VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tots N Toyland
167 Massanetta Springs Road
Rockingham, VA 22801
(540) 421-4754

Current Inspector: Julie Kunowsky (540) 430-9256

Inspection Date: Sept. 27, 2019 , Oct. 3, 2019 and Nov. 8, 2019

Complaint Related: Yes

Areas Reviewed:

22VAC40-185 ADMINISTRATION. 22VAC40-185 STAFFING AND SUPERVISION. 22VAC40-185 PROGRAMS. 22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.

Comments:

An unannounced complaint inspection was conducted on site on 09/27/2019 from 12:00 P.M.-4:15 P.M. and 10/03/2019 from 12:00 P.M.-3:30 P.M, and 11/08/2019 from 10:30 A.M.-12:00 P.M.. The investigation was completed in conjunction with a local agency in response to reports made to the Valley Licensing Office on 09/24/2019, 10/02/2019, and 10/09/2019, and a self-report received on 09/30/2019 following management review of 09/20/2019 video footage. Thirteen staff members were interviewed, and five staff records were reviewed. Classroom observations took place. The Welcome Handbook for Parents and Employees, and video footage from 09/17/2019, 09/20/2019, and 09/23/2019 were reviewed. One staff member was interviewed off site on 10/07/2019 with a local agency. The information gathered during the investigation supports the allegation, so the allegation is determined to be "valid". If you have any questions, please contact your licensing inspector at 540-430-9257.

Violations:

