VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Main Street Day Care Center, Inc.
202 North Main Street
Suffolk, VA 23434
(757) 539-3431

Current Inspector: Melinda Popkin (757) 802-5281

Inspection Date: Oct. 11, 2022

Complaint Related: Yes

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision.

Comments:

A Department of Licensing Programs generated complaint inspection was initiated on 9/14/2022 and concluded on 10/11/2022. The inspector reviewed compliance in the areas of administration, staffing and supervision, and physical plant. Four staff interviews were conducted at the center and a fifth interview was conducted via telephone. Documentation to include incident reports, a photograph provided by the center, as well as written policies and procedures were reviewed. On site observations of the classroom suite, classroom, hallway and restrooms were made. 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. Therefore, the complaint is found to be Valid.

Violations:

Standard #:	8VAC20-780-40-E
Complaint related:	Yes
Description:	Based on a review of documentation and interviews, the licensee did not ensure that the center's activities, services, and facilities were maintained in compliance with the licensing standards and the center's own policies and procedures that are required by these standards. Evidence: It was established through interviews that on 3/23/2022, three or four children, three years of age, were permitted to use a restroom located down the hall from their classroom suite and that they were not in direct sight and sound supervision of staff while still in transit and after reaching the restroom. Staff #1 confirmed that she was observing a group of three year old children in route to the restroom from the doorway of the classroom suite when she returned to the classroom to assist another child. Staff #2 stated that she came down the hallway from the end opposite to the classroom and saw child #1 standing in the hallway. Staff #2 confirmed that there were no other staff in sight at that time. The written injury prevention plan for the center, viewed on site on 10/11/2022, says ?The staff will always walk to the bathroom with each child or group of children and stay within sight and sound. Once all of the bathroom breaks are done and all children are accounted for you may return to the room with the children.? Staff #5 confirmed that the written injury plan was last updated in June of 2022. Staff #1 did not comply with the center?s own injury prevention plan when she allowed children to go to the restroom outside of staff sight and sound supervision on 3/23/2022 and a child was injured while running into the restroom.
Plan of Correction:	The licensee will submit their plan or correction to the licensing inspector within 5 business days. The following written response was received by the department on 10/21/2022: "Staff were informed of incident and were instructed to go out into the hallway with their children during bathroom breaks and to remain in the hallway with them until they are done at the bathroom."
Standard #:	8VAC20-780-80-B-2
Complaint related:	Yes
Description:	Based on interviews and documentation reviewed, the center failed to inform the department?s representative of an injury to a child that required outside medical attention which occurred while the child was under the supervision of the center. Evidence: An incident report reviewed by the licensing inspector on 9/15/2022 documented an injury to a child in care at the center that occurred on 3/23/2022. Interviews with staff confirmed that a three year old child (child #1) fell and hit her head on the hinge of the bathroom stall resulting in a cut above child #1?s eyebrow. Interviews with staff #3 and staff #5 confirmed that child #1 was transported from the center by ambulance to a medical facility for treatment of the cut. The licensing inspector became aware of the injury from a source outside of the center on 9/8/2022. The center had not informed the department or the department?s representative of this injury at that time.
Plan of Correction:	The licensee will submit their plan or correction to the licensing inspector within 5 business days. The following written response was received by the department on 10/21/2022: "Director and Assistant Director were given portal information to report future injuries. Appointed Assistant Director as responsible party for reminding Director to submit report or submitting report independently."
Standard #:	8VAC20-780-270-A
Complaint related:	Yes
Description:	Based on observation, photographic and written documentation as well as interviews, the areas and equipment of the center, inside and outside, were not always maintained in a clean, safe, operable condition. Evidence: Photographic documentation, showing a door hinge / mount on the stall of a restroom used by children in care was provided to the licensing inspector in response to inquiry regarding a child who was injured while in care. The door mount hardware was a thick metal hinge which protruded approximately 1.5 inches from the bottom edge of the stall door frame. The metal hinge had an open slot where the stall door?s hardware would be inserted. However, there was no longer a door mounted on the hinge and instead, a curtain had been hung to provide privacy in the stall. Staff interviews revealed that on 3/23/2022 a three year old child fell and hit her head on the door hinge resulting in a cut above her brow that required outside medical care.
