VIRGINIA DEPARTMENT OF SOCIAL SERVICES

A Little Piece of Heaven Day Care, Inc.
3500 New Kent Highway
Quinton, VA 23141
(804) 932-4222

Current Inspector: Cassie Anderson-Leichty (757) 409-4668

Inspection Date: June 5, 2019

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(17) License & Registration Procedures

Technical Assistance:

USDA snack components. Smaller Playground.

Comments:

An unannounced renewal inspection was conducted on June 5, 2019 from approximately 9:15 am- 2:00 pm. At arrival to the facility, there were 26 children with five staff members. The children were observed doing music and movement, transitioning into classrooms and resting. Infants were observed during their outdoor time. Licensing Inspector reviewed supervision, programs, activities, equipment, indoor and outdoor areas, children and staff records, emergency evacuation and shelter-in-place drill documentation, fire and health inspection reports, emergency supplies and required postings. Five children's records and five staff records were reviewed. One prescription medication was reviewed. The exit interview was conducted with the Owner.

Violations:

Standard #:	22VAC40-185-270-A
Description:	Based on observation and inspection of the facility, the licensee did not ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin. Evidence: The owner verified the following conditions of the outside area: 1. Children were observed playing outdoors in front of the center on a wooden ramp where spindles had become detached from the frame exposing nails. (Picture Exhibit A) 2. There were two black shutters on the front of the building with patches of chipped and peeling paint and one shutter was leaning forward and detached from the building at the top exposing the nails and it could also be easily moved when touched. (Picture Exhibit B)
Plan of Correction:	The spindles were screwed in during the inspection. Two were broken and taken off and will be replaced by Friday. The shutters will be replaced.
Standard #:	22VAC40-185-340-A
Description:	Based on observation and inspection of the facility, the staff members did not ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: An infant was observed sitting in a bouncy chair on the floor and the infant straps had not been secured. Staff #3 confirmed that the infant straps were on the bouncy seat but tucked behind a blanket under the infant.
Plan of Correction:	We will make sure to strap them in every time.
Standard #:	22VAC40-185-510-A
Description:	Based on review, the licensee did not ensure that prescription medication was given according to the center's written medication policy and only with written authorization from the parent. Evidence: Staff # 6 confirmed administering Prescription Medication #1 to Child #2 but the center had not obtained written authorization from the parent. The center's medication policy states that "no prescription diaper rash cream/ointment will be allowed".
Plan of Correction:	The employee was the grandmother of the child and had permission from the parents to administer the medication. As of today we did receive written authorization from both parents but at no time in the future will any prescription medication be administered.
Standard #:	22VAC40-185-510-G
Description:	Based on observation and inspection of the facility, the licensee did not ensure that the center may administer prescription medication that would normally be administered by a parent or guardian to a child provided all requirements were met. Evidence: The owner confirmed that there was no documentation available to review that verified Staff #6 had current Medication Administration Training (MAT). Staff #6 acknowledged administering Prescription Medication #1 to Child #2.
Plan of Correction:	The employee was the grandmother of the child and had permission from the parents to administer the medication. As of today we did receive written authorization from both parents but at no time in the future will any prescription medication be administered. The employee will be reprimanded.
Standard #:	22VAC40-185-510-J
Description:	Based on observation and inspection of the facility, the licensee did not ensure that 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: Staff #6 confirmed that Prescription Medication #1 was observed in an unlocked drawer of the lower cabinets in the Girls Restroom. (Picture Exhibit E).
Plan of Correction:	There will be no prescription medicine on site and the medication was discarded immediately.
Standard #:	22VAC40-185-510-L
Description:	Based on observation and staff interview, the licensee did not ensure that centers shall keep a record of medication given to children which contained all required information documented. Evidence: The owner confirmed that there was not a record of medication given to Child #2 which documented the following: the child to whom medication was administered; amount and type of medication administered to the child; the day and time the medication was administered to the child; staff member administering the medication; any adverse reactions; and any medication error.
Plan of Correction:	The employee was the grandmother of the child and had permission from the parents to administer the medication. As of today we did receive written authorization from both parents but at no time in the future will any prescription medication be administered. The employee will be reprimanded.
Standard #:	22VAC40-185-520-B
Description:	Based on observation and inspection of the facility, the licensee did not ensure that sunscreen was labeled as required. Evidence: Staff confirmed that there was one canister of sunscreen in the Boys Restroom and one canister in the School Age cabinet that were not labeled with the children's names. (Pictures Exhibit F).
Plan of Correction:	Children's names and dates will be put on all over the counter medication or labeled as daycare use.
Standard #:	22VAC40-185-520-C
Description:	Based on observation and staff interview, the licensee did not ensure that diaper ointment or cream was labeled as required. Evidence: Staff #6 confirmed that there was one diaper ointment in the Boys Restroom and one diaper ointment in the Girls Restroom that were not labeled with the children's names. (Pictures Exhibit G)
Plan of Correction:	Children's names and dates will be put on all over the counter medication or labeled as daycare use.
Standard #:	22VAC40-185-520-D
Description:	Based on observation and staff interview, the licensee did not ensure that insect repellent was labeled as required. Evidence: The owner confirmed that there were three canisters of insect repellent in the School Age cabinet that were not labeled with the children's names. (Pictures Exhibit H)
Plan of Correction:	Children's names and dates will be put on all over the counter medication or labeled as daycare use.
Standard #:	63.2(17)-1720.1-B-2
Description:	Based on record review, in one of five staff records reviewed, the licensee did not ensure that staff submit to fingerprinting and obtain results. Evidence: The owner confirmed that Staff #1 (date of hire 10/30/17) had not completed a fingerprint check.
Plan of Correction:	Staff #1 had completed the criminal background check prior to new standards being issued and the director was under the impression that because it was still in date for her three years that it was still good and she would do her fingerprint before her three year expiration date. So now staff member will be getting fingerprinted within one week to meet the new standards.