VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Children of America (Stephens City), LLC
201 Centre Drive
# 101
Stephens city, VA 22655
(540) 868-2700

Current Inspector: Stephanie Reed (540) 272-6558

Inspection Date: Aug. 24, 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) 20 Access to minor's records 22.1 Background Checks Code, Carbon Monoxide 32.1 Report by person other than physician 63.2 Child Abuse & Neglect

Technical Assistance:

Discussed and provided technical assistance on care, protection, guidance; behavioral guidance; diapering & handwashing; medication authorization forms; safe sleep practices; cleaning supplies, personal care items; supplies and materials including water beads

Comments:

An unannounced renewal inspection was conducted August 24, 2023 from 9:00 a.m. through 3:00 p.m. There were 86 children ages 3 months through 4 years old under the supervision of 19 staff. The physical plant, programming, supplies/materials, outdoor playground area, emergency supplies, emergency drills were inspected. Seven staff records and eight children's records were reviewed. Seven medications were reviewed. There are three staff current in Medication Administration Training (MAT). Staff training hours were reviewed. Children were observed finishing breakfast, engaged in free play activities, group story time during transition time, transition time for outdoor play. Infants were observed sleeping, having play time on the floor, drinking bottles and eating. Safe sleep practices were reviewed and determined not to be consistent with recommended guidelines; therefore the inspector provided a VDSS Safe Sleep 365 flyer and encouraged the provider to update their safe sleep practices and policy to be consistent with the safe sleep recommended guidelines. An exit interview was conducted by phone on August 29, 2023 with the director. 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 "Plan of Correction" and "Date to be Corrected" for each area of noncompliance cited on the Violation Notice and return a signed and dated copy to the licensing inspector by 5pm on September 8, 2023. Please contact me at Stephanie.Reed@doe.virginia.gov with any questions.

Violations:

Standard #:	8VAC20-780-130-A
Description:	Based on review of children?s records, not all records contained documentation of immunizations by the first day of attendance. Evidence: 1. The record for Child #6, first day of attendance 12/19/2022, did not have documentation of immunizations in the record.
Plan of Correction:	Child no longer in care
Standard #:	8VAC20-780-60-A
Description:	Based on review of children?s records, not all records contained required information. Evidence: 1. The record for Child #4, first day of attendance 8/29/2022, did not have parent?s place of employment and telephone number for parent/guardian #1 and #2. 2. The record for Child #6, first day of attendance 12/19/2022, did not have parent?s place of employment and telephone number for parent/guardian #1. 3. The record for Child #7, first day of attendance 11/14/2022, did not have a second emergency contact name, full address and telephone number that was not the parent.
Plan of Correction:	File was updated while inspector was in the office
Standard #:	8VAC20-780-270-A
Description:	REPEAT VIOLATION Based on observation, the center failed to ensure that all areas and equipment of the center were maintained in clean, safe, and operable condition. Evidence: 1.In the toddler room, the stripping was missing from the underside of the cubbies and exposed the rough particle board and created a scratching hazard. 2.In the two?s room, the stripping from the underside of the cubbies was missing in some areas and exposed the rough particle board and created a scratching hazard. There was also broken stripping that was jagged and created a scratching hazard. The cabinet under the diapering area had a broken door that created a pinch, crush and shearing hazard and a sharp metal bracket was exposed created a scratch and puncture hazard. 3.In the preschool 2 classroom, there was a thick gray film observed in and around the sink drain in the front of the classroom. The play kitchen was missing a door and had a metal hinge the entire length of the kitchen that created a pinching and scratching hazard. The play kitchen was missing several handles and exposed rough wood inside creating a scratching hazard. 4.In the PreK classroom, a light cover in the ceiling was not connected in two corners and was loosely hanging. A thick coating of dust was observed on the light. 5.In the infant c classroom, the lid of the trash can was visibly dirty and covered in orange colored dried on food debris. 6.In City Place, the stripping was missing on the underside of the cubbies and exposed the rough particle board creating a scratching hazard.
Plan of Correction:	All work orders were submitted to maintenance. The kitchen set was removed while the inspector was present. Sink Cleaned. New trash can bought 8/24/2023, stripings, city place cabinet, ceiling light cover maintenance 9/30
Standard #:	8VAC20-780-340-A
Description:	Based on observation, staff of the center failed to always ensure the care, protection and guidance of all children in care. Evidence: In the Preschool 2 classroom, two staff were observed in the bathroom together and a group of 16 children were observed in the back of the classroom across from the bathroom in the dress up center and play kitchen. Two children were observed climbing on top of and sitting on the play kitchen and one child was observed picking up an approximately four-feet-tall dress up mirror and moving it across the play area. The licensing inspector (LI) was in the classroom for several minutes before staff noticed the LI. No staff intervened in the behaviors engaged in by the children for several minutes.
Plan of Correction:	Policies on sight and sound and care and protection retrained with staff members
Standard #:	8VAC20-780-400-A
Description:	Based on observation, the center failed to ensure that staff interacted with children to provide needed help, comfort and support as required. Evidence: While in the director?s office, the licensing inspector (LI) overheard a child crying for several minutes and then overheard Staff #2 using a loud, harsh voice tone saying ?Why are you crying now, (Child #3)??
Plan of Correction:	Staff trained understanding and promoting development in the preschool years
Standard #:	8VAC20-780-500-A
Description:	REPEAT VIOLATION Based on observation, staff of the center failed to ensure children?s hands were washed with soap and water after eating. Evidence: In the toddler room, Child #2?s hands were not washed after eating breakfast.
Plan of Correction:	Meeting and training with staff member
Standard #:	8VAC20-780-500-B
Description:	Based on observation, the center failed to ensure that disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal, a nonabsorbent surface for diapering or changing was used, and that for children younger than three years, this surface shall be a changing table or countertop designated for changing. Evidence: Evidence: 2. In the infant b classroom, the diapering pad had cracks in the nonabsorbent cover and exposed the absorbent material inside. 1. In the infant 2 classroom, there was not a foot operated disposal system but a blue trash can in which the staff?s hand and diaper touch the outside/lid during disposal. 3. In the preschool 1 classroom that serves older two year olds, the diapering pad was observed on the floor in the bathroom.
Plan of Correction:	New diaper pads and trash can were purchased and replaced the old
Standard #:	8VAC20-780-520-A
Description:	Based on observation, the center failed to ensure that nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Evidence: 1.In the two?s classroom, there was an expired Aquaphor healing ointment (expired 3/23).
Plan of Correction:	expired ointment was removed while inspector was present
Standard #:	8VAC20-780-520-C
Description:	Based on observation, the center failed to ensure all diaper ointment was labeled with the child?s name. Evidence: An Aquaphor healing ointment was not labeled with the child?s name
Plan of Correction:	Correction made while inspector was in the room
Standard #:	8VAC20-780-570-A
Description:	Based on observation, the center failed to ensure that high chairs, infant carrier seats, or feeding tables were used for children under 12 months who were not held while being fed and that protective belts were not fastened securely when children were placed in an infant seat or high chair. Evidence: 1. In the infant b classroom, Infant #3, 11- month -olds, was observed lying in a boppy pillow on the floor drinking a bottle. 2. In the infant a classroom, Infant #1, age 6 months and Infant #2, age 11 months were observed sitting in the feeding table and were not strapped in. There were no straps installed on the feeding table.
Plan of Correction:	This was corrected while the inspector was in the room