VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Boar's Head Child Care
200 Wellington Drive
Charlottesville, VA 22903
(434) 972-6072

Current Inspector: Michelle Argenbright (540) 848-4123

Inspection Date: July 24, 2019 , July 30, 2019 and Aug. 1, 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. 22VAC40-80 SANCTIONS. 22VAC40-80 HEARINGS PROCEDURES. 22VAC40-191 Background Checks (22VAC40-191) 32.1 Report by person other than physician 63.2 Child Abuse & Neglect 63.2(17) License & Registration Procedures 63.2 Facilities & Programs.

Technical Assistance:

We discussed the requirements for staffing, supervision, emergency practice drills, children's records, background checks for staff, injury records, and the care and protection for children. The risk assessments for violations were provided. We discussed the importance of consistently using a locking mechanism on the gate leading to the swimming pool area. The children's program staff must ensure that the pool area is not accessible to children in the program. Administrative staff were informed about the availability of licensing standards training in the Valley Licensing Office.

Comments:

Thank you for your assistance during the unannounced monitoring inspection conducted on July 24, 2019, from 10:37 AM to 5:40 PM, on July 30, 2019 by appointment from 2:15 PM to 4:35 PM and on August 1, 2019 from 12:55 PM to 1:17 PM. On July 24, 2019, there were fourteen children, ages infancy through six years, in attendance with three staff. I viewed program activities, staffing, supervision, interactions with children, equipment, daily routines, written policies, posted information, lunch, snack, agency inspection reports, emergency supplies and drill records, injury records, five records for children, seven records for staff, staff qualifications, staff training, indoor and outdoor areas. The new adjoining room for use with infants and toddlers was measured. The children have been provided opportunities for active play in the gym and on the playground. A variety of age appropriate toys and materials were available. Books and stories have been enjoyed by the children. Staff training was scheduled for August 11 to August 13, 2019. Let me know if you need any assistance. 540/430-9259

Violations:

