VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Children of America Salem Church, LLC
12008 Old Salem Church Rd
Fredericksburg, VA 22407
(540) 548-1555

Current Inspector: Donna Liberman (540) 359-5244

Inspection Date: Sept. 7, 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

Technical Assistance:

Provided consultation on standard: 1) 40M: The center shall maintain in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present. 2) 50: staff and children?s records shall be treated confidentially. Supplemental forms with confidential information are not to be posted in the facility. 3) 240: The Virginia Department of Education sponsored orientation course shall be completed within 90 calendar days of employment. 4) 320: restrooms shall be equipped with soap, paper towels, and disposable towels within reach of children 5) 570E; bottles shall be dated and labeled with the child's name.

Comments:

An unannounced renewal inspection was conducted from 1:20 - 5:20 pm with center director. There were 64 children, ranging from three months to five years of age, present with 13 staff supervising. Children were observed napping, having diapers changed, preparing for and eating snack, and playing with age-appropriate toys. Snack served today: sweet potato crackers and pears. Five child records, seven staff records, ten emergency medications and authorizations, four allergy care plans along with the emergency drill log, daily attendance, written allergy list, fire and health inspections were reviewed. Please complete the columns for "Plan of Correction" and "Date to be Corrected" for each violation cited on the violation notice, and then return a signed and dated copy to the licensing office by 4:00pm on Tuesday, 9/27/2022. If you have further questions about this inspection please contact Donna Liberman at 540-359-5244 or Donna.Liberman@doe.virginia.gov.

Violations:

