VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Learning at the Lake, LLC
16050 Mountain Road
Montpelier, VA 23192
(804) 363-9124

Current Inspector: Heather Dapper (804) 625-2304

Inspection Date: Jan. 3, 2023

Complaint Related: Yes

Areas Reviewed:

X 8VAC20-780 Administration. X 8VAC20-780 Staff Qualifications and Training. X 8VAC20-780 Physical Plant. X 8VAC20-780 Staffing and Supervision. X 8VAC20-780 Programs. X 8VAC20-780 Special Care Provisions and Emergencies X 8VAC20-780 Special Services. X 8VAC20-820 THE LICENSE. X 8VAC20-820 THE LICENSING PROCESS. X 8VAC20-820 HEARINGS PROCEDURES. X 8VAC20-770 Background Checks X 22.1 Early Childhood Care and Education X 63.2 Child Abuse & Neglect

Comments:

The licensing inspector conducted an unannounced complaint investigation in response to a complaint that was received by the Office of Child Care Health and Safety on December 30, 2022, regarding allegations in the area of supervision and behavior guidance. The investigation was initiated on January 3, 2023 and concluded on February 9, 2023. On January 3, 2023, the inspector was on site at the center from approximately 2:55pm to 3:50pm. An interview with the center representative was completed, observations were made in the center, and documentation was reviewed. The inspector and other agencies including law enforcement and Child Protective Services, completed additional interviews on January 12, 2023, January 19, 2023, and February 9, 2023. The preponderance of the evidence gathered during the investigation supports the allegation; therefore, the complaint is determined to be valid. See the violation notice for more details. 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 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. If you have any questions about this inspection, please contact the licensing inspector at (804) 929-3771.

Violations:

Standard #:	8VAC20-780-340-A
Complaint related:	Yes
Description:	Based on interviews, the center staff did not ensure the care and protection of a child they were supervising on December 22, 2022. Evidence: On January 3, 2023, January 12, 2023, January 19, 2023, and February 9, 2023 the licensing inspector and other agencies including law enforcement and Child Protective Services conducted interviews with the center director/owner, staff #1, staff #2 and additional witnesses. The following was determined: 1. Staff #1 and staff #2 was in charge of supervising child #1 (age 11 months) on December 22, 2022. Both staff members noticed that the child?s upper back changed to red or pink in color while in their care. 2. Child # 1 was seen by a physician on December 23, 2022 regarding injuries sustained while in care at the center. The physician then recommended that the child have a forensic exam in order to further evaluate the injuries. 3. It was determined that child #1 had an abrasion on his upper back described as an ?irregular area of mottled, pink discoloration containing multiple, pinpoint, red breaks in the skin?. 4. On the day of the incident, child #1?s mother inquired about the area on the child?s upper back upon pick up and prior to leaving the center. Staff #1 told her that it may have come from rolling around and scooting. 5. Shortly after Child #1 was picked up by his mother, the child?s father arrived at the center to speak with the center director/owner, who was unaware of the injury to the child?s upper back. The center director/owner reported that the injury was not reported to her by staff #1 or staff #2. 6. During an interview with Staff #1, she reported using a flat changing mat located directly on the floor and grabbing the bottom of child #1?s legs to pull him forward when he scooted back. 7. Staff #2 reported observing Staff #1 pulling the child forward to change his diaper, and afterward, Staff #1 pointed out to Staff #2 that the child?s upper back was pink. 8. The parents of child #1 reported that the child winced when the affected area was treated and it took 8 days for the injury to completely heal.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-410-1
Complaint related:	Yes
Description:	Based on interviews and review of documentation, the center did not ensure that roughly handling a child was forbidden. Evidence: 1. On January 3, 2023, January 12, 2023, and February 9, 2023, the licensing inspector and other agencies including law enforcement and Child Protective Services conducted interviews with the center director/owner, staff #1, and staff #2. The following was determined: a. Staff #1 reported the following: While changing child #1 on the floor, the child was scooting back on the carpet and she (staff #1) grabbed the bottom of the child?s legs to pull the child back onto the changing mat. She reported that this occurred a couple of times. b. Staff #2 reported the following: Child #1 began arching their back and pushing off of staff #1 with their legs. Staff #1 pulled child #1 forward to change the child?s diaper. Afterward, staff #1 pointed out that child #1?s upper back was pink. 2. Child #1 sustained an abrasion on his upper back requiring medical attention. The abrasion was described as an ?irregular area of mottled, pink discoloration containing multiple, pinpoint, red breaks in the skin?. 3. The parents of child #1 reported that it took 8 days for the injury to completely heal.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-550-P
Complaint related:	Yes
Description:	Based on record review and interviews, the center did not ensure to maintain a written record ??with all required information of children's serious and minor injuries in which entries are made the day of occurrence. Evidence: 1. Child #1 (11 months) sustained two injuries on December 22, 2022 while in care, a head injury resulting in broken skin on the left side of the child?s forehead and left lateral eyelid and an abrasion on the upper back. 2. The record of child #1 did not contain all required information related to the head injury. The following required information is missing: staff present; date and time when parents were notified; any future action to prevent recurrence of the injury; staff and parent signatures or two staff signatures; and documentation on how the parent was notified. 3. The record of child #1 did not contain any documentation related to the abrasion on the child?s upper back. 4. Staff #2 observed the injury to the child?s head at the time of occurrence and pointed out to Staff #1 that the child?s upper back was pink after Staff #1 had grabbed the bottom of the child?s legs to pull the child forward on a flat changing mat located directly on the floor.
Plan of Correction:	Not available online. Contact Inspector for more information.