VIRGINIA DEPARTMENT OF SOCIAL SERVICES

KinderCare Learning Center - Forest
16780 Forest Road
Forest, VA 24551
(434) 455-0880

Current Inspector: Nicole Scott (804) 588-2372

Inspection Date: May 27, 2021 and June 1, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-185 ADMINISTRATION. 22VAC40-185 STAFF QUALIFICATIONS AND TRAINING. 22VAC40-185 STAFFING AND SUPERVISION. 22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES. 22VAC40-191 Background Checks (22VAC40-191) 63.2(17) License & Registration Procedures

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A monitoring inspection of a self-reported incident was initiated on May 27, 2021 and concluded on June 3, 2021. A self-reported incident was received by the department regarding allegations in the areas of supervision/food allergen served to a child. The assistant director was contacted by telephone to conduct the investigation. The assistant director provided documentation required to complete the investigation. Three staff were interviewed, three staff records were reviewed, the child's record was reviewed, medication records were reviewed, and collateral documentation was reviewed. The evidence gathered during the investigation supported the self-report of non-compliance with standards or law and violations were issued. The non-compliances identified during the inspection can be found on the violation notice.

Violations:

Standard #:	22VAC40-185-340-A
Description:	Based on interviews, the center failed to ensure that when staff are supervising children, they shall always ensure their care, protection, and guidance. Evidence: 1. On May 26, 2021, a 19 month old child was served a known food allergen at lunch. The lunch menu, posted in the classroom, listed chicken taco, shredded cheese, whole-grain tortilla, corn and salsa, oranges, milk. Child #1 has a documented allergy to dairy. Within an hour of the child being served the cheese, the child developed a localized reaction to the eye/cheek area with redness and puffiness. 2. According to interviews with staff #2 who served child #1 the lunch meal, staff #2 indicated that she was aware of the posted list of allergies for child #1 and was aware of the child's allergy. The other staff person present at lunch time, staff #3, was also aware of the allergies of child #1 and aware of the posted list. The inspector observed the list of allergies posted in the classroom which is on a 8 1/2 x 11 paper with large, red font indicating the allergies of child #1. Staff #2 indicated that she was unaware of the cheese mixed with the chicken, corn, and salsa that was served. 3. Child #1 laid down for a nap after lunch. The child awoke from the nap crying with the redness and puffiness which is the time that it was determined that the child had been given cheese at lunch.
Plan of Correction:	The center and the parent have agreed that the child's lunch will be packed by the parent to eliminate any potential for the child to ingest an allergen. The center administrative staff will complete follow-up training with staff on the importance of allergies and monitoring the foods given to children with food allergies.
Standard #:	22VAC40-185-510-A
Description:	Based on record review of medication authorizations and logs, the center failed to ensure that non-prescription medication was given to a child as per written authorization from the parent. Evidence: 1. A written parent authorization dated 1/8/2021 was reviewed for child #1 for a non-prescription liquid brand name antihistamine. The authorization was signed by the parent and by the physician (1/8/2021) to administer 3.5 mL to the child at the onset of an allergic reaction (hives). On 3/23/2021 and 3/31/2021, the dosage of 2.0 mL was documented to be given to the child as documented "mom requested" this dosage. The child was 17 months old at the time that the medication was given on 3/23/2021 and 3/31/2021. There was no written authorization for the lower dosage. The staff person who administered the medication verified to the inspector through interview that the medication was, in fact, given at a lower dose per the mother's verbal request, and there was no written authorization given for this dosage.
Plan of Correction:	All MAT trained staff will be reminded that a written authorization is required to change the dosage, and the instructions on the current written authorization are followed.
Standard #:	22VAC40-185-510-E
Description:	Based on observation of medication, the center failed to ensure that medication was labeled as required (child's name, the name of the medication, the dosage amount, and the time or times to be given). Evidence: 1. An over-the counter medication (liquid brand name antihistamine) that had been given to child #1 at 16 different times since January 22, 2021 was not labeled as required. The medication had the child's name and the name of the medication only; there was no dosage amount or time/times to be given specific for child #1 documented on the medication.
Plan of Correction:	This was corrected and verified to be corrected immediately when the inspector noted that the medication was not labeled as required.