VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Melrose Adventist Child Development Center
1523 Melrose Avenue, NW
Roanoke, VA 24017
(540) 685-4739

Current Inspector: Tara K Martin (804) 588-2371

Inspection Date: Aug. 8, 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. 8VAC20-770 Background Checks 22.1 Early Childhood Care and Education

Comments:

An unannounced monitoring inspection was conducted on 08/08/2023 and concluded with electronic record reviews on 08/11/2023 and 08/14/2023. There were 45 children, ages 2 years- 13 years, and 6 staff members providing direct care and supervision and various support staff present during the inspection. The inspector reviewed compliance in the areas of administration, staff qualifications and trainings, staffing and supervision, physical plant, programs, emergencies and nutrition. The children were observed during arrival, mealtime, teacher directed activities, self-directed activities, and outdoor activities. A total of 5 children?s records, and 5 staff records were reviewed. The inspector discussed the following with the provider: diapering. The inspector arrived for the inspection at 8:00 am and departed at 11:15m. The information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice to the provider. The inspection findings have been updated as a result of a review completed by the Licensing Inspector on 09/08/2023.

Violations:

Standard #:	22.1-289.011-F
Description:	Based on observation, the center failed to ensure that the violation notice, inspection summary and any other documents required by the superintendent are posted in a conspicuous place in the licensed premises. Evidence: The findings of the most recent inspection conducted on 04/12/2023 were not posted in the facility.
Plan of Correction:	Provider posted the copy of violations in front office.
Standard #:	22.1-289.035-B-2
Description:	SECOND REPEAT VIOLATION Based on record review, the center failed to ensure that no person shall be hired for compensated employment prior to the facility obtaining an employment eligibility letter upon the completion of a fingerprint background check as required by the Code of Virginia. Evidence: 1. Staff 1 had a documented hire date of 05/23/2023. The employee eligibility letter was dated 06/13/2023. 2. Staff 5 had a documented hire date of 05/06/2021. The employee eligibility letter was dated 05/08/2021.
Plan of Correction:	Do all the paperwork before they start the first day of work. Make sure that the paperwork has come back and the person is eligible to work in a child care setting.
Standard #:	8VAC20-770-60-C-2
Description:	REPEAT VIOLATION Based on record review and interview with staff, the center failed to obtain the finding from the search of the central registry within 30 days of employment. Evidence: 1. Staff 1 had a documented hire date of 05/23/2023. The search of the central registry was dated 08/10/2023. 2. Staff 4 had a documented hire date of 07/25/2020. The search of the central registry was dated 02/22/2022. 3. Staff 5 had a documented hire date of 05/06/2021. The search of the central registry was dated 02/24/2022.
Plan of Correction:	Make sure that the background checks are done and back before they start their first day of employment.
Standard #:	8VAC20-780-130-A
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on record review, the center failed to obtain documentation that each child has received the immunization required by the State Board of Health before the child can attend the center. Evidence: First date of attendance for Child 3 was 04/14/2022. The immunization record for Child 3 was dated 04/21/2023.
Plan of Correction:	Provider will make sure that children have an updated copy before they attend the center. Provider not except that the doctor will fax it over. Instead, provider will make sure they have in to file before they start.
Standard #:	8VAC20-780-160-A
Description:	SYSTEMIC DEFICIENCY Based on record review, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. Evidence: 1. Staff 2 had a hire date of 07/31/2023. The tuberculosis screening was 08/11/2023. 2. Staff 3 had a hire date of 05/15/2023. The tuberculosis screening was 06/21/2023.
Plan of Correction:	Make sure all documentation is received and filed before the first day of employment.
Standard #:	8VAC20-780-160-C
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on record review, the center failed to ensure that at least every two years from the date of the initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: The most recent tuberculosis screening for Staff 4 was dated 07/30/2020: there was not a follow-up test/screening available for review.
Plan of Correction:	Make a speadsheet to keep up with the dates that all testing needs to be redone by the staff.
Standard #:	8VAC20-780-40-M
Description:	SYSTEMIC DEFICIENCY Based on observation, the center failed to maintain, in a way that is accessible to all staff who work with children, a current written list of all children?s allergies, sensitives and restrictions documented in the allergy plan. Evidence: A written list of children?s allergies, sensitives and restrictions was not available for review during the inspection. Child 2 and Child 3 have documented allergies requiring an allergy care plan.
Plan of Correction:	Provider post allergies/sensitives in each classroom and kitchen.
Standard #:	8VAC20-780-60-A