Standard #:	22VAC40-185-130-B
Description:	Based on a review of five records for children, and an interview with administrative staff, the program failed to obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: Child 1 is 22 months in age and the last immunization report in the file was completed on April 19, 2018. Child 2 turned two years old in May 2019, but, the only immunization record in the file was completed on April 16, 2018 prior to enrollment in April 2018. Child 3 became two in March 2019 and the only immunization record was completed on May 12, 2017 before initial enrollment. Child 4 is one year in age and the only immunization record in the file was completed on November 15, 2018 and was not updated by May 2019.
Plan of Correction:	Administrative staff will request and obtain the updated immunization records for the four children. Administrative staff will review all records of enrolled children who are under age two and make sure the immunization records are updated no later than every six months. A tracking system will be used to request additional immunization records and add information to the children's records.
Standard #:	22VAC40-185-140-A
Description:	Based on a review of five records for children, and an interview with administrative staff, the center failed to obtain a physical examination record for a child no later than one month after initial attendance. Evidence: Child 5 began attending on March 18, 2019 and there was only a copy of the immunization record in the child's file.
Plan of Correction:	The administrator or assigned child care staff will request and obtain a copy of the physical examination report for child 5. The administrator or program director will use a tracking system for requesting and obtaining physical examination records if a child begins attending without a physical examination record for the program file. Administrative staff will review all children's records to make sure they contain all required information.
Standard #:	22VAC40-185-40-E
Description:	Based on observations of the playground, morning activities, surveillance times, interviews with staff, and documentation and policy review, the licensed program did not ensure that the center's own policies and procedures required by the standards were followed at all times. Evidence: The center's policy required head counts both before leaving the playground and after returning to the day care room. On July 24, 2019, staff member 2 and 3 were seen supervising eleven children, ages infancy through four years, while staff member 4 was inside with a child at the bathroom and two additional children were dropped off with her. Staff member 7 instructed staff member 2 and 3 to bring the group of children inside at approximately 11:10 AM. Only ten children entered the building with staff member 2, 3 and 7. The eleventh child, age twenty-two months, was found on the playground by the licensing inspector at 11:17 AM and returned to the day care room at 11:21 AM. Revealed during staff interviews, a head count was conducted while the group was still outside, and no head counts were conducted according to written policy when the group returned to the room.
Plan of Correction:	The staff will receive training in center policies and any updated written procedures during the week of August 11, 2019. Administrative staff will make sure staff know and follow all required policies for accounting for children's whereabouts and providing safe playground procedures.
Standard #:	22VAC40-185-310-F
Description:	Based on observation of the outside use of the playground, and interviews with staff, the program failed to provide a separate infant/toddler playground area. Evidence: During the outside time on the morning of July 24, 2019, a mixed age group of ten children were taken outside with three staff. The group consisted of a seven month old in a stroller, two toddlers age twenty-two months, and seven preschool age children. During the observation, two additional preschool age children were dropped off at the playground.
Plan of Correction:	The staff will schedule separate outside play areas or times using the fenced yard so that infants and toddlers are not with older children during active play on the playground.
Standard #:	22VAC40-185-340-A
Description:	Based on observation of the playground, morning activities, surveillance documentation, and interviews with staff, the program staff did not ensure the care and protection of all children. Evidence: On the morning of July 24, 2019, two staff were supervising a mixed age group of eleven children, ages infancy through four years, at the latter part of the outside time while one staff was inside with one to three children, ages four to six. According to staff member 2, 3 and 7, and a review of documentation from the surveillance video of the front door and entrance area for the building, the children walked from the fenced playground and returned to the building at 11:11 AM. Staff member 2, 3 and 7 indicated that counts were done of the children either at the gate or on the pathway by the fence adjacent to handicap parking spaces. The licensing inspector went to the playground to check on the conditions of the resilient surfacing and saw a young child on the far end of the playground. Upon entering the fenced playground, three school age children, who were not part of the child day center, were seen entering the playground from the adjacent swimming pool area. The gate for the pool area was open. At 11:17 AM, while walking midway in the playground, the licensing inspector did not see an adult and saw the twenty-two month old, child 1, standing under pine trees beyond the wood composite structure, and closer to the far fence. The licensing inspector asked four school age children at the exit area of the tube slide if they knew child 1 and they indicated that he was not known to them. As the licensing inspector approached child 1, child 1 was seen holding a pine bow of a branch, looking outside of the fenced area, and was heard whimpering twice. The licensing inspector asked child 1 his name and child 1 only looked at the licensing inspector. The licensing inspector began looking outside of the fenced area and walking toward the gate, looking outside of the entrance of the playground for an adult. Next, the licensing inspector and child 1 walked inside the building and returned to the day care room at 11:21 AM. Walking toward the opening to the play area from the cubby entrance corridor, the child let go of the hand of the licensing inspector and walked ahead into the room. Staff 4 saw child 1 and asked the child about finding something to play. Most of the children were playing in the center of the room where staff 2 and 3 were standing. The licensing inspector asked the two staff if they knew who child 1 was and they identified him by name. The licensing inspector told the staff she found child 1 on the playground. The staff acknowledged they did not know child 1 did not return inside with the group. Staff 2 and 3 acknowledged they did a head count when leaving the playground and did not conduct a head count when they returned inside.
