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Ms. Bonnie Pridgen
9709 Bearbox Court
North chesterfield, VA 23237
(804) 748-5408

Current Inspector: Ivey Newman (804) 662-9762

Inspection Date: June 10, 2015

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Emergencies
63.2 Facilities and Programs..
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
N/A

Comments:
The licensing inspector completed an inspection in response to a self reported concern that occurred at a family day home on June 8, 2015. The Department was notified of the incident on June 9, 2015. On June 10, 2015 the licensing inspector was on site from approximately 12:00pm-1:30pm. While on site, the licensing inspector interviewed caregivers, made observations and reviewed documentation. The preponderance of the evidence gathered during the investigation supports the allegation; therefore, the self reported concern is determined to be valid. See the violation notice for more 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 10 calendar days from today. You will need to specify how the deficient practice will be or has been corrected. Just writing the word ?corrected? is not acceptable. Your plan of correction must 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, Lynn Powers at (804) 662-9790.

Violations:
Standard #: 22VAC40-111-480-D
Description: Based on interviews and review of documents, the provider did not ensure all equipment used by children was used in accordance with the manufacture's instructions. Evidence: 1. On June 10, 2015, the licensing inspector interviewed Caregiver #1 regarding injuries Child A (three months of age) sustained while in care on June 8, 2015. Caregiver #1 stated that on June 8, 2015, Child A had a cold. Caregiver #1 stated she placed a Fisher Price bouncy seat inside the crib of Child A. Caregiver #1 stated Child A took a morning nap in the Fisher Price bouncy seat located in the crib from approximately 9:30 or 10:00am to 12:15pm. Caregiver #1 stated Child A took an afternoon nap in the Fisher Price bouncy seat located in the crib from approximately 4:30pm to 5:20pm. Caregiver #1 stated both Caregiver #1 and Caregiver #2 would check on Child A while the child was asleep in the crib every few minutes. 2. On June 10, 2015, the licensing inspector read the warning instructions printed on the Fisher Price Bouncy seat. The warning instructions state "To prevent serious injury or death: Never use on any elevated surface since child's movement may cause infant seat to slide or flip over. Never use on a soft surface (bed, sofa, cushion) since seat can tip over and cause suffocation in soft surfaces. Never leave child unattended.

Plan of Correction: The mother was aware of the child taking naps in the bouncy seat in the crib. Steps to correct the problem with the noncompliance standards: 1. Caregiver #1 & #2 will never use bouncy seat on any elevated surface since child's movement may cause infant seat to slide or flip over. 2. Caregiver #1 & #2 will never use bouncy seat on soft surface (bed, sofa, cushion) since seat can tip over and cause suffocation on soft surfaces. 3. Caregiver #1 & #2 will never put child in bouncy seat in crib. 4. Caregiver #1 &#2 will ensure child is only placed on its back while sleeping in crib. Persons responsible for each step & monitoring any preventative measures: Caregiver #1 is responsible for informing Caregiver #2 s of the compliance standards.