Standard #:	22.1-289-036-B-4
Description:	Based on review of documentation, it was determined that no Out of State Child Abuse and Neglect Search request was obtained, as required, for all applicant/agents who have lived outside of Virginia in the past five years. Evidence: The records for applicant/agent #1 and applicant/agent #2, did not have documentation of an Out of State Child Abuse and Neglect Search request.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22.1-289.035-B-4
Description:	Based on review of seven staff records, it was determined that no Out of State Child Abuse and Neglect Search was requested by the end of the 30th day of employment for staff who indicated they have lived outside of Virginia in the past five years. Evidence: the record for staff #6, (Date of hire: 7/14/2022), who indicated that they have lived out of the state of Virginia in the past five years, had no documentation of an out of state search request.
Plan of Correction:	All Out of State Child Abuse and Neglect Search requests have been requested. Going forward will ensure that all requests are made within required timeframes.
Standard #:	22.1-289.036-B-2
Description:	Based on review of documentation, it was determined that not all applicant/agents had an Office of Background Investigations (OBI) fingerprinting-based criminal history record check as required. Evidence: the records for applicant/agent #1 and applicant/agent #2 did not have an OBI determination letter.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-770-40-D-1-a
Description:	Based on review of documentation, it was determined that not all applicant/agents had a sworn statement or Central Registry Search as required. Evidence: the records for applicant/agent #1 and applicant/agent #2 did not contain a sworn statement or Central Registry search results.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-770-60-C-2
Description:	Based on review of seven staff records, it was determined that not all staff had Central Registry Search results within thirty days of employment. Evidence: The record for staff #1 (Date of hire: 12/6/2021), staff #2 (Date of hire: 3/7/2022), staff #3 (Date of hire: 5/24/2022), staff #4 (Date of hire: 11/1/2021) and staff #6 (Date of hire: 7/14/2022) did not have documentation of a Central Registry search report.
Plan of Correction:	All Central Registry search requests will be completed by 9/23/22. Going forward will ensure that all requests are made within required timeframes.
Standard #:	8VAC20-780-130-A
Description:	Based on a review of four children's records, the facility did not obtain documentation that each child has received immunizations prior to the child's first attendance. Evidence: the record for child #1 (date of first attendance: 7/5/2022) and child #2 (date of first attendance: 9/6/2022) did not have documentation of immunizations.
Plan of Correction:	All missing documentation has been obtained. Going forward will ensure documentation is obtained in a timely manner.
Standard #:	8VAC20-780-140-A
Description:	Based on a review of five children's records, the facility did not obtain documentation that each child has received a physical examination prior to the child's first attendance or within one month after attendance. Evidence: the record for child #1 (date of first attendance: 7/5/2022) did not have documentation of a physical examination.
Plan of Correction:	All missing documentation has been obtained. Going forward will ensure documentation is obtained in a timely manner.
Standard #:	8VAC20-780-160-C
Description:	Based on review of six staff records, not all staff had a repeat tuberculosis (TB) test/screening at least every two years from the date of the previous test/screening. Evidence: the record for staff #4 had a TB test/screening dated: 5/26/2020.
Plan of Correction:	Staff had obtained an updated TB test/screening. Have located the missing documentation and put in in the file.
Standard #:	8VAC20-780-60-A
Description:	Based on review of five children's records, it was determined that not all records contained all required information. Evidence: the records for child #1 and child #5 did not have the names address and phone number for two emergency contacts. The record for child #5 (date of first attendance: 3/29/2021) did not have signed parental authorization to obtain emergency medical care, or documentation of viewing proof of the child's identity and age.
Plan of Correction:	All files are now complete. Going forward will ensure documentation is obtained in a timely manner.
Standard #:	8VAC20-780-70
Description:	Based on review of seven staff records, it was determined that not all records contained all required information. Evidence: The records for staff #2, #3, #5, and #6 did not contain complete documentation of two reference checks. The records for staff #3 and staff #5 did not have written information to demonstrate that the individual possesses the education, staff development, certification, and experience required by the job position and were observed acting as lead teachers in a classroom.
Plan of Correction:	All reference checks have been completed and missing documentation added to the files. Going forward will ensure documentation is completed in a timely manner.
Standard #:	8VAC20-780-80-A
Description:	Based on review of the written attendance record, and interviews with staff, it was determined that the facility did not ensure that the written record of daily attendance, for each group of children, documents the arrival and departure of all children in care as it occurs. Evidence: 1) in the infant A class, six children were observed, however seven children were listed on the attendance sheet; 2) in the infant B class, five children were observed, however only four children were listed on the attendance sheet; 3) in the pre-k class, 13 children were observed, however only 11 children were listed on the attendance sheet; 4) in the toddler class, five children were observed, however six children were listed on the attendance sheet; 5) in the two?s class, eight children were observed, however only seven children were listed on the attendance sheet 6) in the preschool IIB class, nine children were observed, however ten children were listed on the attendance sheet.
Plan of Correction:	Going forward, will ensure all children are included on the attendance sheet. Reviewed procedures with each staff member individually.
Standard #:	8VAC20-780-240-B
Description:	Based on review of seven staff records, the facility did not have documentation that all staff received orientation training as required no later than seven days of the date of assuming job responsibilities. Evidence: the record for staff #3 (date of hire: 5/24/22) and staff #5 (date of hire: 11/1/21) did not contain documentation of orientation training.
Plan of Correction:	All staff have had orientation training. The documentation has been signed and placed in each record.
Standard #:	8VAC20-780-270-A
Description:	Based on observation, it was determined that not all areas inside the center were maintained in a safe and operable condition. Evidence: In the infant A classroom, there were four cribs with loose fitting sheets on the mattress. Loose crib sheets are a suffocation hazard and increase the risk of sudden unexplained infant death.
Plan of Correction:	Parents no longer provide their own crib sheets. The center has purchased the correct size sheets, and will be responsible for ensuring that they are used and washed exclusively at the center. There are extra sheets available as well for each classroom with cribs.
Standard #:	8VAC20-780-280-B
Description:	Based on observation, it was determined that not all hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: In the infant A classroom, a bottle of sanitizing solution was observed on top of the diaper changing table and sanitizing tablets were in an unlocked cabinet. In the infant B classroom spray paint with a warning label that stated ?keep out of reach of children? and ?flammable? was observed in an unlocked cabinet. Bleach water solution was observed sitting on a counter accessible to children in the school age classroom though no children were in the class at the time.
Plan of Correction:	Retrained staff on procedures for locking hazardous substances at the staff meeting held 9/14/22.
Standard #:	8VAC20-780-350-B-1
Description:	Based on observation and staff interview, the facility failed to maintain the ratio of one staff for every four children, ages birth through 16 months. Evidence: In the infant B classroom there was one staff member alone with five children. The youngest child in the room (Date of birth: 11/1/21) was ten months old.
Plan of Correction:	Will ensure that all ratios are maintained at all times.
Standard #:	8VAC20-780-510-E
Description:	Based on review of ten emergency medications and authorizations, it was determined that the facility failed to follow their medication procedures as required. Long term prescription drug use and over-the-counter medication may be allowed with written authorization from the child?s physician and parent. Evidence: the record for child #7, #8, #9, #11, and #12 did not contain written authorization from the physician or parent for long term medication observed on site.
Plan of Correction:	All missing documentation has been obtained. Going forward will ensure documentation is obtained in a timely manner.
Standard #:	8VAC20-780-510-P
Description:	Based on review of ten emergency medications and authorizations, the facility did not ensure when an authorization for medication expires, the parent was notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Evidence: The medication authorization for child #6 expired 01/11/2022. The medication has not been returned to the parent nor has the parent renewed the medication authorization form.
Plan of Correction:	The medication authorization form has been updated. Going forward will ensure documentation is obtained in a timely manner.
Standard #:	8VAC20-780-550-E
Description:	Based on review of documentation, not all shelter-in-place drills were practiced a minimum of twice per year as required. Evidence: Documented shelter-in-place drills were conducted on: 7/6/21 and 8/16/22.
Plan of Correction:	Going forward will ensure that all drills are conducted and documented as required.
Standard #:	8VAC20-780-550-F
Description:	Based on review of documentation, not all lockdown drills were practiced at least annually as required. Evidence: The last documented lockdown drill was conducted on: 8/7/2021.
Plan of Correction:	Going forward will ensure that all drills are conducted and documented as required.