VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Bedford Area Family Young Mens Christian Assoc -Thomas Jefferson
1255 Patriot Place
Thomas Jefferson Elementary School
Forest, VA 24551
(540) 586-3483

Current Inspector: Nicole Scott (804) 588-2372

Inspection Date: Aug. 27, 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) 63.2(17) License & Registration Procedures

Comments:

An unannounced renewal inspection was made on 8/27/19. There were 58 children present with six staff supervising. Five children's records and eight staff records were reviewed. Two emergency medications were reviewed. The inspector arrived at the school at 2:55 pm and departed at 6:00 pm. The inspection was completed and exited with the child care director at the main YMCA on 8/28/19.

Violations:

Standard #:	22VAC40-185-240-D-1
Description:	Based on record review, observation, and interview, the center failed to ensure that in order to safely perform medication administration practices listed in 22 VAC 40-185-510, whenever the center has agreed to administer prescribed medications the administration shall be performed by a staff member or independent contractor who has satisfactorily completed a training program for this purpose approved by the Board of Nursing and taught by a registered nurse, licensed practical nurse, doctor of medicine or osteopathic medicine, or pharmacist; or administration shall be performed by a staff member or independent contractor who is licensed by the Commonwealth of Virginia to administer medications. Evidence: 1. There was a rectal medication that was observed for a child in care. There was no documentation in any staff record of any staff person trained with the rectal medication training module developed by the Board of Nursing. 2. Staff #1 verified that no staff at the site has the rectal medication training required.
Plan of Correction:	A staff person will take the module developed by the Board of Nursing to be trained in rectal medications.
Standard #:	22VAC40-185-340-A
Description:	Based on observation, the center failed to ensure the care, protection and guidance of the children in their care. Evidence: 1. There were seven to nine children ages five years through eight years observed jumping and running on bleachers that were stacked three risers high. The children were observed running from one end to the other on the risers and jumping to the floor. The children were observed playing on the bleachers that were three risers high during the entire time of the observation (approximately 20 minutes). This happened multiple times, more than ten times where the children climbed the bleachers and jumped down. There were multiple groups of five or more children during the time frame of approximately 20 minutes that were participating in this play on the bleachers.
Plan of Correction:	The child care director will meet with all staff and reiterate supervision requirements.
Standard #:	22VAC40-185-340-F
Description:	Based on observation, the center failed to ensure that children under 10 years of age were always within actual sight and sound supervision of staff. Evidence: 1. There were two times during open gym time where between five and seven children ages five years through seven years were out of sight supervision of staff. The children were observed in an entry way of they gym approximately 2' by 8' with concrete walls on the sides and doors leading to the outside. The children in this entry way had direct access to exit doors that lead directly to the outside. The two staff in the gym supervising the children were on the same side of the gym as the children and the concrete wall of the entry way prevented sight supervision of the children. Each time the children were out of sight supervision of the staff for approximately 3-5 minutes until a staff person went to the other side of the gym and could then see the children.
Plan of Correction:	The child care director will meet with all staff and reiterate supervision requirements.
Standard #:	22VAC40-185-340-I
Description:	Based on observation and interview, the center failed to ensure that staff greeted a child upon arrival at the center. Evidence: 1. A child was observed to arrive to the program mid-way through the program. The child is dropped off from a middle school bus to the program. The child was observed to stand at the locked entry door and knock to be allowed entry into the program. There was no staff to greet the child at arrival from the bus. The child was 10 years old. The time that the child was observed outside was less than one minute. 2. Staff #1 was asked about the process and stated that the child is dropped off by the bus and has to let the staff at the site know when at the entry door to come into the program.
Plan of Correction:	The child care director will meet with all staff and reiterate supervision requirements. The child care director will also contact the transportation department for the school to ensure the bus waits until a staff person greets the child.
Standard #:	22VAC40-185-350-E-5
Description:	Based on observation, the center failed to ensure that there was one staff person for every 18 children for children from the age of eligibility to attend public school through eight years. Evidence: 1. A staff person (#4) was observed leaving the gym area where 31 children were playing various physical games and one staff was left with the children. The children's ages were from five through eight years. The staff person left the gym for approximately three minutes.
Plan of Correction:	The staff person returned and the ratio was maintained.
Standard #:	22VAC40-185-350-E-6
Description:	Based on observation, the center failed to ensure that there was one staff person for every 20 children from nine through 12 years of age. Evidence: 1. There were 23 children from nine through 12 years old observed with one staff person in the cafeteria for approximately two minutes. The children were eating, doing homework, and playing various table games during this time. The second staff (#2) had left the cafeteria and was tending to a child in the hallway.
Plan of Correction:	The child care director will meet with all staff and reiterate supervision requirements.
Standard #:	22VAC40-185-400-B
Description:	Based on observation, the center failed to ensure that behavioral guidance was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. At arrival into the gymnasium at 3:25 pm where the children had arrived approximately 15 minutes earlier, two children were observed in time out. The children were asked why they weren't playing and informed the inspector they were in time out. The children's ages were five and eight years old. One child was observed by the inspector to ask staff #4 three different times if the child could get out of time out. The staff person kept telling the child to go back to time out. Staff #4 was observed gesturing by pointing to the time out area toward the children when they would get up as to direct them to go back to the time out area. The children were in time out until approximately 3:38 pm (approximately 13 minutes) when staff #1 arrived into the gym and the inspector informed the staff person of the length of time the children were in time out.
Plan of Correction:	The child care director will meet with all staff and reiterate supervision requirements and appropriate discipline.
Standard #:	22VAC40-185-500-A
Description:	Based on observation, the center failed to ensure that the children washed their hands or used disposable wipes after eating snack. Evidence: 1. There were approximately 10 children who were observed eating snack. The children did not wash their hands or use disposable wipes after eating.
Plan of Correction:	The child care director will meet with all staff and reiterate requirements for hand washing.
Standard #:	22VAC40-185-510-J
Description:	Based on observation and interview, the center failed to ensure that all medications were locked. Evidence: 1. There was a loose, capped syringe of prescription diazepam gel medication in a ziploc bag in a child's bookbag. The medication was not locked and was accessible to the children in care as the bookbag was kept on the back of the child's chair in the cafeteria during the inspection.
Plan of Correction:	The site director will lock it each day when the child arrives and return it to the parent when the child leaves each day.
Standard #:	22VAC40-185-560-F
Description:	Based on observation and interview, the center failed to ensure that centers followed the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: 1. The children were observed being served dry cereal for snack. There was no second component as required by USDA for a complete snack. The menu was observed an one component was on the menu since start of school, August 14, 2019. Staff #1 was asked if a second component has been served since August and staff #1 stated that only one component had been served since August 14. 2. The site director stated that the fruit order had not been received and the second component being a fruit was not available to serve.
Plan of Correction:	Staff #1 will ensure a second component is served each day.
Standard #:	22VAC40-185-560-K
Description:	Based on observation and interview, the center failed to ensure that the tables used for feeding children snack were sanitized before and after use. Evidence: 1. The children were observed using four tables for snack. The children were doing homework and playing various table games on the tables. The children were observed to eat snack and the tables were not sanitized before or after use. 2. A second group of children were observed to eat snack on the same tables and were not sanitized before use.
Plan of Correction:	Tables will be sanitized before and after.
Standard #:	22VAC40-185-560-N
Description:	Based on observation, the center failed to ensure that children did not walk around while eating. Evidence: 1. There were approximately ten children observed walking around while eating snack.
Plan of Correction:	The child care director will reiterate the requirement for children to sit while eating.