Standard #:	22VAC40-185-140-A
Complaint related:	No
Description:	Based on a review of children records, the center failed to ensure that there was a physical on file within 30 days of attendance for one child. Evidence: 1. Child #1 did not have a physical on file. Date of enrollment for Child #1 was 08/19/2019. 2. Staff verified that there was no physical on file for Child #1.
Plan of Correction:	The administration will ensure that all physicals are on file before children can begin attending in order to prevent exceeding the allotted time allowed for records.
Standard #:	22VAC40-185-40-E
Complaint related:	Yes
Description:	Based on review of policies and procedures, classroom video footage dated 09/17/2019 and 09/20/2019, and interviews, the operational responsibilities of the licensee did not ensure that the center's activities and services are maintained in compliance with the center's own policies and procedures that are required by these standards. Evidence: 1. The center did not follow their policy for Acceptable and Unacceptable Discipline located in the Welcome Handbook for Parents and Employees. The handbook states, "Unacceptable behaviors may include, but not limited to...inappropriate physical contact (another child or care provider). We strongly encourage positive redirection and self-discipline by leading by example. Remove the children from the situation and calmly speak with them and about their behavior. If the initial removal, redirection and conversation are ineffective a "Time-Out" will be given. The number of minutes in "Time-Out" will correspond with their age in years". 2. On 09/17/2019 Staff #8 placed Child #5 (4 years) in time out. The video footage dated 09/17/2019 shows Child #5 was placed in time out beside the trashcan against wall. Staff #8 kept Child #5 in time out for approximately one hour and four minutes before he is allowed to return to play with the other children. Staff #1 confirmed that Child #5 has been in time-out for approximately one hour and four minutes. 3. "At approximately 9:55 A.M. on 09/17/2019, Staff #8 grabbed and pulled Child #5, four year of age, up by one arm from a seated position on the floor. Staff #8 did not maintain grasp, and the child's buttocks falls to the floor. Staff #8 obtained a firmer grip, and with both feet off the floor, Staff #8 lifted Child #5 up by one arm and moved the child to floor space on the other side of the trashcan for time-out." 4. Staff #2 and Staff #9 stated on 09/20/2019 while outside on the playground that Staff #10 pulled on Child #2's hair because he wasn't listening. 5. Staff #2, Staff #3, Staff #4, Staff #6, and Staff #9 stated that they had witnessed Staff #10 pull or tug on children's hair to redirect them and make them listen. 6. The center did not follow their policy for Playground Safety located in the Welcome Handbook for Parent and Employees. The handbook states, staff responsibilities will include "directly supervise all children using sight and sound supervision at all times. Staff will position themselves near children, will not sit or congregate together, and will actively scan the environment to ensure safe play is being practiced and no additional hazard have presented." 7. On 09/20/2019 there were twenty-two children, two years to three years of age, in the care of Staff #2, Staff #3, Staff #9, and Staff #10. The four staff were sitting on the steps of the wooden structure on the large playground. Children were observed playing on the hill on the side of the play structure and were out of sight supervision of staff. 8. On 09/20/2019 Staff #2, Staff #3, Staff #9 and Staff #10 were observed huddled together around the gated entrance of the small and big playground area. Children playing in the wooden structure were out of sight supervision of the staff. 9. At approximately 10:09 A.M. on 09/20/2019 Staff #2, Staff #3, Staff #9, and Staff #10 were observed huddled together and talking with each other on the playground unaware that a two year old exited the fenced playground area with two additional two year olds.
Plan of Correction:	The offending staff member in violation of this standard was terminated immediately, reported to licensing and CPS and barred from the property. The child involved was comforted and the parent's were notified. All staff have been counseled on appropriate disciplinary actions and how to manage stress and ask for assistance. A CPS worker was invited to educate the staff on 10/08/2019 to further clarify signs of an abuser and abuse and neglect. The appropriate duration for a time-out was reviewed. Staff were encouraged to notify directors of any behavior that is questionable and reminded they are mandated reporters. Staff were reminded to position themselves in a way to never lose sight or sound supervision of children. The Center's policy that includes the verbiage "will not sit or congregate together" has been removed from the center's policy in order to allow staff the opportunity to collaborate together for the improvement of operations.
Standard #:	22VAC40-185-340-A
Complaint related:	No
Description:	Based on review of video footage dated 09/20/2019, the center failed to ensure the care, protection, and guidance of children in care. Evidence: 1. On 09/20/2019, twenty-two children ranging from two years old to three years of age were on the playground and in the care of Staff #2, Staff #9, and Staff #10. At 9:49 A.M. Staff #9 was sitting on a picnic table with her back to the entrance gate of the playground. Staff #2 was sitting on the other side of the fence facing the wooden structure, and was not able to see the playground entrance. Staff #10 was located in the track area leaning against the fence looking at a cell phone. Video footage shows a child in a grey sweatshirt, two years of age, latching and unlatching the gate and opening and closing the gate six times. At 9:51 A.M., the child exited the playground, latched and unlatched the gate, and returned to the inside of the playground area; staff were not aware that the child exited the playground. At 9:52 A.M., the child exited the fenced playground thru the gate, and closed the gate. At 9:53 A.M, Staff #9 realized that the child left the playground and directed the child back inside. 2. At approximately 10:09 A.M., on 09/20/2019, Staff #2, Staff #3, Staff #9, and Staff #10 were observed huddled together and talking with each other on the playground. At 10:12 A.M., Staff #11 entered the playground with five children and closed and latched the gate. The same two-year-old child dressed in a gray sweatshirt returned to the playground entrance and exited the fenced area of the playground unsupervised by staff; two two-year-old children followed the child and also exited the fenced playground unsupervised by staff. A fourth child exited the fenced area and took approximately four steps before staff saw the child outside of the designated area. Approximately 24 seconds elapsed from when the first child exited the gate until the fourth child was observed by staff.
Plan of Correction:	Although this violation is being appealed..because we choose to have a fence barrier around our playground, we expect children to stay with those boundaries until their attending staff are fully ready to escort them beyond it. We will continue to overlap our playground staff members during transitions to ensure the safety net of multiple staff on the and around the playground at vulnerable times. All staff have been reminded of the importance of awareness and reasonable exceptions related to the duration of time surrounding children's actions have been reviewed.The benefits of a team effort have been discussed and all staff will continue to work together to compliment each other's actions and maintain safety.
