VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Amberley Child Care
1547 & 1543 Amberley Forest Road
Virginia beach, VA 23453
(757) 416-3526

Current Inspector: D'Nae Goodwin (757) 404-3063

Inspection Date: Jan. 24, 2020

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. 22VAC40-191 Background Checks (22VAC40-191)

Technical Assistance:

Medication procedures were discussed with the program director. The exposed tree roots, presenting a potential tripping hazard were discussed with the program director.

Comments:

An unannounced, mandated monitoring inspection was conducted today. The inspector was in the facility between 10:00 AM and 2:30 PM. Fifty-three children were in care. A sample size of five staff records and five children's records were reviewed. Morning activities were observed. Medication administration was reviewed. An exit meeting was conducted to the review the Acknowledgement Form with the program director.

Violations:

Standard #:	22VAC40-185-140-A
Description:	Based upon review of five children's records and staff interview, the facility has not ensured that documentation of a physical examination by or under the direction of a physician is obtained with one month after the child's attendance. Evidence: 1. The record provided for child 2, who began attending on 03/11/219, did not include the results of a physical examination. 2. The record provided for child 3, who began attending on 03/11/2019, did not include the results of a physical examination. 3. The record provided for child 5, who began attending on 09/16/2019. did not include the results of a physical examination. 4. Staff 1 verified thatrr results of physical examinations for child 2, 3 and 5 were not in the children's records.
Plan of Correction:	The facility responded with the following: In the future, parents will be required to provided results of physical examinations prior to the child attending. We will ensure that results of physical examinations are in the records of those children currently enrolled.
Standard #:	22VAC40-185-50-A
Description:	Based upon observation, the facility has not ensured that children's and staff records are treated confidentially. Evidence: The Supplemental Information sheet from the previous inspection and on which are listed staff and children's names, was posted on the parent information wall by the director's office. This form specifically states that the information on the Supplemental sheet is confidential and that the sheet is not to be posted.
Plan of Correction:	The facility responded with the following: The Supplemental Information sheet was taken down during the inspection. in the future, the Supplemental Information sheets will not be posted with the Inspection Notices.
Standard #:	22VAC40-185-70-A
Description:	Based upon review of five staff records and staff interview, the facility has not ensured that each staff record includes the name, address and telephone number of an emergency contact person. Evidence: 1. The records provided for staff 1 and 5 did not includes the addresses of the emergency contact persons. 2. Staff 1 stated that a new form that included the addresses of emergency contacts is in use with newer staff but that those staff who have been employed longer had not been required to complete new forms.
Plan of Correction:	The facility responded with the following: All staff will be required to complete the newer emergency contact forms on which the address of the emergency contact is required.
Standard #:	22VAC40-185-500-B
Description:	Based upon observation and staff interview, the facility has not ensured that disposable diapers are disposed in a leak proof or plastic-lined storage system that is either foot operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. Evidence: 1. Diaper changing procedures were observed in the infant/young toddler area. When disposing of a soiled diaper, staff 6 used her hand to open the lid of the diaper disposal can. Prior to disposal, staff 6 had laid the soiled diaper on the edge of a counter that is not a part of the diaper changing station. 2. Staff 1 observed the diapering procedure and corrected staff 6 as soon as hands were used to open the diaper disposal can.
Plan of Correction:	The facility responded with the following: Appropriate and sanitary diaper changing procedures will be reviewed and enforced with all staff. Routine observation will take place to ensure that procedures are being following.
Standard #:	22VAC40-185-510-A
Description:	Based upon review of records and staff interview, the facility has not ensured that medication is administered according to the center's written medication policies to include that medication is administered to children only with written parental authorization. to children only with written parental authorization. Evidence: 1. Documentation provided recorded that medication (albuterol) was administered to child 4 twice in May 2019, five times in September 2019 and twice in October 2019. There was no written parental authorization for the albuterol to be administered. The physican authorization for the administration of the albuterol expired in November 2019 however the albuterol was still at the facility. 2. Staff 1 verified that there was no written parental authorization for the albuterol to be administered to child 4. 3. There was an Auvi Q stored for emergency administration to child 1 in the event of an allergic reaction. There was no written parental authorization for this medication to be administered and no length of time for which authrorzation would be given.
Plan of Correction:	The facility responded with the following: The facility's written medication policy will be reviewed and re-written as necessary to ensure that procedures will be followed. The medication administration notebook will be updated to only current medication forms/authorizations. Routine weekly review of the medication and required documents will be performed and documented.
Standard #:	22VAC40-185-510-N
Description:	Based upon observation and staff interview, the facility has not ensured that medication is returned to the parent within ten days after it is no longer being administered. Evidence: 1. There was acetaminophen stored for administration to child 3. The parental authorization for the administration of the acetaminophen expired 10/18/2019. The medicaiton was not returned to the parent. 2.There was acetaminophen stored for administration to child 4. The parental authorization for the administration of the acetaminophen expired 10/18/2019. The medicaiton was not returned to the parent. 3. Staff 1 acknowledged that the parent authorizations for the above two chidlren expired on 10/18/2019 and that the medication was not returned to the parents.
Plan of Correction:	The facility responded with the following: A tracking system will be put into place to monitor authorization dates for medication. Written medication procedures for staff will be re-written to detail new procedures for medication administration.
Standard #:	22VAC40-191-60-C-2
Description:	Based upon review of five staff records and staff interview, the facility has not ensured that results of a child protective services (CPS) central registry search are obtained within 30 days of employment or the staff is denied further employ. Evidence: 1. The record provided for staff 2 indicated a date of employ of 06/14/2019. Staff 2 was on duty during the inspection. 2. Staff 1 verified that results of a CPS central registry search had not been received for staff 2 and could not provide documentation of any follow up with the office of background investigations. 3. The record provided for staff 3 indicated a date of employ of 10/03/2019. Staff 3 was on duty during the inspection. 4. Staff 1 verified that results of a CPS central registry search had not been received for staff 3 and could not provide documentation of any follow up with the office of background investigations.
Plan of Correction:	The facility responded with the following: CPS searches will be requested and documented for all staff at the time of employment. If results are not received within 30 days, the office of background investigations will be contacted and the results of the contact will be documented in the employee record. All follow-up will be documented in the employee record until acceptable results are received.