VIRGINIA DEPARTMENT OF SOCIAL SERVICES

YMCA SACC at Harrison Road Elementary School
6230 Harrison Road
Fredericksburg, VA 22407
(540) 371-9622

Current Inspector: Donna Liberman (540) 359-5244

Inspection Date: June 15, 2022

Complaint Related: No

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Staff Qualifications and Training. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies. 8VAC20-770 Background Checks (8VAC20-770) 22.1 Background Checks Code

Comments:

An unannounced monitoring inspection was conducted on 6/15/22 from 1:00pm to 3:30pm with the on-site Director and staff. There were 122 children present, ranging in age from five- to 12-years-old, supervised by 11 staff. Children were observed rotating through ?Theater?, ?Music?, ?Art?, ?Financial Literacy?, and ?STEM? activities as grade-level groups. Six staff records and six child records were reviewed. The First Aid kit was observed. The Director reported that no children had medication on-site, but there were two staff with current certification in Medication Administration Training. There were five staff with current certification in CPR and First Aid, and five staff with current Daily Health Observation Training. The most recent health inspection on record was dated 9/9/21 and the most recent fire inspection on record was dated 6/23/21. If you have questions regarding this inspection, you may contact the Licensing Inspector, Laura Brindle, at laura.brindle@doe.virginia.gov or 540-905-2062. Please complete the ?Plan of Correction? and ?Date to be Corrected? areas on the Violation Notice for each violation cited and return to me by close of business on Friday, July 1, 2022. Plans of correction should include steps to correct the noncompliance with the standard, and measures to prevent the noncompliance from occurring again.

Violations:

Standard #:	22.1-289.035-B-2
Description:	Based on review of six staff records, the program did not obtain documentation of the results of a national fingerprint-based background check prior to date of hire for each staff. Evidence: The record submitted for Staff #1, with a hire date of 5/30/21, and the record submitted for Staff #4, with a hire date of 5/26/22, did not contain documentation of a national fingerprint-based background check.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-770-60-B
Description:	Based on review of six staff records, the program did not obtain documentation of a sworn disclosure statement for each staff prior to date of hire. Evidence: The record submitted for Staff #1, with a hire date of 5/30/21, and the record submitted for Staff #4, with a hire date of 5/26/22, did not contain documentation of a sworn disclosure statement.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-160-A
Description:	Based on review of six staff records, the program did not ensure that each staff member submitted documentation of a negative tuberculosis (TB) screening at the time of employment and prior to coming into contact with children. Evidence: The records submitted for Staff #1, with a hire date of 5/30/21, Staff #2, with a hire date of 5/26/22, Staff #5, with a hire date of 5/26/22, and Staff #6, with a hire date of 5/26/22, did not contain documentation of a TB screening.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-70
Description:	Based on review of six staff records and interview with staff, the program did not obtain all required items for staff records. Evidence: 1. The record for Staff #1, with a hire day of 5/30/21, was requested. No documents were submitted by the program for Staff #1. 2. The record submitted for Staff #2, with a hire date of 5/26/22, did not contain documentation that two or more references as to character and reputation as well as competency were checked before employment. 3. The records for Staff #3 and Staff #6, with hire date of 5/26/22, did not contain documentation that a second reference as to character and reputation as well as competency was checked before employment.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-80-A
Description:	Based on observation, record review, and interview, the program did not ensure that for each group of children a written record of daily attendance was maintained that documented the arrival and departure of each child in care as it occurred. Evidence: At approximately 2:00pm on 6/15/22 the attendance record for the 4th grade group was requested. The attendance record had not been marked for the day and children had arrived at the program at approximately 12:30pm. The group had transitioned between three different classrooms by 2:00pm.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-240-B
Description:	Based on review of six staff records, the program did not ensure that staff completed orientation training prior to the staff member working alone with children and no later than seven days from the date of assuming job responsibilities. Evidence: The records submitted for Staff #1, with a hire date of 5/30/21, Staff #2, with a hire date of 5/26/22, Staff #3, with a hire date of 5/26/22, Staff #4, with a hire date of 5/26/22, and Staff #5, with a start date of 5/26/22, did not contain documentation of orientation training. Staff began working alone with children on 6/6/22. The record submitted for Staff #6, with a hire date of 5/26/22, contained documentation of orientation training on 6/15/22. The staff began working alone with children on 6/6/22.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-340-A
Description:	Based on observation and interview, the program did not ensure the care, protection, and guidance of children in their care. Evidence: On 6/15/22 at approximately 3:00pm an adult in the building took a child from the office of the Director in order to call the parent of the child. The adult was not a staff member for the program.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-350-B-5
Description:	Based on observation and interview, the program did not ensure that the required ratio of staff-to-school-age children was maintained. Evidence: On 6/15/22 at approximately 1:05pm, one staff member was observed in a classroom with 21 school-age children. The required ratio was 1 staff: 18 children.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-530-A
Description:	Based on observation, record review, and interview, the program did not ensure that at least one staff in each classroom or area where children were present had current certification in cardiopulmonary resuscitation (CPR). Evidence: On 6/15/22 the program was observed to have six groups of children rotating through activities in five different rooms of the school. Four of the six groups did not have a staff member present who had certification in CPR.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-540-C
Description:	Based on observation and interview, the program did not ensure that the first aid kit contained all of the required items. Evidence: The first aid did not contain the required tweezers, adhesive tape, manual, triangular bandages, battery-operated flashlight, or battery-operated radio.
Plan of Correction:	Not available online. Contact Inspector for more information.