VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Gingerbread House, Inc.
305 Crescent Drive
Franklin, VA 23851
(757) 569-8658

Current Inspector: Anita Drewry (757) 404-5261

Inspection Date: July 22, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-185 ADMINISTRATION. 22VAC40-185 STAFF QUALIFICATIONS AND TRAINING. 22VAC40-185 STAFFING AND SUPERVISION.

Comments:

An unannounced inspection was conducted on July 22, 2019 in response to a self-reported incident which was received on July 11, 2019. A child with a documented food allergy was served the food to which she is allergic. Based on record review and staff interviews this incident is found to be valid. A violation in the area of care and protection was identified and appears on the violation notice.

Violations:

Standard #:	22VAC40-185-340-A
Description:	The center failed to demonstrate care and protection based on the following incident which took place on July 10, 2019. Evidence: 1 - At approximately 3:00pm on July 10, 2019 child 1, who had known allergy to peanut butter, was served a peanut butter cracker for snack by staff 2. a. In interview staff 2 stated that she was aware that child 1 was listed on the allergy sheet as a child with an allergy to peanut butter. 2 - Staff 3 who was present during snack stated that she asked staff 2 if child 1 had been served a peanut butter cracker. Staff 2 answered yes. 3 - Staff 3 stated that she attempted to use her finger to clean any peanut butter cracker out of the mouth of child 1. However, the child had already swallowed the cracker. 4 - During interview staff 3 stated that she was aware that child 1 had an allergy to peanut butter. 5 - Staff 3 reported the incident to staff 1 who removed the child from the snack room. Staff 1 stated that she had been made aware that child 1 was fed a peanut butter cracker at snack time. 6 - Upon interview staff 1 stated that she was aware that child 1 had an allergy to peanut butter. 7 - Staff 2 and 3 drew a picture showing the approximate size of the bite of peanut butter cracker child 1 ingested. The renderings measured approximately 1 inch in length with a depth of 1/4 inch. 8 - Staff 1 and 2 stated that they observed child 1's lips swell slightly after the child ingested the peanut butter cracker. 9 - The allergy action plan for child 1 calls for diphenhydramine to be administered for mild symptoms. However, the medication was not administered because it was not available in the center. a. Staff 1 stated that the medication was returned to the parent because it had expired.
Plan of Correction:	The time frame that took place for this incident lasted a total of 15 minutes. Once the situation happened, the mother was called within 4 minutes and instructed us to give the Epipen and she was on her way. At this time the child was showing no symptoms. Staff 1 & 4 took the child to the office and the Epipen. Staff 1 did not give the Epipen due to several reasons one being I panicked and the other begin she was not in any distress. The mother arrived and gave the child the Epipen, at this time her lips looked a little puffy, which the child has very define lips. The center could not administer the Benadrly for the puffy lips at this time being we had none on site for the child. The Benadryl had been sent home prior and requested for more being the medication on hand was out of date. The parents had not sent any in return. The child returned to the center the next day with all new medication. The parents came back to the center to discuss further action to reassure them that this not occur again. We discussed making the center peanut free, a staff meeting was held to refresh all staff on allergies. We made a special chair for the child that no one else uses. All staff will be have a training on allergies.