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Ms. Jacqueline Hitchcock
1118 Joyce Lee Circle
Hampton, VA 23666
(757) 224-8488

Current Inspector: Anita Drewry (757) 404-5261

Inspection Date: Feb. 28, 2019

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Household Members
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 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies
63.2 Licensure and Registration Procedures

Comments:
An unannounced monitoring inspection was conducted February 28, 2019 from approximately 12:45 pm until 4:25 pm. Provider was present with nine children for a total of twenty-seven points. Seven children's records and one caregiver record were reviewed. Inspection will be staffed with Licensing Administrator regarding possible further review by the department. Please complete the columns for description of action to be taken and date to be corrected for each violation cited on the violation notice, and then return a signed copy to the licensing office within 5 calendar days of receipt. If you have any questions, please call (757) 404-5261.

Violations:
Standard #: 22VAC40-111-730-D
Description: Based on observation, provider did not ensure medications are kept in a locked place using a safe locking method that prevents access by children. Evidence: On February 28, 2019 at approximately 2:36 pm, a prescription medication was observed on a dresser in a household member's bedroom where child #8 and child #9 were present. The medication was not in a locked place preventing access by children.

Plan of Correction: Provider will ensure that all bedroom doors are locked and any medication be made inaccessible in a locked place preventing access to children.

Standard #: 22VAC40-111-830-A
Description: Based on review, provider did not ensure emergency evacuation procedures are practiced monthly. Evidence: On February 28, 2019, there was not documentation of a completed emergency evacuation drill June 2018, July 2018, August 2018, September 2018, October 2018 and January 2019. Provider confirmed missing evacuation drills.

Plan of Correction: Provider will ensure emergency evacuation procedures are practiced on a monthly basis and documented.

Standard #: 22VAC40-111-960-E
Description: Based on observation, provider did not ensure bottles are labeled with the child's full name and date when there is more than one infant is in care. Evidence: On February 28, 2019, four infants were in care and three infants were observed drinking from bottles. One of the bottles was labeled with the child's first name only. All three bottles were not labeled with the date.

Plan of Correction: Provider will ensure that bottles have infants names and dates on them. No two infants have the same first name.

Standard #: 22VAC40-111-100-A
Description: Based on review, provider did not ensure 5 of 7 children's records have a physical examination prior to child's attendance or within 30 days after the first day of attendance. Evidence: On February 28, 2019, the record for child #2 (first date of attendance July 30, 2018), child #3 (first date of attendance June 14, 2018), child #4 (first date of attendance September 4, 2018), child #5 (first date of attendance August 2016) and child #7 (first date of attendance December 28, 2018) did not have a physical examination.

Plan of Correction: Provider has informed parents of child #2, #3, #4, #5 and #7 that the physical examination has to be included in their child's record. Parents will comply.

Standard #: 22VAC40-111-110-B
Description: Based on review, provider did not ensure 2 of 7 immunizations records were signed by a licensed physician, the physician's designee or an official of a local health department. Evidence: On February 28, 2019, the records for child #2 (first date of attendance July 30, 2018) and child #5 (first date of attendance August 2016) had immunization records that were not signed as required. Provider confirmed missing information.

Plan of Correction: Provider will request that parents of child #2 and child #5 comply with the standards by providing missing information.

Standard #: 22VAC40-111-120-B
Description: Based on review, provider did not ensure 1 caregiver record has documentation of required information. Evidence: On February 28, 2019, the record for caregiver record #1 (date of employment February 19, 2019) did not have documentation of verification of age, job title, emergency contact address and two or more reference checks. Provider confirmed missing information.

Plan of Correction: Provider will obtain missing documentation required for records.

Standard #: 22VAC40-111-60-B
Description: Based on review, provider did not ensure 2 of 7 children's records have documentation of required information. Evidence: On February 28, 2019, the following was found during record review: 1. The record for child #3 (first date of attendance June 14, 2018) did not have father's employment address, name/policy number of child's medical insurance and second emergency contact. 2. The record for child #7 (first date of attendance December 28, 2018) did not have father's employment address, physician's name and name/policy number of child's medical insurance. 3. Provider confirmed missing information.

Plan of Correction: Provider has informed parents of child #3 and #7 of the importance of the missing information. Parents have agreed to ensure that records are completed and updated.

Standard #: 22VAC40-111-170-A
Description: Based on review, provider did not ensure 1 caregiver record has a TB test or screening at the time of hire. Evidence: On February 28, 2019, the record for caregiver #1 (time of hire February 19, 2019) did not have a TB test or screening. Provider confirmed missing information.

Plan of Correction: Provider will ensure caregiver has TB test or screening done.

