VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tiny Toes Creative Learning Center
4540 Plank Road
Suite E
Fredericksburg, VA 22407
(540) 412-0771

Current Inspector: Donna Liberman (540) 359-5244

Inspection Date: June 3, 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. 22VAC40-191 Background Checks (22VAC40-191)

Technical Assistance:

Technical assistance was providing regarding documentation requirements for proof of identification.

Comments:

An unannounced monitoring inspection was conducted today from 9:50am-1:00pm. There were 55 children directly supervised by 7 staff and all 5 classrooms were in ratio. The physical plant, programming, menu, 5 staff records, 6 children?s records, evacuation drills, injury reports, emergency supplies, and policies were inspected. The director advised no medication is on site today. Children were observed playing in centers, reading books, playing with blocks, building car tracks, doing a hand painting jellyfish art project to learn about the letter "J", and playing on the playground. Infant care including feeding and diapering was also observed. School age children were engaged in a group game. Lunch served today was whole wheat bread, chicken nuggets, pineapple, french fries, and milk. Positive interactions between children and staff were observed during this inspection. Areas of non-compliance are identified in the Violation Notice. If you have any questions regarding this inspection, please contact me at morgan.bryson1@dss.virginia.gov.

Violations:

Standard #:	22VAC40-185-140-A
Description:	Based on record review, 2 of 6 children's records did not contain documentation of a physical examination within 30 days of the child's first day of attendance. Evidence: 1. Child #2's first day of attendance was 11/14/16 and did not have a physical examination on file. 2. Child #6's first day of attendance was 3/18/19 and did not have a physical examination on file.
Plan of Correction:	I will email their mothers to ask the doctors to fax over the physical.
Standard #:	22VAC40-185-240-D-5
Description:	Based on record review and staff interview, there is not at least one staff member who has obtained instruction in performing the daily health observation of children within the last 3 years. Evidence: 1. 5 staff records were reviewed and no staff had Daily Health Observation (DHO) training. 2. The director stated no staff have had DHO training within the last 3 years.
Plan of Correction:	I have the Daily Health Observation training scheduled for July 12, 2019 and all lead teachers will receive DHO training.
Standard #:	22VAC40-185-270-A
Description:	Based on observation, areas inside and outside the center have not been maintained in a clean, safe, and operable condition. Evidence: 1. In the Infant/Toddler classroom, there was an exposed nail sticking out from the wall at the gate separating the Infant and Toddler areas. 2. In the School Age classroom bathroom, the base of one of the toilets was not securely attached to the floor and could be moved. The toilet was leaking water onto the floor. 3. On the playground area's large climbing structure, there is a piece of wood that has detached from the structure exposing a nail that could entangle clothing or snag skin.
Plan of Correction:	1. I screwed in the nail in the Infant/Toddler classroom. 2. We have a maintenance man coming in to fix the toilet tonight. 3. The maintenance man will fix the exposed nail on the climbing structure.
Standard #:	22VAC40-185-280-B
Description:	Based on observation, hazardous substances, such as cleaning materials, were not kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. On the Toddler side of the Infant/Toddler classroom, cleaning supplies were located in the unlocked adult bathroom connected to the room. The bathroom was unlocked making it accessible to the children in care. 2. Lysol cleaner was sitting on the ledge next to the toilet and a bottle of Clorox was sitting on top of a Clorox box on the floor.
Plan of Correction:	We will put a lock on the door.
Standard #:	22VAC40-185-500-B
Description:	Based on observation of the Infant/Toddler classroom, the Toddler area diapering changing pad was found to no longer be nonabsorbent. Evidence: 1. The changing pad had a tear making it absorbent and not able to be properly cleaned and sanitized.
Plan of Correction:	We will get a new changing pad.