Plan of Correction:	The licensee will submit their plan or correction to the licensing inspector within 5 business days. The following written response was received by the department on 10/21/2022: "Hinge was removed from door frame to prevent further incidents."
Standard #:	8VAC20-780-340-A
Complaint related:	Yes
Description:	Based on observations, interviews with staff and a review of documentation, staff did not always ensure the care, protection and guidance of children under their supervision. Evidence: It was confirmed through interviews and documentation that a 3 year old child was running to the restroom when she fell and sustained a cut above her brow. During an interview on 10/11/2022, staff #1 stated that on 3/23/2022 three or four children were permitted to walk to the restroom located down the hallway from the classroom suite. Staff #1 stated that she intended to supervise the children in the restroom from the door of the classroom suite. An injury report completed by staff #1 and dated 3/23/2022 revealed that Staff #1 was standing at the door to the classroom suite when she `asked [child #1 (3 years old)] to walk and [child #1] turned around laughing and ran?. The report revealed that another child (child #2) was screaming from the classroom inside of the suite and staff #1 ?left from the door and helped [child #2]?That?s when I heard a scream from the hallway? The injury report documents that staff #1 saw that child #1 was in staff #2?s arms. Child #1 had fallen inside of the restroom and sustained a cut above her brow. Staff #1 confirmed in the interview that she ran back to the classroom to pour a cup of milk for child #2 when she ?heard child #1 hollering? in the hallway. Staff #1 established that her co-teacher (staff #2), who was returning from the cafeteria, saw child #1 before she did. During an interview on 10/11/2022, Staff #2 stated she was coming down the hallway toward the restrooms from the opposite end of the hallway from the classroom when she saw child #1 standing in the middle of the hallway. Staff #2 said that she ran to child #1, picked her up, and saw that she was bleeding. Staff #2 confirmed that she did not see any other staff in sight at the time that she discovered child #1 standing in the hallway. During the inspection on 10/11/2022, the inspector stood at the classroom door, which is located inside of a suite of classrooms on the same hallway as the restroom. From inside of the suite where the classroom is located, the inspector was not able to see out into the hallway or down to the restroom which is located approximately 24 feet down the hallway from the entry to the suite.
Plan of Correction:	The licensee will submit their plan or correction to the licensing inspector within 5 business days. The following written plan of correction was received by the department on 10/21/2022: "Staff will remain with children when taking them to the restroom. Additional training was completed 9/2 to ensure actual sight and sound of children at all times."
Standard #:	8VAC20-780-340-F
Complaint related:	Yes
Description:	Based on interviews with staff the program did not ensure that children under 10 years of age are in actual sight and sound supervision with the exception that they need only be able to hear a child who is using the restroom provided that there is a system for ensuring that individuals who are not staff members or persons allowed to pick up a child do not enter the restroom while in use by children. Evidence: An interview with staff #1 revealed that staff #1 was working alone in her classroom with a group of three year old children when staff #1 walked three or four children to the doorway of the suite where the classroom is located, leaving another three or four children alone in the classroom. Staff #1stated that she intended to stand in the doorway of the suite where she could view both the classroom and the door to the restroom where the children were headed. However, she said that one child in the classroom called to her saying that he did not get milk with his snack ?so [she] ran back to the classroom to get milk and gave it? to the child. The four children, advancing toward the restroom at the time, were not in staff #1?s sight or sound supervision when she returned to the classroom to assist the other child. Furthermore, once the three or four children reached the restroom staff #1 was not able to view the restroom door to ensure that anyone who was not staff or a person allowed to pick up a child did not enter the restroom.
Plan of Correction:	The licensee will submit their plan or correction to the licensing inspector within 5 business days. The following written plan of correction was received by the department on 10/21/2022: "Additional training was conducted 9/2 to ensure staff are within sight and sound of all children. Additional staff were hired to increase supervision."