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Middlesex Family YMCA Operated by Peninsula Metropolitan YMCA
11487 General Puller Highway
Hartfield, VA 23071
(804) 316-9191

Current Inspector: Christine Mahan (757) 404-0568

Inspection Date: June 19, 2017

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.
63.2 Licensure and Registration Procedures

Comments:
An unannounced monitoring inspection was conducted on June 19, 2017 from approximately 11:15 a.m. to 4:45 p.m. Upon arrival there were 8 staff with 56 children. Children were observed eating lunch and playing outside. Seven staff records and four children's records were reviewed on this date. One medication was observed on site. Areas of non-compliance are identified on the violation notice. If you have any questions, contact your licensing inspector at (757) 404-0568.

Violations:
Standard #: 22VAC40-185-60-A
Description: Based on record review and staff interviews, the licensee did not ensure that a separate record for each child enrolled which contained all the required information was maintained at the center. Evidence: During the inspection on June 19, 2017, the following children's records were reviewed and determined to be incomplete; 1) The record for child# 1 did not include the home address for a second emergency contact or the complete address (no house number/ apartment number or city listed ) for the first emergency contact. The was no information listed for the second parent to include name, home address, home phone number, employment location and employment phone number. 2) The record for child #2 did not include information listed for the second parent to include home address, home phone number, employment location and employment phone number. 3) The record for child #3 did not include information listed for the second parent to include name, home address, home phone number, employment location and employment phone number.

Plan of Correction: The program director will have the records completed.

Standard #: 22VAC40-185-70-A
Description: Based on record review and staff interviews, the licensee did not ensure all staff records were kept for each staff person and contained all the required information. Evidence: During the inspection on June 19, 2017, the following staff records were determined to be incomplete; 1) The record for staff #6 did not include written information to demonstrate that the individual possesses the education, staff development and certification required by the job position. The record for staff #6 who is designated as a program leader only had 18 hours out of the required 24 hours of training documented and available for review. The promotion date for staff #6 was 1-30-2017. 2) The record for staff #1 did not include the required two reference checks as to character and reputation.

Plan of Correction: The program director will have the records completed.

Standard #: 22VAC40-185-280-B
Description: Based on observation and staff interviews, the licensee did not ensure hazardous substances such as cleaning materials, insecticides, and pesticides were kept in a locked place using a safe locking method that prevents access by children. Evidence: During the inspection on June 19, 2017, in the "Preschool Camp" building the following items were observed and stored in an unlocked places and all had the statement "keep out of reach of children" and at least one of the other statements "caution", "flammable" and "warning"; 1) On the book shelf by the back door there was 1 container of room deodorizer and 3 containers of spray paint. 2) On a shelf in the bathroom there was 1 spray container of window cleaner.

Plan of Correction: The program director will have the items locked.

Standard #: 22VAC40-185-500-A
Description: Based on observation and staff interviews, the licensee did not ensure children's hands were washed with soap and running water or disposable wipes before and after eating meals or snacks. Evidence: During the inspection on June 9, 2017, the children in the "Blue Group" were observed during their lunch time routine and they did not wash their hands after eating lunch.

Plan of Correction: The program director will retrain the staff.

Standard #: 22VAC40-185-510-J
Description: Based on observation and staff interviews, the licensee did not ensure that all medication, except for those prescriptions designated otherwise by written physician's orders, including refrigerated medication and staff's personal medication, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: During the inspection on June 19, 2017, one medication (Focalin) for child #1 was observed in an unlocked draw in the program directors office which was unlocked.

Plan of Correction: The program director locked it up during the inspection.

Standard #: 22VAC40-185-540-E
Description: Based on observation and staff interviews, the licensee did not ensure there was one working, battery-operated flashlight and one working, battery-operated radio in each building used by children. Evidence: During the inspection on June 19, 2017, there was not a working battery operated radio or a battery operated flashlight for the preschool camp building.

Plan of Correction: The program director will purchase the items.

Standard #: 22VAC40-185-550-C
Description: Based on observation and staff interviews, the licensee did not ensure there was an emergency evacuation and shelter-in-place procedures/maps that were posted in a location conspicuous to staff and children on each floor of each building. Evidence: During the inspection on June 19, 2017, there were not emergency evacuation procedures posted in the preschool camp building.

Plan of Correction: The program director will post plans tomorrow.

Standard #: 22VAC40-185-550-D
Description: Based on documentation review and staff interviews, the licensee did not ensure the center implemented a monthly practice evacuation drill and a minimum of two shelter-in-place practice drills per year for the most likely to occur scenarios. Evidence: During the inspection on June 19, 2017, there was not documentation for monthly evacuation drills for December 2016, January 2017, April 2017 and May 2017. There was also not documentation for the 2 required shelter-in-place drills 2016.

Plan of Correction: The program director will conduct drills in the future.

Standard #: 22VAC40-185-560-G
Description: Based on observation and staff interviews, the licensee did not ensure that when food is brought from home the food container was sealed and clearly dated and labeled in a way that identifies the owner. Evidence: During the inspection on June 19, 2017, the children in the "Red Group" were observed during their lunch time routine. Ten lunch boxes/containers were observed and 9 did not include today's date and 2 did not include a name or way that identifies the specific owner of the lunch container.

Plan of Correction: The program director will come up with a system to document date and name.

Standard #: 63.2-1720-F
Description: Based on record review and staff interviews, the licensee did not ensure a licensed child welfare agency obtained for any compensated employees within thirty days of employment an original criminal record clearance (CRC) and that no employee shall be permitted to work in a position that involves direct contact with a child receiving services until an original criminal record clearance or original criminal history record has been received, unless such person works under the direct supervision of another employee for whom a background check has been completed in accordance with the requirements of this section. Evidence: During the inspection on June 19, 2017, staff #2 and staff #7 were observed working together with 11 children and neither staff had documentation in their record of a clear CRC. The date of hire for staff #2 was 5-19-17 and staff #7 was 6-9-17. Staff #2 and staff #7 were observed working without supervision of someone who had obtained a clear CRC.

Plan of Correction: The program director rearrange groups so a staff member with a CRC is supervising children always.

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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