Standard #: 22VAC40-111-200-C
Description: Based on review, provider did not ensure there is documentation of completed orientation by the end of their first week of assuming job responsibilities that is signed and dated by the provider and assistant. Evidence: On February 28, 2019, the record for caregiver #1 (time of hire February 19, 2019) did not have documentation of completed orientation. Provider confirmed missing information.

Plan of Correction: Provider will conduct orientation and provide documentation after completion.

Standard #: 22VAC40-111-430-A
Description: Based on observation and hearing, provider did not ensure children under two years old do not have access to stairs without supervision. Evidence: On February 28, 2019 at approximately 2:06 pm, child #7 (twelve months old) was heard crawling up three stairs from the downstairs main child care room to the kitchen. Child #7 was then observed pulling up to stand at the stove which is by the door leading down the stairs. Provider was observed in the room used for infant care. Child #7 was not visible to provider during this incident. Provider stated upon returning to the kitchen that she "should have closed the door".

Plan of Correction: Provider will ensure that all children under age 2 will not have access to the (2) stairs that lead to the kitchen without supervision and by keeping the door closed.

Standard #: 22VAC40-111-510-A
Description: Based on observation, provider did not ensure a child is provided with an individual crib, cot, rest mat or bed for resting or napping. Evidence: On February 28, 2019 at approximately 2:36 pm, child #9 (age seventeen months) was observed sleeping in the bed with a household member that was holding child #8 (age twelve months). Child #8, Child #9 and household member were in the same bed.

Plan of Correction: Provider will ensure that all children have their individual cribs. Mats are labeled to prevent the spread of disease (no sharing). No child will be in the same bed. Children will remain in the 2 rooms designated for child care, not household member's bedroom.

Standard #: 22VAC40-111-540-A
Description: Based on observation, provider did not ensure that when high chairs and infant carrier seats are used and occupied by a child, the safety strap is securely fastened. Evidence: On February 28, 2019, the following was observed: 1. At approximately 1:20 pm, child #7 (age twelve months) was sitting in a high chair in the dining room and the safety belt was not fastened. Child #7 was observed playing with one end of the belt while the other end of the belt hung loosely below the high chair seat. 2. At approximately 3:53 pm, child #8 (age twelve months) was laying in an infant car seat in the dining room and the safety belt/straps were not fastened.

Plan of Correction: Provider will ensure that when a high chair or car seat is occupied by a child, a safety strap shall be used and securely fastened at all times.

Standard #: 22VAC40-111-560-A
Description: Based on observation and hearing, provider did not ensure a caregiver is physically present on site and providing direct care and supervision of each child at all times. Evidence: On February 28, 2019 at approximately 2:06 pm, child #7 (age twelve months old) was in the downstairs main childcare room. Provider was observed going to the infant room which is located beyond the kitchen, dining room and living room. During this time, child #7 crawled up three stairs to the kitchen. Provider did not ensure a caregiver watched each child.

Plan of Correction: Provider shall give direct care and supervision to each child. Provider shall be physically present and aware of children in care and near enough to intervene if needed.

Standard #: 22VAC40-111-570-A
Description: Based on observation and review, provider did not ensure that a caregiver does not exceed sixteen points by using the required point system. Evidence: On February 28, 2019 at approximately 1:02, caregiver #1 (assistant) left the home leaving the provider as the only caregiver in the home. At that time, there were seven children present. Upon walk through of the home, two additional children were observed at approximately 2:36 pm in a household member's bedroom totalling nine children for a total of twenty-seven points. There were four children present from birth through fifteen months of age, one child from sixteen months up to age two years and four children from two to four years.

Plan of Correction: Provider will ensure that each caregiver is aware of the point system if provider is alone. Provider will arrange to caregiver in place when one has an appointment or will be late.

Standard #: 22VAC40-191-60-B
Description: Based on review, provider did not ensure a caregiver has a completed sworn statement or affirmation prior to beginning employment. Evidence: On February 28, 2019, the record for caregiver #1 (date of employment February 19, 2019) did not have a completed sworn statement or affirmation. Provider confirmed missing information.

Plan of Correction: Provider will request assistant provide a completed sworn statement.

Standard #: 63.2-1720.1-B-2
Description: Based on review, provider did not ensure caregiver has a completed Office of Background Investigations (OBI) national fingerprinting determination letter prior to beginning employment. Evidence: On February 28, 2019, the record for caregiver #1 (date of employment February 19, 2019) did not have a OBI national fingerprinting determination letter. Provider confirmed missing information.

Plan of Correction: Provider will ensure caregiver completes fingerprinting determination letter.

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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