VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tiffany's Learning Center
12140 Amos Lane
Fredericksburg, VA 22407
(540) 845-1829

Current Inspector: Laura Brindle (540) 905-2062

Inspection Date: May 22, 2023

Complaint Related: No

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Staff Qualifications and Training. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies. 8VAC20-780 Special Services. 8VAC20-770 Background Checks (8VAC20-770) 22.1 Background Checks Code, Carbon Monoxide

Technical Assistance:

Shared with the Director: - 8VAC20-780-560: When centers choose to provide meals or snacks, the following shall apply: 1. Centers shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). - 8VAC20-780-550-E: Shelter in place procedures shall be practiced a minimum of twice per year. - 8VAC20-780-550-F: Lockdown procedures shall be practiced at least annually. -8VAC20-780-330-F: A shady area shall be provided on playgrounds during the months of June, July, and August. -8VAC20-780-510-E-4: The center?s procedures for administering medication shall include methods to prevent use of outdated medication. -8VAC20-780-60-A: Children?s records requirements.

Comments:

An unannounced renewal inspection was conducted on 5/22/23 from 11:15am to 2:25pm with the Director. There were 55 children in care, ranging in age from eight-weeks to five-years-old, supervised by nine staff. The children were observed having free play, eating lunch, and getting ready for nap. Five child records and five staff records were reviewed. The Center has staff with current certification in CPR and First Aid, as well as staff trained in Daily Health Observation. A sample of eight medications and authorization forms were reviewed and the center had five staff present with Medication Administration Training (MAT). The attendance, menu, and emergency drill log were reviewed. The most recent Fire Inspection on file was dated 12/28/22 and the most recent Health Inspection on file was dated 11/30/22. The center is beginning to have their food catered, so some children ate lunch from home, others had chicken nuggets, cooked broccoli, and peaches. If you have questions regarding this inspection, please contact the Licensing Inspector, Laura Brindle, at laura.brindle@doe.virginia.gov or 540-905-2062. Please complete the "Plan of Correction" and "Date to be Corrected" areas on the Violation Notice for each violation cited and return to me by close of business on 5/30/23. Plans of correction should include steps to correct the noncompliance with the standard, and measures to prevent the noncompliance from occurring again.

Violations:

Standard #:	22.1-289.011-F
Description:	Based on observation and interview, the center did not ensure that documents required by the Superintendent were posted in a conspicuous place on the licensed premises. Evidence: On 5/22/23 the most recent inspection was not posted on the licensed premises.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22.1-289.035-B-2
Description:	Based on review of 11 staff records, the center did not ensure that the results of a national fingerprint-based criminal history check were obtained prior to employment for four staff. Evidence: The record for Staff #5, with an employment date of 5/4/23, did not contain documentation of the results of a national fingerprint-based criminal history check. The fingerprints on record for Staff #1, with an employment date of 4/3/23, were dated 4/18/23. The fingerprints on record for Staff #2, with an employment date of 4/18/23, were dated 4/20/23. The fingerprints on record for Staff #3, with an employment date of 3/18/23, were dated 3/21/23.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22.1-289.035-B-4
Description:	Based on review of five staff records and interview, the center did not obtain the results of a criminal history record check or sex offender registry check from all states in which staff members have resided within the past five years prior to employment, or the results of a central registry check from all states in which staff members have resided within the past five years within 30 days of employment. Evidence: The record for Staff #1, with an employment date of 4/3/23, contained documentation that the staff member had lived in the state of West Virginia within the past five years. There was no documentation of a sex offender registry check or a central registry check from West Virginia on record for Staff #1. The record for Staff #5, with an employment date of 5/4/23, contained documentation that the staff member had lived in the state of Illinois within the past five years. There was no documentation of a criminal history record check or central registry check from Illinois on record for Staff #5.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-770-60-C-2
Description:	Based on review of 11 staff records, the center did not obtain the results of a search of the central registry for eight staff within 30 days of employment. Evidence: The records for Staff #1, with an employment date of 4/3/23; Staff #2, with an employment date of 4/18/23; Staff #6, with an employment date of 3/6/23; Staff #7, with an employment date of 2/6/23; Staff #8, with an employment date of 2/13/23; Staff #9, with an employment date of 1/20/23; and Staff #11, with an employment date of 2/5/23 did not contain documentation of the results of a central registry check. The central registry check results on record for Staff #3, with an employment date of 3/18/23, were dated 5/3/23.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-140-A
Description:	Based on review of five child records, the center did not obtain documentation of a physical examination for each child by or under the direction of a physician within 30 days after the first day of attendance. Evidence: The record for Child C, with a start date of 3/23/23, did not contain documentation of a physical.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-160-A
Description:	Based on review of five staff records, the center did not obtain documentation of a tuberculosis (TB) test or screening for staff at the time of employment or prior to contact with children. Evidence: The record for Staff #2 contained documentation of a start date of 4/18/23. The TB test on record for Staff #2 was dated 5/17/23. The record for Staff #5 contained documentation of a start date of 5/4/23. The TB test on record for Staff #5 was dated 5/8/23.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-280-B
Description:	Based on observation, the center did not ensure that hazardous substances such as cleaning materials, were kept in a locked place using a safe locking method. Evidence: On 5/22/23, two containers of disinfecting wipes were observed on a high, open shelf in the three-year-old classroom.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-350-C
Description:	Based on observation and interview, the center did not ensure that when children were in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group applied to the entire group. Evidence: On 5/22/23, two staff were observed supervising 16 children in the two-year-old classroom. There were four children present in the classroom who will not turn two-years-old until July and August 2023. With these children present in the classroom, the required ratio was one staff to five children.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-440-G
Description:	Based on observation and interview, the center did not ensure that cribs were used for children under 12 months of age. Evidence: On 5/22/23 a child who was reported to be 10-months-old was observed sleeping on a cot in the infant classroom.
Plan of Correction:	The parent obtained a doctor's note to allow the child to sleep on a cot due to climbing out of cribs.
Standard #:	8VAC20-780-500-A
Description:	Based on observation, the center did not ensure that staff washed their hands with soap and running water after any contact with body fluids. Evidence: On 5/22/23, in the two-year-old classroom, staff were observed wiping children?s noses with tissue and then using hand sanitizer, but not washing hands with soap and running water.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-510-E
Description:	Based on review of medication, medication authorizations, and interview, the center did not follow the policy for administration of medication in that the duration of the parent?s authorization shall expire or be renewed after 10 work days and long-term medication authorization may be allowed with written authorization from the child?s physician and parent. Evidence: A sample of eight medications and authorizations were reviewed on 5/22/23. Of the eight medications and authorizations, five authorizations were expired as the parent authorization was beyond the 10 days and there was no written physician authorization on record.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-550-D
Description:	Based on review of documentation and interview, the center did not implement a monthly practice evacuation drill. Evidence: The drill log did not contain documentation of a drill conducted in April 2023.
Plan of Correction:	Not available online. Contact Inspector for more information.