VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Groomed for Greatness Learning Center II
5038 East Princess Anne Road
Norfolk, VA 23502
(757) 222-5404

Current Inspector: Nanette Roberts (757) 404-2322

Inspection Date: July 26, 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. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-191 Background Checks (22VAC40-191) 63.2 Child Abuse & Neglect 63.2(17) License & Registration Procedures 63.2 Facilities & Programs.

Technical Assistance:

Technical assistance was provided in the following areas of the standards: Background checks; 22VAC40-185-(3)-210 (Program leader qualifications); 22VAC40-185-(5)-350 (Staff-to-child ratios); 22VAC40-185-(6)-370-5-g (tummy time); 22VAC40-185-(6)-440 (Cribs and cots); 22VAC40-185-(6)-450 (Linens); 22VAC40-185-(7)-510 (Diapering); 22VAC40-185-(7)-520 (Topical ointments)

Comments:

An unannounced monitoring inspection was conducted on 7/26/19 from 11:15am - 1:55pm. During the inspection there were 36 children ages four months old through eight years old in care with seven staff. Children were observed participating in various activities in the classrooms, playing outside, and eating lunch. Records were reviewed for four children and five staff. There is no medication at the facility. Emergency procedures and emergency supplies were reviewed during the inspection. Areas of non-compliance are identified on the violation notice and were discussed during the exit interview.

Violations:

