not obtained within the required time frames.

Plan of Correction: This cannot be corrected for these children. In the future, the Director will notify parents that their child can no longer attend the center if the physical has not been submitted within one month of attendance.

Standard #: 22VAC40-185-160-A
Description: Based on a review of staff records and interview, the licensee failed to ensure that a staff submit documentation of a negative tuberculosis screening completed within 12 months prior to or within 21 days after employment for one of five staff. Evidence: 1. Staff #2 was hired on August 31, 2018. 2. Staff #2?s record lacked a negative tuberculosis screening. 3. Administrator #1 acknowledged a tuberculosis screening has not been documented in Staff #2's record.

Plan of Correction: The Director will have the staff obtain a copy of her tuberculosis screening from the physician.

Standard #: 22VAC40-185-40-E
Description: Based on observation and review of the center's medication policy, the licensee failed to ensure that the center?s activities are maintained in compliance with the standards and the center?s own policies and procedures that are required by the standards. Evidence: 1. A prescription epi-pen, for Child #11, with an expiration of September 2017 and a non prescription cold medicine, for Child #12, with an expiration of October 2017, were observed. 2. The center's medication policy states that "all leftover or expired medication will be given back to the child's parent for disposal" and that all medication not picked within five days will be disposed of. 3. Administrator #1 acknowledged these medications were expired and had not been disposed of.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-185-70-A
Description: Based on a review of staff records and interview, the licensee failed to maintain all the elements of staff?s records for one of five staff. Evidence: 1. Staff #2 was hired on August 31, 2018 as a program leader. 2. Staff #2's record lacked documentation that Staff #2 possesses the education and orientation training required by the job position and documentation of references. 3. In an interview with Administrator #1 it was determined that Staff #2 completed the orientation training and that references were checked but that these items were not documented in the record. Administrator #1 acknowledged documentation of Staff #2's high school completion was also absent from the record.

Plan of Correction: The Director will have the staff submit the missing educational documentation and will document the staff's initial training and references.

Standard #: 22VAC40-185-270-A
Description: Based on observation of the outdoor space, the licensee failed to ensure that areas and equipment of the center are maintained in a clean, safe and operable condition. Evidence: 1. A chain link fence, accessible to children, containing metal strips through each hole of the fencing, was observed on one of the four sides of the fence surrounding the playground. The metal strips were observed to have detached and broken in many places, creating multiple sharp and jagged edges within children's reach. 2. Administrator #1 acknowledged the metal parts of the fence create unsafe conditions for children.

Plan of Correction: The Director will consult with a handyman to address this fencing issue to find a material, such as a plywood, that can be placed over this portion of the fence. The Director will fix the fence by adding a safe material that covers the metal. The Director advised this section connects to a neighbor's fencing and the metal portion belongs to the neighbors and this is why the metal strips cannot be removed.

Standard #: 22VAC40-185-510-D
Description: Based on a review of medication authorizations, the licensee failed to maintain available medication authorizations for medication during the entire time it is effective for five of twelve children. Evidence: 1. A prescription epi-pen was observed for Child #3, a prescription inhaler for Child #6, non-prescription cough medicine for Child #7, a prescription inhaler for Child #8 and a prescription inhaler for Child #9. 2. Medication authorizations were not present for these medications. 3. Administrator #1 acknowledged the authorizations were not present.

Plan of Correction: The Director will implement a spreadsheet for tracking medication authorizations and expirations.

Standard #: 22VAC40-185-510-E
Description: Based on observation and interview, the licensee failed to ensure medication was labeled with the child's name. Evidence: 1. Several nonprescription medications, to include liquid allergy medicine and liquid pain reliever, were observed with no name. A prescription cream was observed with a prescription label containing the name of an individual who is not an enrolled child. 2. In an interview with Administrator #3 it was determined that the prescription cream is prescribed to an enrolled child's grandmother. Administrator #1 acknowledged this prescription medication and the nonprescription medications were not labeled with children's names.

Plan of Correction: The Director will implement a spreadsheet for tracking medication authorizations and expirations.

Standard #: 22VAC40-185-510-N
Description: Based on a review of medications, the licensee failed to notify a parent after a medication authorization expired that the medication needed to be picked up within 14 days, and then failed to dispose of medications that were not picked up for two of twelve children. Evidence: 1. Medication authorizations, for a nonprescription antacid, for Child #10, with an expiration of November 2018 and for a prescription epi-pen, for Child #1, with an expiration of December 2018 were observed. 2. Administrator #1 acknowledged these medications were not properly disposed of and were still on site at the center, after fourteen days of notifying the parents that the authorizations were expired.

Plan of Correction: The Director will implement a spreadsheet for tracking medication authorizations and expirations.

Standard #: 22VAC40-185-560-F
Description: Based on observation, the licensee failed to ensure that when snacks are provided by the center that children three years or younger may not be offered foods that are considered to be potential choking hazards. Evidence: 1. Nine children, eighteen months to two years old, were observed during snack time. The children were observed to be served and eating whole grapes. 2. Administrator #1 acknowledged the children were served whole grapes and acknowledged this is a choking hazard.

Plan of Correction: Not available online. Contact Inspector for more information.

Disclaimer:
A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

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