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Community Improvement Council, Inc.
540 Holbrook Street
Danville, VA 24541
(434) 793-5710

Current Inspector: Rebecca Forestier (540) 309-2835

Inspection Date: Nov. 7, 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 SPECIAL CARE PROVISIONS AND EMERGENCIES.

Comments:
An unannounced monitoring inspection was conducted on 11/07/2018. Present during the inspection were 186 children, ages 3 years-5 years, 24 staff providing direct care and supervision and various support staff. The inspector reviewed 10 children's records, 10 staff records and five medications during today's inspection. The children were observed in the following activities: having breakfast, in free choice/center play, in circle time, preparing to go for a walk outdoors and having lunch. The inspector reviewed the emergency procedures and emergency supplies during the inspection today. The inspector discussed the following with the site staff: children's record, model forms available for providers, nutrition and services provided by outside organizations. The inspector arrived at 9:00 a.m. and departed at 3:15 p.m. If you have any questions, please contact Becky Forestier at 540-309-2835.

Violations:
Standard #: 22VAC40-185-60-A
Description: Based on observations, record review and discussion with the staff the facility failed to ensure that the separate record for each enrolled child contained all elements as required by the standards. Evidence: The records for Child #1, #2, #3, #4, #5, #6, #7, #8, #9 and #10 did not contain the following information; the information was not on the enrollment form: names of persons authorized to pick up the child, name of any additional programs or schools that the child is concurrently attending and first date of attendance. In addition to the missing elements listed above, the following children's records were also missing the elements listed below: 1. The record for Child #2 did not contain the following information: name, address and phone number of two designated people to call in an emergency if a parent cannot be reached; one of the contacts listed was a parent. 2. The record for Child #3 did not contain the following information: work phone number and place of employment of each parent who has custody; employment was indicated in the record but no work phone number nor place of employment was listed, phone number of the child's physician, name, address and phone number of two designated people to call in an emergency if a parent cannot be reached; one of the contacts listed was a parent, and documentation of viewing proof of the child's identity. 3. The record for Child #4 did not contain the following information: phone number of the child's physician. 4. The record for Child #5 did not contain the following information: work phone number and place of employment of each parent who has custody; employment was indicated in the record but no work phone number nor place of employment was listed, phone number of the child's physician, name, address and phone number of two designated people to call in an emergency if a parent cannot be reached; there was only one contact provided. 5. The record for Child #6 did not contain the following information: work phone number and place of employment of each parent who has custody; employment was indicated in the record but no work phone number nor place of employment was listed and a phone number of the child's physician. 6. The record for Child #7 did not contain the following information: work phone number and place of employment of each parent who has custody; employment was indicated in the record but no work phone number nor place of employment was listed. 7. The record for Child #8 did not contain the following information: phone number of the child's physician. 8. The record for Child #10 did not contain the following information: work phone number and place of employment of each parent who has custody; employment was indicated in the record but no work phone number nor place of employment was listed and name, address and phone number of two designated people to call in an emergency if a parent cannot be reached; there were no addressed listed for either contact provided.

Plan of Correction: The program will adjust the enrollment form based off of the VDSS Enrollment Form. The program will seek missing information from families and will correct all 204 children's records.

Standard #: 22VAC40-185-70-A
Description: Based on observations, record review and discussion with the staff, the facility failed to ensure that each staff record contained all elements as required by the standards. Evidence: 1. The personnel record for Staff #4 did not contain the health information as required by 22VAC40-185-160. 2. The personnel record for Staff #6 did not contain documentation of the signature of the person making the call for the reference checks that are required to be checked before employment.

Plan of Correction: The program will get the missing information into the records.

Standard #: 22VAC40-185-260-B
Description: Based on observations, document review and discussion with the staff, the facility failed to obtain an annual approval from the health department stating approvals for meeting requirements for: water supply, sewage disposal system and food service if applicable. Evidence: The most recent approval from the health department that stated approvals for meeting requirements for: water supply, sewage disposal system and food service was dated 08/28/2017.

Plan of Correction: A phone call to the local department was made during the inspection.

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.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.

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