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Lakeside PAL After-School
6700 Cedar Croft Street
Henrico, VA 23228
(804) 690-0639

Current Inspector: Heather Dapper (804) 662-7014

Inspection Date: March 23, 2018

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
63.2 Facilities and Programs..
22VAC40-191 Background Checks (22VAC40-191)

Technical Assistance:
N/A

Comments:
The licensing inspector conducted an unannounced renewal inspection Friday, March 23, 2018 from approximately 2:25PM to 5:00PM. During the inspection, there were a total of 95 children present at the facility being supervised by 14 staff members. The licensing inspector observed children arriving to the facility, playing outside, working on computers, washing their hands and eating snack. Snack consisted of animal crackers and juice. A second helping of snack was offered. All areas of the facility including classrooms, hallways, gym, bathrooms and outdoor play areas were inspected. The facility was equipped with toys and supplies and items were available to the children. The following information was reviewed: injury reports, menu, daily attendance, emergency supplies, emergency preparedness plan, practiced emergency drill logs, parent agreements and required postings. Medication is administered and medication and medication authorization forms were reviewed. During the inspection, 10 children's records were reviewed. Earlier in the day, the licensing inspector reviewed 16 staff records at an off-site location. The risk profile tool will be used for the licensing recommendation by the licensing department. If you have any questions about this inspection, please contact the Licensing Inspector, Lynn Powers at (804) 662-9790.

Violations:
Standard #: 22VAC40-185-60-A
Description: Based on review of 10 children's records, six records did not contain the required information.

Evidence:
During the inspection, the licensing inspector observed the records for Child #2, Child #3, Child #7, Child #8, Child #9 and Child #10 did not contain the address for the two emergency contacts listed in the record. The record for Child #3 did not contain the parent's signature agreeing to the center's policies regarding emergency care, picking up when a child is ill, and reporting communicable diseases. A member of management reviewed the records and could not locate the information during the inspection.

Plan of Correction: We will reach out to the parents and obtain the missing information.

Standard #: 22VAC40-185-70-A
Description: Based on review of 16 staff records, six records did not contain the required information.

Evidence:
During the review of records and interviews the following was determined
1. The records for Staff #3 and Staff #6 did not contain proof of CPR and First Aid certification. The staff was identified as transportation drivers. Management stated staff has the certification through Henrico County with Red Cross. Cards were emailed to the staff but the staff needs to print off the cards.
2. The records for Staff #2 (hire date 09/27/17) and Staff #8 (hire date 09/27/17) did not contain documentation of orientation. Management stated orientation was completed but the documentation needed to be added to the record.
A member of management reviewed the records and could not locate the information during the inspection.

Plan of Correction: We have previously requested this information. We will reach out to the staff again and obtain the missing information to add to the records.

Standard #: 22VAC40-185-510-C
Description: Based on review of medication and medication authorization, the facility did not obtain physician authorization for one of the long term medications present at the facility. Evidence: During the inspection, the licensing inspector observed a prescribed long-term medication present at the facility for Child #2. The medication authorization form contained the parent's signature but did not contain authorization from a physician. A member of management reviewed the records and could not locate the information during the inspection.

Plan of Correction: We will contact the parent and let them know that we need the medication authorization to be signed by the doctor as well.

Standard #: 22VAC40-191-60-B
Description: Based on review of 16 staff records, one staff member did not complete a sworn statement prior to beginning employment. Evidence: During the review of records, the licensing inspector observed the record for Staff #2 (hire date 09/27/17) did not contain a completed sworn statement. A member of management reviewed the records and could not locate the information during the inspection.

Plan of Correction: We have previously requested this information. Staff was notified during the inspection and is completing the sworn statement date.

Standard #: 63.2-1720.1-B-3
Description: Based on the review of 16 staff records and interview, the facility did not request a search of out-of-state founded complaints of child abuse for one staff member who has lived outside of Virginia within the last five years.

Evidence:
During the inspection, the licensing inspector observed the record for Staff #5 (hire date 09/27/17) indicated the staff member has lived outside of Virginia within the last five years. The record did not contain documentation of a request for founded complaints of child abuse from the state the staff member indicated she had lived in within the last five years. On 03/23/2018, management stated a request for the out of state child abuse registry search has not been requested. Staff #5 was observed working at the facility on 03/23/2018.

Plan of Correction: During the inspection, Staff #5 completed the child abuse check from Maryland.

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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