Plan of Correction:	The staff will always conduct head counts and the counts will be completed before leaving the fenced playground, during a stop while walking toward the building, and as soon as the group is walked inside of the room. The children's schedule and a log with names carried on a clip board will be used to check attendance lists and who is actually counted. The program will inquire about using an application so that stickers with the check-in time and name of the child are kept on the back of each child during attendance. During outside play time, the infants and toddlers will be taken outside separate from the older children and will not use the fenced playground at the same time. The staff will be retrained in all playground procedures during scheduled training days the week of August 11, 2019.
Standard #:	22VAC40-185-340-F
Description:	Based on observation of the playground, morning activities, surveillance documentation, and interviews with staff, the program staff did not ensure that all children under ten years of age were always within actual sight and sound supervision of staff. Evidence: On the morning of July 24, 2019, two staff were supervising a mixed age group of eleven children, ages infancy through four years, during the latter part of the outside time, while one staff was inside with one to three children, ages four to six. According to staff member 2, 3 and 7, and a review of documentation from the surveillance video of the front door and entrance area for the building, the children walked from the fenced playground and returned to the building at 11:11 AM. The licensing inspector went to the playground to check on the conditions of the resilient surfacing and saw a young child on the far end of the playground. Upon entering the fenced playground, three school age children, who were not part of the child day center, were seen entering the playground from the adjacent swimming pool area. The gate for the pool area was open. At 11:17 AM, while walking midway in the playground, the licensing inspector did not see an adult and saw the twenty-two month old, child 1, standing under pine trees beyond the wood composite structure, and closer to the far fence. The licensing inspector asked four school age children at the exit area of the tube slide if they knew child 1 and they indicated that he was not known to them. As the licensing inspector approached child 1, child 1 was seen holding a pine bow of a branch, looking outside of the fenced area, and was heard whimpering twice. The licensing inspector asked child 1 his name and child 1 only looked at the licensing inspector. The licensing inspector began looking outside of the fenced area and walking toward the gate, looking outside of the entrance of the playground for an adult. Next, the licensing inspector and child 1 walked inside the building and returned to the day care room at 11:21 AM. While walking toward the opening to the play area from the cubby entrance corridor, the child let go of the hand of the licensing inspector and walked ahead into the room. Staff 4 saw child 1 and asked the child about finding something to play. Most of the children were playing in the center of the room where staff 2 and 3 were standing. The licensing inspector asked the two staff if they knew who child 1 was and they identified him by name. The licensing inspector told the staff she found child 1 on the playground. It was estimated that child 1 was out of sight and sound supervision of staff for ten minutes.
Plan of Correction:	The staff will always conduct head counts and the counts will be completed before leaving the fenced playground, during a stop while walking toward the building, and as soon as the group is walked inside of the room. The children's schedule and a log with names carried on a clip board will be used to check attendance lists and who is actually counted. The program will inquire about using an application so that stickers with the check-in time and name of the child are kept on the back of each child during attendance. During outside play time, the infants and toddlers will be taken outside separate from the older children and will not use the fenced playground at the same time. The staff will be retrained in all playground procedures during scheduled training days the week of August 11, 2019.
Standard #:	22VAC40-185-350-C
Description:	Based on observations and interviews with staff, the program failed to ensure that when children are regularly in ongoing mixed age groups, the staff-to-children ratio applicable to the youngest child in the group was applied for meeting staffing requirements. Evidence: After 10:45 AM on July 24, 2019, the licensing inspector verified there were ten children, including an infant, two toddlers and seven preschool age children, with three staff who went onto the playground together. Staff member 4 took a four year old indoors before 11:00 AM and two more children, ages two and four years, were dropped off by a parent on the playground where staff member 2 and 3 then supervised eleven children. Indoors at around 11:10 AM, the licensing inspector observed a parent checking in two children, both six years in age, who were supervised by staff member 4 with plans to take the three children outside to join the group after a child finished in the bathroom. Three staff were scheduled to supervise the fourteen children between 11:10 AM until a parent came to pick-up the seven month old and a four year old after 11:25 AM. During the transition indoors from the playground, staff member 7 was present outside and in the hallway and indicated she was not counted in ratio due to her assigned role with the program. Interviews confirmed that children of mixed ages have been regularly combined together.
