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Enderly Heights Head Start Child Development Center
101 Woodland Avenue
Buena vista, VA 24416
(540) 261-0000

Current Inspector: Kelly Ann Campbell (540) 309-2494

Inspection Date: Dec. 3, 2015 and Dec. 8, 2015

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 conducted in the Center on December 8, 2015. The LI observed 31 children present, grouped in two classrooms. As reported, 36 children are currently enrolled in the program. Four staff members were observed supervising the children's activities. An additional staff member was also present in the center. The children were observed during free play, a music activity, nap/rest time , afternoon snack and dismissal procedures. The children were not taken outdoors due to heavy fog in the area. A sample of 4 children's records was reviewed. Five partial staff records were reviewed during the inspection. On December 3, 2015, the LI reviewed one complete staff record at the main office. Documentation of the Center's annual fire and health inspections was current. Prescribed medications and written parental authorizations were reviewed for 4 children. A discussion was held with staff regarding practiced emergency evacuation drills. Both classrooms shall participate in the drills together at the same time, monthly. Complete documentation of the practiced drills shall be maintained in the Center for review. Findings of the inspection were reviewed upon exit. The inspection concluded at approximately 2:30PM. If you have any questions, please call or e-mail (elaine.moore@dss.virginia.gov) Thank you.

Violations:
Standard #: 22VAC40-185-70-A
Description: Based on a review of partial staff records and staff interview, the Center failed to maintain the name, address, and phone number of a person to be notified in an emergency for a staff member. Evidence: One of six staff records reviewed did not have emergency contact information at the Center. Staff 2 was substituting at the center from another center location.

Plan of Correction: The responsible staff will audit all staff records to ensure all required information for staff is maintained in the center. Any staff substituting from their base center will be requested to complete the information upon arrival to the center.

Standard #: 22VAC40-185-550-D
Description: Based on documentation reviewed and staff interviews, the Center failed to implement a practice evacuation drill monthly. Evidence: The LI reviewed documentation of the practiced emergency drills, drills that were conducted after September, 2015 indicated only children in classroom A had participated in the monthly drill. Staff reported that both classrooms did not practice the drills at the same time. Staff could not provide documentation of the practiced drills for classroom B, stating that a staff member had taken the information home with them.

Plan of Correction: Center staff will follow the Center's policies and will conduct evacuation drills monthly. Both classrooms will practice the drills as one group and documentation will be maintained in the Center. Documentation will be monitored on-going by the responsible administrative staff.

Standard #: 22VAC40-191-40-D-1-B
Description: Based on documentation reviewed, the Center failed to obtain a criminal history record check for a staff before 30 days of employment at the facility. Evidence: The record of staff 1, date of hire 9/30/15, criminal record report was dated 11/19/15. The individual continued to work in the center past the 30th day.

Plan of Correction: Effective immediately, the staff member will not be scheduled to work with the children until the background check is verified. Once received, documentation will be retained in the staff's record. The Licensee will review and revise internal procedures to ensure background check requests are submitted within the first 7 days of employment. Records will be audited ongoing.

Standard #: 22VAC40-191-60-C-2
Description: Based on documentation reviewed in a staff record, the Center failed to ensure a verified central registry finding was obtained within 30 days of employment or volunteer service. Evidence: The LI reviewed the record of staff 1, date of hire 09/30/15. The record did not contain documentation of a verified search of the Central Registry. The background request was not submitted within the first week of employment, the record noted the request was mailed on 11/2/15. The staff is currently working in the center.

Plan of Correction: Effective immediately, the staff member will not be scheduled to work with the children until the background check is verified. Once received, documentation will be retained in the staff's record. The Licensee will review and revise internal procedures to ensure background check requests are submitted within the first 7 days of employment. Records will be audited ongoing.

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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