VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Lightbridge Academy Virginia Beach
2121 Salem Road
Virginia beach, VA 23456
(757) 301-9900

Current Inspector: Emily Walsh (757) 404-2575

Inspection Date: Aug. 8, 2019

Complaint Related: Yes

Areas Reviewed:

22VAC40-185 ADMINISTRATION. 22VAC40-185 STAFF QUALIFICATIONS AND TRAINING. 22VAC40-185 STAFFING AND SUPERVISION. 22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.

Comments:

A complaint was received in the Licensing office on 6/27/19 and forwarded to the eastern licensing office on 7/2/19. Investigation of the allegations was begun on 7/3/19. On site facility investigation was begun on 8/8/19. The investigation included administrator interviews, staff interviews, review of records and observation. The complainant alleged that infants were not being fed per parent direction. A preponderance of evidence was not found to support this allegation. Also alleged and determined to not be in violation was lack of parent notification of children with contagious diseases. The allegation of inadequate protection of children with allergies was determined to be valid. Violations cited can be found on the violation notice.

Violations:

Standard #:	22VAC40-185-40-E
Complaint related:	Yes
Description:	Based upon review of facility policies and records and staff interview, the facility has not ensured that their activities comply with their own policies. Evidence: 1. The facility did not follow the policies/procedures in the medication administration packet as distributed to parents. A. According to the Care Plan for Children with Special Health Needs, the provided "form should be completed by the health care provider in the event a child has any special health care needs including asthma and allergies". a.The record provided for child 1, the parent indicated that child 1 has a serious medical condition. The record contained no information from a health care provider regarding the child?s condition and needs. B. According to the Food Allergy and Anaphylaxis Emergency Care Plan, the provided "form should be completed by the health care provider and signed by both the health care provider and/or parent/guardian for any child with life-threatening allergies that require epinephrine auto injectors". a. According to the record provided, child 2 has a physician diagnosed allergy to peanuts requiring emergency administration of Benadryl and an epi-pen. Staff 1 acknowledged an awareness of this child?s need for emergency medication, stating that an epi-pen was previously found in the child?s bag. Staff 1 stated that there had been no follow through with the parent regarding the required written authorization form and provision of the needed emergency medication. C. According to the facility's Medication Administration In Child Care Policy "3. Medication will only be given.....with written consent of the child's parent/legal guardian". a. According to the documentation provided of medication administration, Benadryl was administered to child 3 by staff 5 on 6/4/2019 and 6/13/2019. The facility did not have a written authorization form from the parent for the facility's administration of the Benadryl. D. According to the facility's Medication Administration In Child Care Policy "8. All medications will be stored: Life-saving medication will be stored in the child's classroom". a. Child 4 has a physician documented allergy to peanuts, requiring the administration of emergency medication in the event of anaphylaxis. The three staff on duty in child 4's classroom the day of the inspection stated that they were not sure where the emergency medication was stored as they checked their classroom emergency bag and the required medication (epi-pen) was not in the bag. b, Staff 1 stated that they kept Benadryl for child 4 in the main office but that the epi-pen was stored in the classroom. When questioned regarding procedures, staff 1 was unable to explain why Benadryl, the first line of care for child 4, according to the life threatening allergy management plan in the child's record, was being kept in the office and not in the classroom.
Plan of Correction:	The facility responded with the following: 1.A.a We had information, from the parent,about the allergy of the child in question. The allergy is not an anaphylactic-reactive allergy and did not have a life-saving device prescribed by a health care provider. 1.B.a. The child's parent marked "NA" for allergies on our Registration paperwork, so there was no further action taken by administration until the staff found an epi-pen in the child's bag. Administration asked the parent to get an allergy plan from their health care provider, but the parent said that since we are a nut-free facility, she did not think her child would need it and removed the epi-pen from the school. Unfortunately, at the time of the inspection, the parent had the epi-pen in the child's bag again. Coincidentally, that was the child's last day, so no further action was taken. C.a We had the medication form, completed by the child's health care provider and signed by the parent, on file. We did not have the additional medication form (created by Lightbridge Academy) that is completed by the parent, not signed by a physician. This is one of the areas that, between licening and Lightbridge Academy requirements, is redundant becasue we merged both requirements.