Standard #:	22VAC40-185-340-F
Complaint related:	No
Description:	Based on review of video footage on 09/17/2019 and 09/20/2019, the center failed to ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: 1. Video footage dated 09/17/2019 and time stamped at approximately 9:17 A.M., showed Staff #8 stepping outside of the doorway of Classroom #1 leaving nine children three years to four years of age on the carpet area. While out of sight supervision, Child #4 had hit and kicked a peer, and had wrapped his feet around his peer's ankles and feet. 2. On 09/20/2019, twenty-two children, ages two years to three years, were in the care of Staff #2, Staff #3, Staff #9, and Staff #10. Children were observed playing on the hill to the side of the play structure and were out of sight supervision of staff. Staff #2, Staff #3, Staff #9, and Staff #10 were sitting on the steps of the wooden structure on the large playground and unable to see the children playing on the sides of the play structure. 3. On 9/20/2019 Staff #2, Staff #3, Staff #9, and Staff #10 were observed huddled together around the connecting entrance of the small and big playground area. Children, ages two to three years, were playing in the wooden structure out of sight supervision of the four huddled staff members.
Plan of Correction:	The playground design does not allow for children to play inside the playhouse structures without having a staff member present inside the playhouses as well. Although you can see through the large windows of the playhouse structure, there are solid paneled areas that children pass behind the prevent visibility. Additionally, the playhouses block a 4 foot by 5 foot section of the playground when staff are positioned inside the structure to maintain sight and sound of children playing inside. Due to the limitations imposed on how many children are allowed to be on the playground at one time and to ensure no child has the opportunity to play around the the corner, the playhouse structures will be disassembled. Staff have been reminded that children are to never be out of sight and sound supervision. The Center's policy that includes the verbiage "will not sit or congregate together" has been removed from the center's policy in order to allow staff the opportunity to collaborate together for the improvement of operations.
Standard #:	22VAC40-185-400-B
Complaint related:	Yes
Description:	Based on review of classroom video footage dated 09/17/2019. 09/20/2019, and 09/23/2019 and interviews, the center failed to use behavioral guidance that was constructive in nature, age and stage appropriate, and intended to redirect children to appropriate behavior and resolve conflicts. Evidence: 1. On 09/17/2019, Staff #8 placed Child #5, age 4, and Child #3, age 3 in time out by the trashcan against the wall. Child #5 is kept in time out for an hour and four minutes before he is allowed to return to play with the other children. Staff #1 confirmed that Child #5 had been in time-out for one hour and four minutes. 2. Staff #2 and Staff #9 stated on 09/20/2019 while outside on the playground that Staff #10 pulled Child #2's hair because the child wasn't listening. Staff #10 sat the child in time-out and the child was seen rubbing his head where his hair had been pulled. 3. Staff #2, Staff #3, Staff #4, Staff #6, and Staff #9 stated they witnessed Staff #10 pull or tug on children's hair to redirect them and make them listen. 4. At approximately 3:12 P.M. on 09/23/2019, Child #5, (four years), was sitting on the floor next to a trashcan. Staff #8 positioned herself at eye level with and close to the child's face, directed Child #5 to "Turn around now like I told you to!" and then, placed her hands on Child #5 and roughly turned the child to face the wall.
Plan of Correction:	The offending staff member in violation of this standard was terminated immediately, reported to licensing and CPS and barred from the property. The parent's of the children involved were notified. All staff have been counseled on appropriate disciplinary actions and how to manage stress and ask for assistance. A CPS worker was invited to educate the staff on 10/08/2019 to further clarify signs of an abuser and abuse and neglect. The appropriate duration for a time-out was reviewed, as well as effective and acceptable way to maintain children's attention and institutional control of a class. Staff were encouraged to notify directors of any behavior that is questionable and reminded they are mandated reporters.
Standard #:	22VAC40-185-410-1
Complaint related:	Yes
Description:	Based on review of video footage dated 09/17/2019, 09/20/2019, and 09/23/2019, the center failed to ensure that children were not roughly handled. Evidence: 1. At approximately 9:55 A..M. on 09/17/2019, Staff #8 grabbed and pulled Child #5 (4 years) by one arm, raising Child #5 up from a seated position on the floor. Staff #8 dragged Child #5 for approximately one footstep. Staff #8 did not maintain grasp, and the child's buttocks fell to the floor. Staff #8 obtained a firmer grip on the child's arm, and with the child lifted up by one arm and both feet off the floor, Staff #8 relocated the child to floor space on the other side of a trashcan to resume time-out. Child #5 was visibly upset and placed his face in his hands. 2. At approximately 10:19 A.M. on 09/17/2019, Staff #8 pulled Child #4, (age 3), down to the floor by one arm from a standing position. 3. At approximately 10:26 A.M. on 09/20/2019, Staff #10 was directing children two years to three years of age thru the gate to exit the playground. Staff #10 pulled five children by one arm thru the gate. 4. At approximately 3:12 P.M. on 09/23/2019, Child #5, (age 4) was sitting on the floor next to the trashcan. Staff #8 redirected Child #5 to follow directives, and then placed her hands on Child #5 and roughly turned the child to face the wall.
Plan of Correction:	The offending staff member in violation of this standard was terminated immediately, reported to licensing and CPS and barred from the property. The child involved was comforted and the parent's notified. All staff have been counseled on appropriate disciplinary actions and how to manage stress and ask for assistance. A CPS worker was invited to educate the staff on 10/08/2019 to further clarify signs of an abuser and abuse and neglect. The appropriate handling of children who are being moved, which always involves two hands and a careful and gentle grip, was reviewed. Staff were encouraged to notify directors of any behavior that is questionable and reminded they are mandated reporters.
Standard #:	22VAC40-185-500-A
Complaint related:	No
Description:	Based on review of video footage on 09/20/2019, the center failed to ensure that children washed their hands before eating snack. Evidence: 1. At approximately 10:30 A.M., on 09/20/2019 children were observed coming back to Classroom #2 after outside play time. The children removed their cots and went to the table. Staff #3 and Staff #10 hand out a snack of cheerios and a drink. None of the children washed their hands before eating snack. 2. Staff #1 verified that none of the children washed their hands before eating snack.
Plan of Correction:	All staff were reminded that children are to wash their hands before drinking water or other fluids or eating any kind of food item. Staff were also instructed to restrict all food intake outside of normal eating schedules, with the exception of infants, in order to main compliance with this standard to ensure children have been given the proper amount of time to wash their hands before ingesting any food or drink items. Staff were also instructed to carry wipes during transitions to ensure child'rs hands can be cleaned whenever tehy become soiled with anything other than bodily fluids.