VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Augusta Health Childcare Center
127 Medical Center Circle
Fishersville, VA 22939
(540) 332-5600

Current Inspector: Michelle Argenbright (540) 848-4123

Inspection Date: Nov. 18, 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. 22VAC40-191 Background Checks (22VAC40-191) 63.2(17) License & Registration Procedures 63.2 Facilities & Programs.

Technical Assistance:

We discussed the requirements for injury records, outdoor maintenance, annual fire inspections, formula record, immunization records and background checks. The risk assessments for violations was provided. Also, we talked about fence maintenance and playground repairs, education information for records and staff training sources.

Comments:

Thank you for your assistance during today's unannounced monitoring inspection conducted from 10:58 AM to 4:35 PM. Today, there were ninety-eight children, ages infancy through five years, with sixteen staff. After school, twelve children, ages five through ten years, were supervised by one staff member. I viewed program activities, daily routines, infant care, infant records, staffing, supervision, interactions with children, equipment, posted information, agency reports, insurance, skin products, diaper ointment, nutrition, meals/snacks, medication, diapering procedures, injury records, emergency supplies and drill records, ten records for children, twelve staff records, staff qualifications, staff training, indoor and outdoor areas. The teachers have implemented age appropriate learning activities for their groups. Planning has been according to children's interests and emerging skills. Active play has been provided during regular outside time. Let me know if you need any assistance. 540/430-9259

Violations:

Standard #:	22VAC40-185-130-B
Description:	Based on a review of ten records for children, and interviews with administrative staff, the center failed to obtain documentation of additional immunizations at least once every six month for children under age two years. Evidence: Child 4 will not be two years in age until April 2020 and the immunization record completed on February 6, 2019 was not updated until September 12, 2019. Child 5 will be two years old in December 2019 and the immunization record completed on September 24, 2018 was not updated until May 23, 2019.
Plan of Correction:	Administrative staff will use a tracking and reminder system to make sure arrangements are made to obtain updated immunization records by every six months for children under age two years.
Standard #:	22VAC40-185-260-A
Description:	Based on a review of the annual agency inspection reports, and an interview with administrative staff, the center failed to ensure that an annual fire inspection report was available from the appropriate fire official. Evidence: The most recent fire inspection report was from October 31, 2018. Administrative staff indicated that the facility manager was not contacted until October 31, 2019 to begin arranging for the annual fire inspection. The inspection has was not conducted by twelve months from the last report.
Plan of Correction:	The director will inquire about arrangements for a fire inspection. In the future, contact will be made in advance of the month since the last fire inspection so that the annual inspection is not late.
Standard #:	22VAC40-185-270-A
Description:	Based on observation of the outdoor areas, and an interview with administrative staff, the center failed to maintain the playground surface in a safe condition. Evidence: The uniform, resilient surface, outside of the fall zone of equipment, had a section missing the top layers, at least thirteen inches long, and the edge of the area flapped on the top, causing a tripping hazard.
Plan of Correction:	The director is contacting the facilities manager to arrange for a repair or a safe way to make the section inaccessible until changes with the surfacing are arranged.
Standard #:	22VAC40-185-550-M
Description:	Based on a review of injury records, and an interview with administrative staff, there was required information missing from an injury report. Evidence: A minor injury record for October 14, 2019 did not have documetation of any future action to prevent recurrence of the injury.
Plan of Correction:	The director will make sure the plan to prevent recurrence is added to the injury report. The administrative staff will make sure all required documentation has been added to reports prior to filing.
Standard #:	22VAC40-185-570-C
Description:	Based on a review of the records for infants on formula, and an interview with staff, the center failed to ensure all required written information was obtained from the parent of one child. Evidence: The brand of formula and feeding schedule was not written on the feeding schedule form for child 1F.
Plan of Correction:	A teacher will arrange for a parent of child 1F to update the information on the feeding schedule form to include the brand of formula and current schedule. Whenever there are changes with formula use for infants, the teacher will make sure parents write the information on the form used for the record.
Standard #:	22VAC40-191-60-C-2
Description:	Based on a review of twelve staff records, and an interview with administrative staff, the center failed to obtain the findings of a Virginia Central Registry check for one staff member within thirty days of employment. Evidence: Staff member 11 signed the request form on October 3, 2019 and began work on October 10, 2019. There was not a recorded date for when the request form was mailed. Administrative staff indicated that they have not contacted the agency in Richmond to inquire about the status of processing the request as it became late.
Plan of Correction:	The director called and left a message with the agency in Richmond and will ask about the background check, documenting the communication for the record. The background check finding will be obtained for the record and shared with the licensing inspector. In the future, administrative staff will track request forms sent to Richmond and make sure the agency is contacted if the finding has not been received in a timely manner. All communication will be documented for the records.