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Culpeper Human Services - Kid Central Pearl Sample
18480 Simms Drive
Culpeper, VA 22701
(540) 829-2124

Current Inspector: Kelly Adriazola (804) 840-8245

Inspection Date: Aug. 31, 2022

Complaint Related: No

Areas Reviewed:
8VAC20-780 Administration.
8VAC20-780 Staff Qualifications and Training.
8VAC20-780 Physical Plant.
8VAC20-780 Staffing and Supervision.
8VAC20-780 Programs.
8VAC20-780 Special Care Provisions and Emergencies.
8VAC20-780 Special Services.
8VAC20-770 Background Checks (8VAC20-770)
22.1 Background Checks Code, Carbon Monoxide

An unannounced monitoring inspection was conducted on-site August 31, 2022. The director was available during the inspection. There were 0 children present as the program is currently not operating. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming, medication, special care and emergencies and nutrition. A total of 5 child records and 4 staff records were reviewed.

Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program.

Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 5 business days from today. Please specify how the deficient practice will be or has been corrected. Your plan of correction should contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measures. Please do not use staff names; list staff by positions only.

Standard #: 22.1-289.035-A
Description: Based on a review of staff records on August 31, 2022, the center failed to obtain a sworn
disclosure statement every five years for all employees.
Evidence: The record of staff #3 contained documentation of a sworn statement dated
8/28/17, which expired 8/28/22.

Plan of Correction: The program will meet the VA state licensing requirement of
22VAC40-185-70. Staff records.
3. Background checks as required by the regulation entitled Background Checks for Licensed Child Day Centers (22VAC15-51).
The program will meet this requirement by using an electronic tracker that shows when the background checks are going to expire so they can be renewed on time. This will be monitored and maintained by the Program Manager monthly.

Standard #: 8VAC20-780-70
Description: Based on a review of staff records and interview on August 31, 2022, the center failed
to ensure that each staff record contains all required information to be kept at the center.
Evidence: There were no on-site records for staff #1 and staff #5. Staff #4 stated the center
did not have the documentation needed to be kept at the center for staff #1 and staff #5.

Plan of Correction: The program will meet the VA State licensing requirement
22VAC40-185-70. Staff records.
7. Information, to be kept at the center, about any health problems which may interfere with fulfilling the job responsibilities
The program will meet this requirement by placing a copy of the Emergency Contact Information sheet which contains the required information for each employee at the center.
This is the responsibility of the Program Manager and will be monitored at each center by the Team Leader.

Standard #: 8VAC20-780-350-C
Description: Based on observation and interview on August 31, 2022, the center failed to ensure when
children are regularly in ongoing mixed age groups, the staff-to-children ratio applicable to
the youngest child in the group shall apply to the entire group.
Evidence: 1. An interview with staff #4 confirmed that during after-school care, children ages 5 years to 12 years assemble in the cafeteria.
2. For approximately 8 minutes 1 staff and approximately 35 children were observed in the
cafeteria. Staff #4 stated the youngest child in care was 5 years old.
3. When children are regularly in ongoing mixed age groups, the staff-to-children ratio
applicable to the youngest child in the group shall apply to the entire group. The applicable
staff-to-child ratio was 1 staff member for every 18 children.
4. Staff #4 confirmed the program was out of ratio with 1 staff caring for approximately 35

Plan of Correction: Corrected immediately on 8/31/22 with Pearl Sample staff
Follow up training program wide provided on 9/9/2022
The program will assure that there will always be adequate staff supervision to meet the 1:18 ratio for a mixed age 5-12 year old group per VA State licensing regulation:
22VAC40-185-350. Staff-to-children ratio requirements.
A. Staff shall be counted in the required staff-to-children ratios only when they are directly supervising children.
The program will meet this requirement by providing adequate staff for the amount of children in care and will make sure that if a staff member needs to leave their group one of the following will happen:
a. the staff member who needs to leave the group will take a number of children with him/her, leaving both staff in ratio, or
b. Another staff member will replace him/her in the group to assure that ratio is met at all times.
We have provided training to the staff members at this site to implement a system that if a staff member needs to leave the group for any reason, they will do follow the guidance above.
The Program Manager is responsible to train the staff on how to maintain staff:child ratio licensing regulations and the team Leader is responsible at the site to make sure this is followed.


A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. To find programs participating in Virginia Quality, click here.

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