Plan of Correction:	The administrative staff and lead child care teacher who schedule children's attendance times will make sure adequate staff are scheduled to supervise children according the staff-to-child ratio requirements.
Standard #:	22VAC40-185-550-D
Description:	Based on a review of the emergency practice drill records, and interviews with administrative staff, the center failed to implement emergency practice drills as required. Evidence: There was not an evacuation drill record for December 2018 and staff could not confirm that the monthly drill was conducted. The only shelter-in-place drill viewed for 2018 was for May 14, 2018. The minimum of two shelter-in-place practice drills per year were not conducted in 2018.
Plan of Correction:	Administrative staff have planned for an evacuation drill by the end of July. An administrative staff person will make sure the required shelter-in-place drills are conducted and documented each year. Drills will be scheduled the second Friday of each month and the record of all drills will be maintained in an organized manner in the designated binder.
Standard #:	22VAC40-185-550-M
Description:	Based on a review of minor injury records, and an interview with administrative staff, the program did not maintain all required written information in the records. Evidence: The injury records for incidents on May 29, 2019 and June 17, 2019 did not include any future action planned by staff to prevent recurrence of the injuries. There was a section on action taken that was used by staff to describe treatment and other types of actions taken by staff.
Plan of Correction:	Administrative staff will make sure the staff providing care to children and treating any injuries are retrained to complete all required information on the report forms, including any preventive action for future similar injuries. The assigned program director or administrator will read the injury reports after each treatment of an injury and make sure all required information has been written on the report.
Standard #:	22VAC40-191-60-B
Description:	Based on staff interviews, and obtainment of information on file with the human resources office, the managing staff failed to obtain a completed sworn statement or affirmation prior to placing a staff member in a position with the licensed children's program. Evidence: Staff member 7 indicated that she received written notice from management that she had added responsibilities and was assigned as administrator responsible for the licensed child care operation beginning June 15, 2019. During the interviews with staff member 7 on July 24, 2019 and August 1, 2019 and contact with human resources office regarding the background checks on July 31, 2019, it was confirmed that the required sworn statement was not completed by staff member 7 until July 31, 2019. Staff member 7 confirmed that she supervises the child care staff and has been assigned involvement in the daily operations.
Plan of Correction:	Staff member 7 completed the sworn statement for the staff record. In the future, staff will not begin a position with the licensed children's program without completing a sworn statement that is viewed by administrative staff.
Standard #:	22VAC40-191-60-C-2
Description:	Based on interviews with staff, and information obtained for the records of new staff, the managing staff did not ensure that a staff member obtained a finding of the Virginia Central Registry within thirty days of a position with the licensed children's program. Evidence: Staff member 7 indicated that she received written notice from management that she had added responsibilities and was assigned as administrator responsible for the licensed child care operation beginning June 15, 2019. During the interviews with staff member 7 on July 24, 2019 and August 1, 2019 and contact with human resources office regarding the background checks on July 31, 2019, it was confirmed that the required Virginia Central Registry check was not requested in June 2019 and obtained within thirty days. Staff member 7 confirmed that she supervises the child care staff and has been assigned involvement in the daily operations. Staff indicated that on July 31, 2019, staff member 7 completed the request form so that the background check can be obtained for the record.
Plan of Correction:	The request form for the Virginia Central Registry search was sent to Richmond and the results will be obtained, viewed and maintained in the file for staff member 7. Management or assigned administrative staff will make sure requests for the central registry findings are completed within days of changes with a position and the results are obtained within thirty days.
Standard #:	63.2(17)-1720.1-B-2
Description:	Based on interviews with staff, and information obtained for the records of new staff, the managing staff did not ensure that a staff member submitted to fingerprinting and the required criminal history check was obtained prior to beginning a position and involvement in the day to day operation of the licensed program. Evidence: Staff member 7 indicated that she received written notice from management that she had added responsibilities and was assigned as administrator responsible for the licensed child care operation beginning June 15, 2019. During the interviews with staff member 7 on July 24, 2019 and August 1, 2019 and contact with human resources office regarding the background checks on July 31, 2019, it was determined that the required background check was not obtained prior to June 15, 2019. Staff member 7 confirmed that she supervises the child care staff and has been assigned involvement in the daily operations. Staff indicated that on July 31, 2019 a fingerprint appointment was made for August 1, 2019.
Plan of Correction:	The administrative staff will make sure human resources obtain the required criminal record check results to view and maintain in the file of staff member 7. In the future, management or administrative staff will make sure newly assigned staff submit to fingerprinting and the results of the criminal record check are obtained prior to staff beginning in a new position.