Description:	SYSTEMIC DEFICIENCY THIRD REPEAT VIOLATION Based on record review, the center failed to ensure that the separate record for each enrolled child contains all of the elements as required by the standards. Evidence: 1. Child 1 record did not contain the following information: previous child day care and schools attended by child and work phone number for each parent (an employer was listed but the record did not contain a work phone number). 2. Child 2 record did not contain the following information: previous child day care and schools attended by child, phone number of physician and written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. A food allergy was documented. 3. Child 3 record did not contain the following information: work phone number for each parent (an employer was listed but the record did not contain a work phone number), name address and phone number of two designated people to call in an emergency if a parent cannot be reached (for one designated person, the address was incomplete and no phone number was provided) and written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. A food allergy was documented. 4. Child 4 record did not contain the following information: name address and phone number of two designated people to call in an emergency if a parent cannot be reached (the addresses for both designated people were incomplete). 5. Child 5 record did not contain the following information: chronic health problems and pertinent developmental information and any special accommodations needed, and allergies a intolerance to medication or any other substances and actions to take in an emergency situation.
Plan of Correction:	When filling paper work provider will make sure that office manager will put one child per file. Parents were asked to complete paperwork.
Standard #:	8VAC20-780-70
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on record review and interviews with staff, the center failed to ensure that staff records contain all of the elements as required by the standards. Evidence: 1. Staff 1 had a documented hire date of 05/23/2023 and did not have two required reference checks prior to employment. Two reference checks were dated 05/24/2023. 2. Staff 3 had documented hire date of 05/15/2023 and did not have two required reference checks prior to employment. Two reference checks were dated 05/17/2023.
Plan of Correction:	Make sure that reference checks are done prior to start date.
Standard #:	8VAC20-780-80-A
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on observation, the center failed to ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: At approximately 8:10 am on 08/08/2023, the daily attendance for the group of children in the Yellow Room documented 5 children. There were 9 children observed in care. The daily attendance record did not document the arrival of each child as it occurred.
Plan of Correction:	Instead of having the list at the front office provider will have the teachers check the children in on the computer and on paper.
Standard #:	8VAC20-780-270-A
Description:	SYSTEMIC DEFICIENCY Based on observation, the center failed to ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Evidence: 1. The outlet in the reading area of the Yellow Room had a broken wall plate and wires were visible. Children, ages 2 years to 5 years, were observed in this area. 2. The outlet under the TV in the Orange Room had a broken wall plate and wires were visible. Children, ages 4 years to 6 years, were observed in this room.
Plan of Correction:	Staff will fill out maintenance sheets daily. Replacement has been made.
Standard #:	8VAC20-780-280-B
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on observations the center failed to ensure that hazardous substances such as cleaning materials, insecticides and pesticides shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. There was an unlocked cabinet under the left sink in the Yellow Room that contained the following materials: Spic and Span, (2) aerosol glass cleaner, Lysol toilet bowl cleaner, and degreaser. Children were observed in this area. 2. There was an unlocked aerosol can of ?Baby Air Freshener? located on the changing table in the Yellow Room. Children were observed in this area.
Plan of Correction:	Provider spoke to staff and told them that they need to inform provider when maintenance is needed. They will move products to another cabinet.
Standard #:	8VAC20-780-330-B
Description:	SYSTEMIC DEFICIENCY Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Evidence: 1. The resilient surfacing (mulch) under the small climbing equipment with the blue slide measured approximate one inch at the base of the slide and steps. Grass and landscaping fabric were visible in multiple areas within the fall zone. The required about of resilient surfacing in the fall zones is 6 inches. Children were observed playing on this structure during the inspection. 2. The resilient surfacing (mulch) under the large climbing equipment with the yellow slide measured approximate one inch at the base of the slide and steps. Grass and landscaping fabric were visible in multiple areas within the fall zone. The required about of resilient surfacing in the fall zones is 6 inches. Children were observed playing on this structure during the inspection.
Plan of Correction:	Provider made an appointment with the landscaper to put more mulch on the playground.
Standard #:	8VAC20-780-560-F
Description:	Based on observation and interviews with staff, the center failed to ensure a menu listing foods to be served for meals and snacks during the current one-week period shall be: dated; be posted in a location conspicuous to parents or given to parents; list any substituted food and be kept on file for one week at the center. Evidence: 1. A July menu was posted in the Yellow Room. Staff 1 confirmed an August menu was not available. 2. A July menu was posted in the Green Room. Staff 6 confirmed an August menu was not available.
Plan of Correction:	Provider will make sure all menus are posted on boards in each classroom and the kitchen.
Standard #:	8VAC20-780-560-J
Description:	Based on observation and interviews with staff, the center failed to ensure that tables shall be sanitized before and after each use for feeding. Evidence: While the children were sitting at the table in the Green Room, Staff 6 was observed wiping the table with a white cloth before children were served breakfast. Staff 6 confirmed they wiped the tables with a soap and water solution and did not sanitize the tables before children ate breakfast.
Plan of Correction:	Provider reassured the staff that they are supposed to spray the table before each use.