Standard #: 22VAC40-111-560-A
Description: Based on interviews and documentation review, the provider did not ensure direct care and supervision for each child in care, including being near enough to intervene if needed. Evidence: 1. On 06/10/15, the licensing inspector interviewed Caregiver #1 and Caregiver #2 regarding injuries Child A (three months of age) sustained while in care on 06/08/15. Caregiver #1 and Caregiver #2 stated that on 06/08/15, at approximately 4:30pm, the two caregivers were outside supervising 12 children. Caregiver #1 and Caregiver #2 stated Child A began to get fussy. Caregiver #1 stated she instructed Caregiver #2 to take Child A inside and place Child A in the crib located in the crib room for an afternoon nap. Caregiver #1 and Caregiver #2 stated they did not see marks on the face of Child A prior to the child being placed in the crib. Caregiver #1 and Caregiver #2 stated Child B (four years of age) was in the home using the bathroom when Caregiver #2 took Child A into the home and placed the child in the crib. Caregiver #1 stated Child B came back outside while Caregiver #2 was placing Child A in the crib. Caregiver #1 and Caregiver #2 stated Child A was alone in the home while they were supervising the remaining 11 children outside. Caregiver #1 stated an Infant monitor was used. Caregiver #1 stated Child B asked to use the bathroom again. Caregiver #1 stated she allowed Child B to go into the home unsupervised to use the bathroom. The first floor of the home is used for the family day home. The bathroom is located beside the crib/napping room. Caregiver #1 stated Child B came back outside after a few minutes. Caregiver #1 and Caregiver #2 stated after about five minutes, Caregiver #2 went inside to get water for the children to drink. Caregiver #2 stated she heard Child A crying like the child was upset. Caregiver #2 stated she went into the crib room and patted Child A trying to sooth the child back to sleep for one to two minutes. Caregiver #2 stated she did not turn on the light and did not pick up the child. Caregiver #2 stated she did not notice any marks on Child A. Caregiver #2 stated she went back outside with Caregiver #1 and continued to supervise the remaining children. Caregiver #2 stated children began to leave for the day and she left at approximately 5:00pm. Caregiver #1 stated at approximately 5:00pm, she and the remaining children came back into the home. Caregiver #1 stated she peeked in on Child A and the child was sleeping in the crib. Caregiver #1 stated at approximately 5:20pm the parent for Child A arrived for pick up. Caregiver #1 stated Child A began to cry when she picked Child A up out of the bouncy seat located in the crib. Caregiver #1 stated when she brought Child A out to the main room, the parent for Child A asked what was wrong with the face of Child A. Caregiver #1 stated the eyes of Child A were red and swollen and there was some bruising across the forehead. Caregiver #1 stated later that evening a toy that is not normally located in the crib room was found. Caregiver #1 stated she believed it was possible Child B may have injured Child A while the children were in the home without adult supervision. Caregiver #1 stated Child B can be 'handsy, a bit aggressive, likes getting in children's faces, and is interested in the babies'. 2. The licensing inspector reviewed an injury report date 06/08/15 for Child A completed by Caregiver #1 and Caregiver #2. The injury report stated 'Child A was put to bed at 4:30pm without any bruising and when Child A was picked up at 5:20pm, Child A had one big bruise on right side of forehead and three little ones to left. Both eyes were red and swollen when Caregiver #1 got Child A from crib'. 3. On 06/15/15 the licensing inspector received emailed pictures showing markings underneath the eyes and on the forehead of Child A consistent with bruising and redness. Medical reports from an area hospital states Child A was treated for facial and scalp contusions on 06/08/15.

Plan of Correction: Local police concluded in their investigation that there was no criminal intent in this case of a child throwing a toy which accidentally injured an infant while in a crib. Steps to correct the problem with the noncompliance standards: 1. Caregiver #1 & #2 will ensure direct care and supervision for each child in care, including being near enough to intervene if needed. 2. Caregiver #1 & #2 will no longer allow any child in their care to go in the house unsupervised. 3. Caregiver #1 or #2 will remain in the house during the time a child is sleeping to ensure supervision is present. 4. Caregiver #1 had the parents of Child B come to the daycare together for a conference. Due to the policies of zero tolerance for aggression/violence, the child was dismissed immediately to ensure the safety of all the children in care. Persons responsible for each step & monitoring any preventative measures: Caregiver #1 has informed Caregiver #2 s of the new policies and procedures of Compliance Standards. 1. To include Caregiver #1 & #2 will ensure direct care and supervision for each child in care, including being near enough to intervene if needed. 2. Caregiver #1 & #2 will no longer allow any child in their care to go in the house unsupervised. 3. Caregiver #1 or #2 will remain in the house during the time a child is sleeping to ensure supervision is present. 4. Caregiver #1 will hold weekly meetings with Caregiver #2 to review current & new policies & procedures to ensure implementation within Licensing Standards & Guidelines.

Standard #: 22VAC40-111-590-B
Description: Based on interviews, the provider did not ensure when an infant that falls asleep in a play space other than the crib, the infant is moved to a safe area/position. Evidence: During the June 10, 2015 inspection, Caregiver #1 and Caregiver #2 stated Child A (three months of age) was having "tummy time" on June 8, 2015 at approximately 1:30-2:00pm. Caregiver #1 and Caregiver #2 stated Child A fell asleep while the child was lying on the floor on her stomach. Caregiver #1 and Caregiver #2 stated they allowed Child A to continue to sleep on her stomach for at least 30 minutes while they remained nearby the child. Infants should be placed on their backs to sleep to reduce chances of suffocation.

Plan of Correction: The mother asked Caregiver #1 to place the child face down on the belly to sleep. Caregiver #1 was not allowed to put child asleep on its belly due to licensing standards. So to compromise, Caregiver #1 or #2 would put the child down on its belly for tummy time. (tummy time is during one-on-one time while the other children are napping themselves) and Caregiver #1 or #2 are able to give 100% attention to the tummy time child. Steps to correct the problem with the noncompliance standards: 1. Caregiver #1 & #2 will place all non-movable infants in cribs on their backs when they fall asleep on the floor to reduce chances of suffocation. Persons responsible for each step & monitoring any preventative measures: Caregiver #1 is responsible for informing Caregiver #2 s of the Compliance Standards.

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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