VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Natural Steps Child Development Center
64 Toby Way
Palmyra, VA 22963
(434) 589-5891

Current Inspector: Kelly Adriazola (804) 840-8245

Inspection Date: March 7, 2023

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. 8VAC20-820 THE LICENSE. 8VAC20-820 THE LICENSING PROCESS. 8VAC20-770 Background Checks (8VAC20-770) 22.1 Background Checks Code, Carbon Monoxide

Comments:

An unannounced renewal inspection was conducted on-site March 7, 2023. The director was available during the inspection. There were 71 children present, ranging in ages from 6 months to 5 years, with 15 staff supervising. 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 10 child records, 1 owner record and 7 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.

Violations:

Standard #:	8VAC20-770-60-C-2
Description:	Based on a review of staff records and interview on March 7, 2023, the center failed to ensure that each staff record contained a central registry finding within 30 days of employment. Evidence: The record of staff #4, hired August 25, 2022, contained documentation of a central registry finding dated November 21, 2022. Staff #1 acknowledged the central registry was late.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-140-A
Description:	Based on a review of children's records on March 7, 2023, the center failed to obtain documentation of a physical examination by or under the direction of a physician for each child before the child's attendance or within one month after attendance. Evidence: The record of child #7, enrolled June 3, 2019, contained documentation of a physical exam dated August 27, 2019.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-40-E
Description:	Based on observation, a review of records and interview on March 7, 2023, the licensee failed to ensure that the center?s activities, services, and facilities are maintained in compliance with the center?s own polices and procedures that are required by these standards. Evidence: 1. A review of the center?s medication policy states ?any and all medication shall be administered by MAT personnel. No one other than MAT personnel will be allowed to dispense medicine. Outdated medication will not be accepted nor administered.? 2. The Albuterol medication for child #2 was observed in the original box with an expiration date of September 2022. 3. Staff #1 confirmed the medication was administered on January 23, 2023. A review of the medication log showed the medication was administered on that date by staff #7. 4. Staff #1 confirmed that staff #7 is not MAT certified.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-280-B
Description:	Based on observation on March 7, 2023, the center failed to ensure that hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. In a two year old classroom there was a can of Barbasol on the teacher's desk. The label on the Barbasol stated "keep out of reach of children" and "caution." There was bleach water located on the diaper table. There was no diapering occurring. 2. In a four year old classroom there was air freshener in an unlocked box in the bathroom. The air freshener label stated "keep out of the reach of children" and "caution." 3. In a three year old classroom there were two containers of liquid soap in an unlocked box in the bathroom. The soap label stated "keep out of the reach of children" and "caution."
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-510-I
Description:	Based on staff interview and review of the medication log on March 7, 2023, the center failed to ensure that prescription medications that would normally be administered by a parent or guardian to a child provided the medication is administered by a staff member or an independent contractor who is MAT certified. Evidence: 1. A review of the medication log indicated that medication was administered on January 23, 2023 by staff #7 to child #2. 4. Staff #1 confirmed that staff #7 is not MAT certified.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-550-P
Description:	Based on a review of records on March 7, 2023, the center failed to ensure that written records of children's serious and minor injuries contained all the required information for one of three records reviewed. Evidence: 1. The incident report for child #3 did not contain documentation of the method of notifying the parents and the date and time the parent was notified of the incident.
Plan of Correction:	Not available online. Contact Inspector for more information.