VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Natural Steps Child Development Center
64 Toby Way
Palmyra, VA 22963
(434) 589-5891

Current Inspector: Kelly Adriazola (804) 840-8245

Inspection Date: Nov. 25, 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) 32.1 Report by person other than physician 63.2(17) License & Registration Procedures 63.2 Facilities & Programs.

Technical Assistance:

We discussed the requirements for infant records, cleaning supply storage and tuberculosis statements. The risk assessments for violations were provided. Also, we talked about diapering procedures, playground safety, resilient surfacing maintenance and supervision of rooms during nap time.

Comments:

Thank you for your assistance during the unannounced monitoring inspection conducted from 11:04 AM to 4:10 PM. Today, there were seventy five children, ages infancy through five years, with thirteen staff. Eight school age children received supervision after school. We viewed program activities, staffing, supervision, interactions with children, equipment, infant care, infant records, nutrition, meals, posted information, medication, diaper ointment, diapering procedures, injury records, emergency supplies and drill records, seven records for children, seven staff records, staff qualifications, staff training, agency inspection reports, indoor and outdoor areas. The staff were observed providing attentive supervision and responding to individual needs for care. The teachers have planned age appropriate activities and there were regular opportunities for art experiences. Let me know if you need any assistance. 540/430-9259

Violations:

Standard #:	22VAC40-185-160-A
Description:	Based on a review of seven records for staff, and an interview with administrative staff, the center failed to ensure that the initial tuberculosis screening and statement for one staff member was completed within twelve months prior to employment. Evidence: Staff member 4 began work on August 19, 2019 and the TB statement in the record was completed on June 2, 2016.
Plan of Correction:	The director immediately arranged for the staff member to obtain a TB screening and statement for the center record.
Standard #:	22VAC40-185-280-B
Description:	Based on observation of the bathroom areas at classrooms, and an interview with staff, the staff of the three year old pod did not ensure that the mounted storage box containing a hazardous substance was kept latched. Evidence: Before lunch, the storage box door was open and toilet bowl cleaner was visible.
Plan of Correction:	The director reviewed the requirement to keep all cleaning supplies in the latched storage boxes when they are finished using anything from the box. The teachers will make sure the storage boxes are not left open.
Standard #:	22VAC40-185-420-E-1
Description:	Based on a review of the daily records posted for parents of infants, and interviews with staff, the center failed to ensure that the amount of time infants spent on their stomachs was recorded when infants could not roll over on their own. Evidence: A daily record of a young infant who staff described as needing "tummy time" daily was viewed in Kinderlime. There was not any information for the "tummy time" during the date of the morning of the inspection and during a recent date. Staff indicated they did not record the times that infants were placed on their stomachs.
Plan of Correction:	An activity was created in Kinderlime for the documentation of the increments of time each young infant spends on their stomach. The director reviewed the requirement for including "tummy time" in the daily records posted for parents.
Standard #:	22VAC40-185-570-C
Description:	Based on a review of the records for infants fed formula at the center, and interviews with staff, the center failed to obtain all required information in writing from parents. Evidence: Staff indicated that the feeding schedule for infants has been verbally provided by parents and written by staff where it is posted in the infant area. In the registration information for infants, parents provided the brand of formula. However, parents were not asked to write the feeding schedule.
Plan of Correction:	The director is developing a feeding schedule form for parents to complete. The record will be available to the infant caregivers and kept current as part of children's records.