Standard #:	22VAC40-185-130-A
Description:	Based on a review of four children's records, it was determined that the licensee did not ensure that the center obtains documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Evidence: 1. The record for child #4 (date of enrollment 6/19/19), present during the inspection, did not contain documentation of an immunization record.
Plan of Correction:	The facility responded: An immunization record was provided by the parent of child #4.
Standard #:	22VAC40-185-140-A
Description:	Based on a review of four children's records, it was determined that the licensee did not ensure that each child in attendance had a completed physical within one month of attendance. Evidence: 1. The record for child #3 (date of enrollment 5/28/19), present during inspection, did not contain a physical examination. 2. The record for child #4 (date of enrollment 6/19/19), present during inspection, did not contain a physical examination.
Plan of Correction:	The facility responded: Physicals were requested & obtained from the parents of child#3 and child#4.
Standard #:	22VAC40-185-50-A
Description:	Based upon observation and interview, it was determined that the licensee did not ensure that staff and children's records are treated confidentially. Evidence: 1. The Supplemental Information page from the most recent inspection was posted on the licensing board. The Supplemental information sheet included the names of staff and children, and indicates "Information found on the Supplemental Information page is confidential and this document is not to be posted in the facility. 2. Staff #6 (Program Director) confirmed the Supplemental page was posted.
Plan of Correction:	The facility responded: The Supplemental page was removed during the inspection.
Standard #:	22VAC40-185-60-A
Description:	Based on a review of four children's records, it was determined that the licensee did not ensure that they maintain and keep at the center a complete record for each child enrolled that contains all required information. Evidence 1. The record for child #1 (date of enrollment 4/15/19), present during inspection, did not contain any information about the child's father, the street address for the two emergency contacts, and did not indicate whether or not the child had previously attended child care. 2. The record for child #2 (date of enrollment 4/15/19), present during inspection, did not contain documentation for viewing the proof of identity and it did not contain any information about the child's father. 3. The record for child #3 (date of enrollment 5/28/19), present during inspection, did not contain documentation for viewing the proof of identity. 4. The record for child #4 (date of enrollment 6/19/19), present during inspection, did not contain any information about the child's father and the mother's employment information.
Plan of Correction:	The facility responded: An audit was conducted on all student records; parents were notified of information to update.
Standard #:	22VAC40-185-70-A
Description:	Based on a review of five staff records, it was determined that the licensee did not ensure that a staff record is kept for each person with all of the required information. Evidence: 1. The record for staff #1 did not include documentation that two or more references as to character and reputation as well as competency were checked before employment. There was only one written reference in the record for staff #1. 2. Staff #2 was observed on duty during the inspection.
Plan of Correction:	The facility responded: A second reference was added to the personnel file for Staff#1.
Standard #:	22VAC40-185-270-A
Description:	Based on observation, it was determined that the licensee did not ensure that all areas and equipment of the center shall be maintained in a safe and operable condition. Evidence: 1. In the School Age classroom, there was a dangling electrical cord from the television mounted on the wall. The electrical cord posed an entanglement hazard and was accessible to the children who were present in the this classroom throughout the inspection.
Plan of Correction:	The facility responded: The television cord was removed from hanging beyond the wall mount.
Standard #:	22VAC40-185-280-B
Description:	Based on observation, it was determined that the licensee did not ensure that all hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. The door for the closet in the School Age classroom that is located next to the door that exits to the playground was not secured properly as the Licensing Inspector was able to open the door with a simple pull. The closet contained several cans of exterior paint. 2. The door for the kitchen was not secured properly as the Licensing Inspector was able to open the door with a simple pull. The kitchen contained several bottles of hazardous substances used for cleaning.
Plan of Correction:	The facility responded: The kitchen and closet door were locked and secured during the inspection.
Standard #:	22VAC40-185-290-3
Description:	Based on observation, it was determined that the licensee did not ensure that electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. Evidence: 1. There were two uncapped electrical outlets below where the television was mounted on the wall in the School Age classroom where children as young as 17 months were eating lunch . 2. There were two uncapped electrical outlets in the kitchen, and the door was unlocked. The door to the kitchen is located in one of the Preschool classrooms.
Plan of Correction:	The facility responded: All electrical outlets were covered with a plastic covering.
Standard #:	22VAC40-185-340-A
Description:	Based on observation and interview, it was determined that the licensee did not ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1. Child #1 (17 months) was observed walking around in the School Age classroom after finishing lunch with a small plastic toy in her mouth which could be a choking hazard. There were 23 children (ages 17 months- eight years old) present in the School Age classroom with only three teachers, when there should have been five teachers present based on the staff-to-child ratio required by the standards. None of the three teachers on duty in the classroom noticed that child #1 had a plastic toy in her mouth until the Licensing Inspector informed staff #4 about it. Staff #4 then proceeded to remove the toy from the mouth of child #1. However, staff #4 placed the toy back in a plastic container with various other small toys on a shelf that was still accessible to child #1. 2. Staff #6 (Program Director) confirmed that the small plastic toy that child #1 had in her mouth was a choking hazard. 3. Child #2 (6 months) was observed sleeping on his stomach in a crib in the Infant classroom with a blanket covering his head. The blanket is a possible suffocation hazard. In addition, none of the three staff in the Infant room were able to visually see the child's face.
Plan of Correction:	The facility responded: The staff received training regarding proper ratio and supervising children to ensure children aren?t picking up toys that are not age appropriate. Blankets are no longer allowed in the cribs at all in the infant classroom.
Standard #:	22VAC40-185-350-E-2
Description:	Based on observation and interviews, it was determined that the licensee did not ensure that for children, a ratio of 16 months old to two years, one staff member for every five children is maintained at all times children are in care. Evidence: 1. 23 children were observed eating lunch with three staff in the School Age classroom. Staff #6 (Program Director) was in and out the adjacent kitchen and the School Age classroom, but stated that she was on duty and counted in the staff-to-child ratio for this grouping of children. The children present were ages 17 months old to 8 years old which would required a total of 5 teachers present in the classroom. 2. Staff #6 (Program Director) confirmed that the facility did not maintain the required staff-to-child ratio of 1 staff for every 5 children for this grouping of children for approximately 45 minutes.
