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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: Dec. 13, 2016

Complaint Related: Yes

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Medication Administration

Technical Assistance:
N/A

Comments:
On December 2, 2016 the department received a complaint regarding forbidden actions. On December 13, 2016 the licensing inspector conducted an unannounced complaint inspection along with another local agency at the provider's home from approximately 12:00pm until 1:40pm. Interviews with caregivers were completed, observations were made, and documentation was reviewed. The inspection was completed on December 30, 2016. The preponderance of the evidence gathered during the investigation supports the allegation; therefore, the complaint is determined to be valid. See the violation notice for more details. If you have any questions about this inspection, please contact the licensing inspector, Lynn Powers at (804) 662-9790.

Violations:
Standard #: 22VAC40-111-750-A
Complaint related: No
Description: Based on interview and documentation, a topical skin product was applied without written parent authorization. Evidence: During an interview with the provider, the provider stated on 12/01/2016 she applied coconut oil on the scratches located on the face of Child #1 after the child woke from nap time. The parent of Child #1 stated written permission to apply coconut oil to Child #1 was not given.

Plan of Correction: Provider #1 did have a verbal agreement with the mother of Child #1 that we could use Coconut Oil in the Family Day Home for all the children. Steps to correct the noncompliance with the standard. Provider #1 will have a written agreement form: AUTHORIZATION TO APPLY A NON-PRESCRIPTION TOPICAL SKIN PRODUCT from the parent allowing Provider #1 & #2 to apply standard coconut oil as a lotion to all children in care. Measure to prevent noncompliance from occurring again: Provider #1 will have each parent sign the form: AUTHORIZATION TO APPLY A NON-PRESCRIPTION TOPICAL SKIN PRODUCT, allowing coconut oil to be used as a lotion. Person Responsible for Implementing Each Step: In accordance with the signed form: AUTHORIZATION TO APPLY A NON-PRESCRIPTION TOPICAL SKIN PRODUCT Provider #1 will attach a list of every child?s name on the diaper changing station that is approved for Coconut Oil as a lotion. Provider #1 is responsible for creating , maintaining and implementing this list.

Standard #: 22VAC40-111-30-E
Complaint related: Yes
Description: Based on interview, written documentation and observation, the provider did not ensure the home activities, services and facilities are conductive to the welfare of children in care. Evidence: During the 12/13/2016 inspection, it was determined through interview and documentation review that on 12/01/2016, Child #1 (two years of age) was spitting milk during lunch. The provider stated on the injury record that she used three fingers on the right hand and said "Please no spitting milk". The provider wrote that she put three fingers down over the lips of Child #1 twice and noticed marks on the child face and stopped. The provider wrote that there were four to five light scratches on the child's upper lip. During the interview with the licensing inspector, the provider mentioned she originally thought her finger nails may have been the cause of the scratches. The provider stated after examining the cup Child #1 was drinking out of the next day, she noticed the straw on the sippy cup had bite marks around the edge of the straw. The provider stated she believes the jagged edge of the plastic straw attached to the cup, scratched the child's mouth as the provider pushed the cup down and stated "Please no spitting milk". This additional information was added to the injury report.

Plan of Correction: Children's brain are not mature enough to connect all the aspects of language until the age of 3 ? It is a common practice with children under three (3) for the provider to touch them as a way of connecting while using words to help them understand exactly what you mean. As a means of getting Child #1 to understand that spitting milk is not acceptable, the Provider gently pushed the sippy cup down from the mouth as Child #1 was holding the cup to her mouth, it became a game to Child #1 as she kept pulling the straw back into her mouth as the Provider stated ?please, no spitting milk?. This was done twice at which point scratches were noticed and was stopped immediately. The cup was then taken away immediately for the light scratches were noted on the upper lip. First Aid was immediately administered. The Parent was notified by phone. The parent was informed of the provider?s methods of correction at the time of initial entrance interview for Child #1 and the parent fully agreed with the process. Also, noted during initial entrance interviews, the parent is made aware of the three (3) strike & you?re out process that the provider uses in her Family Day Home. Steps to Correct the Non Compliance with the standard: First step: The Provider redirects the child from the negative behavior to the corrected behavior that is acceptable. Second Step: The provider gives a warning that a natural consequence will occur, i.e. if their behavior is not corrected. Third Step: The action step (Example:) Sippy-cup taken away & child would be ask to put head down on table. Measures to Prevent the Noncompliance from occurring again: The Provider will copy & post on the bulletin board the above Three Strikes Process for daily review & monitoring. Effective January 9, 2017. Person Responsible for Implementing Each Step: The Provider #1 is responsible for implementation of each step and/or monitoring any preventive measures daily. Provider #1 will initiate implementation with Provider #2.

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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