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Natural Steps Child Development Center
64 Toby Way
Palmyra, VA 22963
(434) 589-5891

Current Inspector: Maureen Gallagher-McLeod (540) 430-9259

Inspection Date: Feb. 26, 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.
22VAC40-80 THE LICENSING PROCESS.
22VAC40-191 Background Checks (22VAC40-191)
63.2(17) License & Registration Procedures
63.2 Facilities & Programs.

Comments:
An unannounced renewal inspection was conducted on February 26, 2019, between the hours of approximately 10:15 a.m. and 3:30 p.m. Thirty-seven (37) children were in the care of eight staff members, in six classrooms, during the on site inspection. One additional staff member was present and assisted, as needed. Five children's records were reviewed, five staff records were reviewed and background clearances were viewed for four staff members. No medications were administered/on site during this inspection. The facility, program activities, daily routines, interactions with children, staffing, supervision, equipment, posted information, injury records, emergency supplies, and emergency drill records were observed/reviewed. The facility was observed to be clean and supplied with a variety of age/stage appropriate learning and play materials. Program observation was completed. Activities observed on this date included: infant care (feeding, diapering, napping and play); craft, music and dance time with a contracted vendor; handwashing, diapering and restroom procedures; lunch; indoor play and naptime. Staff/child interactions, behavior guidance and daily routines/transitions were observed. Previously cited violations were reviewed for compliance; one repeat violation was cited. Refer to the accompanying violation notice for the exceptions to compliance. Please contact me if you have concerns regarding this inspection, the licensing standards and/or if I may be of assistance to you (540) 430-9262.

Violations:
Standard #: 22VAC40-185-160-A
Description: Based on review of five staff records and discussion with staff on February 26, 2019, the program failed to obtain documentation of a negative tuberculosis (TB) screening within 21 days after employment. Evidence: 1. Review of staff #3's record, on this date, determined that a TB screening was not on file.

Plan of Correction: A TB screening will be obtained. In the future, tuberculosis screenings will be obtained no later than 21 days after employment.

Standard #: 22VAC40-185-440-G
Description: Based on classroom observation and discussion with staff on February 26, 2019, the program failed to ensure that cribs were used for all children under 12 months of age. Evidence: 1. Observation in the infant classroom and discussion with staff, on this date, determined that cribs were not identified and available for three infants (child A, child B and child C). 2. Staff #1 and #2 confirmed the lack of an available crib for every infant in attendance.

Plan of Correction: Additional cribs will be obtained. Infants over the age of one year will be transitioned to mats.

Standard #: 22VAC40-185-500-B
Description: Based on classroom observation and discussion with staff on February 26, 2019, the program staff failed to implement required diapering procedures. Evidence: 1. Observation of diapering procedures, on this date, determined that the foot-operated mechanism on the soiled diaper storage container was not used. The classroom program leader lifted the lid of the diaper storage container to dispose of soiled diapers. 2. Observation of diapering procedures, on this date, determined that the diapering surface was not correctly sanitized after each use. The bleach/water solution did not remain on the diapering surface for at least 2 minutes before being wiped off. 3. Staff #7 confirmed the lid of the diaper storage container was lifted to dispose of soiled diapers and the foot-operated mechanism was not used. 4. Staff #7 confirmed that the bleach/water solution was sprayed on the diapering surface and immediately wiped off after each diaper change.

Plan of Correction: Staff will be reminded to use the foot-operated mechanism on the diaper storage containers and to sanitize the diapering surface by spraying the surface with a bleach/water solution, waiting 2 minutes, and then wiping the surface off. Administrative staff will monitor diapering to ensure correct procedures are followed.

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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