Standard #:	22VAC40-185-340-A
Complaint related:	Yes
Description:	Based upon observation, review of records and staff interview, the facility has not ensured that when supervising children, the staff ensure the care and protection of the children. Evidence: 1. The program director admitted that office personnel had not reviewed each child's record and spoken with parents, as necessary, to ensure an awareness and understanding of each child's allergies or other special needs in order to relay this information to the staff supervising the children. 2. The program director stated that the master allergy list prepared by administrative staff and posted for staff in each classroom was not updated to include newly diagnosed children's allergies or allergies of newly enrolled children between 3/20/2019 until 6/24/2019. 3. Staff 6, 7 and 8, on duty in the mobile infant room on 8/8/2019, verified that child 4 had an allergy to peanuts and would need emergency medication. Staff checked the classroom emergency bag for the child's medication and found that the medication was not in the bag. All three staff stated that they were not sure where the medication was and had not followed up upon the child's medication with administration.
Plan of Correction:	The facility responded with the following: 1. We have reviewed all documented allergies and reviewed their files and information with their families. We also met with all classroom teachers to ensure an awareness and understanding of each child's allergies or special needs. 2. We are new to the area and have merged our Lightbridge Academy standards with Virginia licensing requirements. This was all approved with our original licensure. The posting of an allergy list is not required by licensing, but is Lightbridge Academy policy. While the posted list was not up-to-date, the internal documents were all current. 3. The medication in question was in the school office and was moved to the classroom emergency bag the same day as the inspection. We have ensured that all emergency medications are in the classroom emergency bags and all over-the-counter medication is locked in the school office.
Standard #:	22VAC40-185-340-D
Complaint related:	No
Description:	Based upon review of records and staff interviews, the facility has not ensured that in each grouping of children at least one staff member who meets the qualifications of a program leader or program director is regularly present. Evidence: 1. According to staff 1, between the dates of 3/15/2019 and 6/24/2019, the mobile infant classroom was regularly staffed by staff 2, 3 and 4. A. According to the records provided, staff 2 was the program leader. The record for staff 2 did not contain any documentation as to the qualifications (education, experience or training) required for the position of program leader. B. Staff 1 verified that staff 2 was promoted to program leader by the previous director and that she (staff 1) did not know how staff 2 was qualified for the position. C. Staff 2 verified that she was the program leader in the classroom, however she did not know how she qualified for the position. D. There was no documentation in the records of staff 3 and 4 to demonstrate that either was program leader qualified.
Plan of Correction:	The facility responded with the following: The staff member in question was promoted to lead teacher by the previous director. It was assumed that the director ensured the staff member met requirements. At the time of the inspection, the staff member was no longer at our school.
Standard #:	22VAC40-185-510-A
Complaint related:	No
Description:	Based upon review of records, the facility has not ensured that medication is given only with written authorization from the parent. Evidence: 1. According to the record provided, child 3?s allergy management plan indicates the need to administer medication if an allergic reaction develops. According to the documentation provided of medication administration, Benadryl was administered to child 3 by staff 5 on 6/4/2019 and 6/13/2019. The facility was unable to provide documentation of written authorization from the parent for staff to administer the medication. 2. Staff 1 verified that the record for child 3 did not include written parental permission for child 3 to be administered the Benadryl.
Plan of Correction:	The facility responded with the following: We had the medication form, completed by the child's health care provider and signed by the parent, on file. We did not have the additional medication form (created by Lightbridge Academy) that is completed by the parent, not signed by a physician. This is one of the areas that, between licensing and Lightbridge Academy requirements, is redundant because we merged both requirements.