Plan of Correction:	The facility responded: Staff was trained on ratio and advised to stay inside the classroom and not adjacent to the classroom.
Standard #:	22VAC40-185-370-1
Description:	Based on observation and interview, it was determined that the licensee did not ensure that when an infant is placed in a crib, the infant shall be placed on their back. Evidence: 1. Child #2 (6 months) was observed sleeping in a crib in the Infant classroom on his stomach. 2. When staff #5 was asked how child #2 was placed in his crib, she stated that she placed Child #6 on his stomach in the crib.
Plan of Correction:	The facility responded: Staff#5 was reprimanded for placing an infant on their stomach during nap time.
Standard #:	22VAC40-185-430-A
Description:	Based on observation and interview, it was determined that the licensee did not ensure that all furnishings, equipment, and materials shall be of an appropriate size for the child using it. Evidence: 1. Child #1 (17 months) was observed eating lunch at a table in the School Age classroom. In order for child #1 to reach her food, a book was placed under her in her chair. Her head was barely above the top of the table and her feet did not touch the ground. 2. There were at least two other children eating lunch in the School Age classroom that were under two years old. The chairs and table they were sitting were not of an age appropriate size. 3. There was a plastic tub of small plastic toys, possible choking hazards) that were not age appropriate for the children present in the School Age classroom. The plastic tub of small toys was located on a shelf within the reach of the children (17 months to 8 years old) present in the School Age classroom. 4. Staff #6 (Program Director) confirmed that the plastic tub small plastic toys was not appropriate for all of the children present in the classroom.
Plan of Correction:	The facility responded: All toys were separated and placed in appropriate classrooms.
Standard #:	22VAC40-185-440-J
Description:	Based on observation and interview, it was determined that the licensee did not ensure that when cribs are occupied there should be 30 inches of space on the service side of the crib for staff to gain access to the crib. Evidence: 1. Child #2 was observed in an occupied crib in the Infant room that had less than 30 inches of space on the service side of the crib. 2. Staff #5 confirmed that the crib for child #2 did not have 30 inches of space on the service side.
Plan of Correction:	The facility responded: Staff were trained on crib measurements in the infant classroom.
Standard #:	22VAC40-185-500-B
Description:	Based on observation and interviews, it was determined that the licensee did not ensure that disposable diapers shall be disposed of in a leak-proof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches the exterior surface of the storage system during disposal. Evidence: 1. A soiled diaper was observed in the trash can without hands-free operation in the bathroom located in the School Age classroom. 2. Staff #4, who changed child #7 in the bathroom confirmed that the soiled diaper was not disposed of in a hands- free operational trash can. 3. Staff #5 was observed opening a trash can with her hand in the Infant classroom. The trash can contained soiled diapers. 4. Staff #5 said that the trash can was broken and that is why she used her hand to open the trash can instead of the foot pedal.
Plan of Correction:	The facility responded: Staff were trained to use the hand-free trash can to dispose of diapers.
Standard #:	22VAC40-185-520-C
Description:	Based on observation and interviews, it was determined that the licensee did not ensure that when diaper cream is used a parent authorization is obtained and a record of its use is kept. Evidence: 1. Three tubes of diaper cream labeled with the names of child #2, child #5, and child #6 were found in each of the child's cubbies in the Infant classroom. 2. Staff #5 confirmed that there were no written parents authorizations available for any of the three diaper creams, and that there was no written record for when the diaper cream was applied as required.
Plan of Correction:	The facility responded: VDSS topical authorization forms were provided for parents to sign if/when they provide diaper rash cream.
Standard #:	22VAC40-185-550-M
Description:	Based on a review of injury reports for the months of June and July, it was determined that the licensee did not ensure that the written record of children's serious and minor injuries includes all of the required items. Evidence: 1. None of the injury reports contained the future action to prevent recurrence of the injury or the time of parent notification.
Plan of Correction:	The facility responded: The injury/incident reports were reformatted to include missing information as required by the VDSS Childcare Standards.
Standard #:	22VAC40-185-560-F
Description:	Based on observation and interview, it was determined that the licensee did not ensure that when the center chooses to provide meals or snacks, a menu listing foods to be served for meals and snacks during the current one week period should be dated. Evidence: 1. The menu posted for the current week listed grapes as being served for lunch today. However, the children in care today were observed eating fruit cocktail for lunch. 2. Staff #6 (Program Director) confirmed that fruit cocktail was substituted for grapes, but was not listed on the menu.
Plan of Correction:	The facility responded: Staff were trained to add any substitutions to the posted menu.
Standard #:	22VAC40-185-560-G
Description:	Based on interviews, it was determined that the licensee did not ensure that when food is brought from home it is labeled with the child's name and date. Evidence: 1. An open container of Organic Milk was found in the refrigerator in the Infant classroom for child #8 with no date labeled on the container. 2. Staff #5 acknowledged that the container of Organic Milk for child #8 was not labeled with the date.
Plan of Correction:	The facility responded: Staff were trained to label all containers of milk in the infant refrigerator.
Standard #:	22VAC40-185-570-C
Description:	Based on a review of documentation and interviews, it was determined that the licensee did not ensure that the record of each child shall contain brand of formula and the child's feeding schedule. Evidence: 1. There was no record of the brand of formula and a feeding schedule for each child who is on formula. 2. Staff #5 confirmed that there was no record of the brand of formula and a feeding schedule for each child who is on formula available for viewing during the inspection.
Plan of Correction:	The facility responded: A feeding schedule was created for all students in the infant classroom.
Standard #:	22VAC40-185-570-I
Description:	Based on observation and interview, it was determined that the licensee did not ensure that the facility shall maintain a one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care. Evidence: 1. There was not a one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care at the child day center during the inspection. 2. Staff #6 (Program Director) confirmed that currently there was not a one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care.
Plan of Correction:	The facility responded: An emergency supply of disposable bottles, nipples and commercial formula was placed in the infant classroom.
Standard #:	22VAC40-191-60-C-2
Description:	Based on a review of five staff records, it was determined that the facility did not deny continued employment of a staff who did not have a search of the central registry finding within 30 days of employment. Evidence: 1. The record for staff #4 (date of hire 6/17/19), on duty during the inspection, did not contain documentation of a completed search of the central registry finding. 2. Staff #6 (Program Director) confirmed that the search of the central registry finding has not been received for staff #4.
Plan of Correction:	The facility responded: The central registry department was contacted by the Director to check the status of the results for Staff#4.