VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Barrow Center
790 Irisburg Road
Axton, VA 24054
(276) 806-2797

Current Inspector: Rebecca Forestier (540) 309-2835

Inspection Date: Dec. 12, 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 BACKGROUND CHECKS, CODE, CARBON MONOXIDE

Comments:

An unannounced monitoring inspection was conducted on 12/12/2023. There were 9 children, ages 5 months-4 years, and 5 staff members 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 in free choice activities, during lunch and during rest time. A total of 5 children?s records, 5 staff records, 5 applicant/agent records and 6 medications were reviewed. The inspector arrived for the inspection at 8:30 am and departed at 12:35 pm. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the provider.

Violations:

Standard #:	8VAC20-770-60-C-2
Description:	Based on record review, the center failed to obtain the findings from a search of the central registry within 30 days of employment. Evidence: 1. The record for Staff 2 contained a documented hire date of 06/20/2023. The findings from the search of the central registry were dated 08/04/2023. 2. The record for Staff 3 contained a documented hire date of 09/28/2023. The findings from the search of the central registry were dated 10/31/2023.
Plan of Correction:	Will follow-up when not back by day 20.
Standard #:	8VAC20-780-110-A
Description:	SYSTEMIC VIOLATION Based on record review, the center failed to ensure an individual assessment completed within six months before the child?s attendance or 30 days after the first day of attendance shall be maintained for each child. Evidence: 1. There was not an individual assessment in the record for Child 1 during the 12/12/2023 inspection; the record contained a documented start date of 08/16/2023. 2. There was not an individual assessment in the record for Child 3 during the 12/12/2023 inspection; Staff 5 verified that the start date for Child 3 was 10/19/2023. 3. There was not an individual assessment in the record for Child 4 during the 12/12/2023 inspection; Staff 5 verified that the start date for Child 3 was 11/09/2023.
Plan of Correction:	Will create a document/checklist that will be completed at enrollment.
Standard #:	8VAC20-780-120-A
Description:	SYSTEMIC VIOLATION Based on record review, the center failed to ensure that an individual service, education or treatment plan shall be developed for each child by the director or his designee and primary staff responsible for plan implementation and shall be implemented within 60 days after the first day of the child?s attendance. Evidence: There was not an individual service, education or treatment plan in the record for Child 1 during the 12/12/2023; the record contained a documented start date of 08/16/2023.
Plan of Correction:	Will create a document/checklist that will be completed at enrollment.
Standard #:	8VAC20-780-60-A
Description:	2nd REPEAT VIOLATION/ SYSTEMIC VIOLATION Based on record review, the center failed to ensure that the separate record for each enrolled child shall contain all of the elements as required by the standards. Evidence: 1. The record for Child 3 did not contain the first date of attendance. 2. The record for Child 4 did not contain the following information: the written agreements between the parent and the center as required by the standards; and the first date of attendance.
Plan of Correction:	Will make sure that all information is in the record before they start.
Standard #:	8VAC20-780-70
Description:	2nd REPEAT VIOLATION/ SYSTEMIC VIOLATION Based on record review, the center failed to ensure that each staff record contains all of the elements as required by the standards. Evidence: 1. The record for Staff 1 did not contain documentation that two or more references as to character and reputation as well as competency were checked before employment (there was only one completed reference check available for review). 2. The record for Staff 3 did not contain documentation that two or more references as to character and reputation as well as competency were checked before employment (there was only one completed reference check available for review).
Plan of Correction:	Will get 2 references before employed.
Standard #:	8VAC20-780-80-A
Description:	SYSTEMIC VIOLATION Based on observation and document review, 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: The attendance record for the Non-potty Trained group of children indicated there were 2 children present. There were 3 children observed in the group during the inspection. The attendance record did not document arrival as it occurred.
Plan of Correction:	Will create a separate attendance document.
Standard #:	8VAC20-780-240-A
Description:	Based on record review, the center failed to ensure that the Virginia Department of Education sponsored orientation course shall be completed within 90 calendar day of employment. Evidence: 1. The record for Staff 1 contained a documented hire date of 07/15/2023. There was no documentation that Staff 1 has completed the Virginia Department of Education sponsored orientation course in the record. 2. The record for Staff 2 contained a documented hire date of 06/20/2023. There was no documentation that Staff 2 has completed the Virginia Department of Education sponsored orientation course in the record.
Plan of Correction:	Staff have been told the training is due by Friday.
Standard #:	8VAC20-780-240-B
Description:	Based on record review, the center failed to ensure that staff shall complete orientation training prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Evidence: 1. The record for Staff 1 contained a documented hire date of 07/15/2023. There was no documentation that Staff 1 has completed orientation training. Staff 1 was observed working alone during the 12/12/2023 inspection. 2. The record for Staff 2 contained a documented hire date of 06/20/2023. There was no documentation that Staff 2 has completed orientation training. Staff 1 was observed working during the 12/12/2023 inspection. 3. The record for Staff 3 contained a documented hire date of 09/28/2023. There was no documentation that Staff 3 has completed orientation training. Staff 3 was observed working alone during the 12/12/2023 inspection.
Plan of Correction:	Orientation will be done before starting.
Standard #:	8VAC20-780-290-A-3
Description:	Based on observation, the center failed to ensure that in areas used by children of preschool age or younger, electrical outlets shall have protective covers. Evidence: There were two uncovered electrical outlets at ground level in the infant classroom.
Plan of Correction:	Will have staff check all outlets at opening.
Standard #:	8VAC20-780-340-D
Description:	Based on observations and record review, the center failed to ensure that in each grouping of children at least one member who meets the qualifications of a program leader or program director shall be regularly present. Evidence: 1. Staff 1 was the only staff member supervising the infant class until Staff 5 arrived at 9:00 am. Staff 1 does not meet the qualifications of a program leader or program director. 2. Staff 2 was the only staff member supervising Potty Training Class. Staff 2 does not meet the qualifications of a program leader or program director. 3. Staff 3 and Staff 4 were the only staff members supervising the Non-potty Trained Class. Staff 3 and Staff 4 do not meet the qualifications of a program leader or program director.
Plan of Correction:	We are working on getting them program lead qualified. Will rework the staff to make sure that there is a program lead with each group.
Standard #:	8VAC20-780-430-H
Description:	Based on observations and staff interviews, the center failed to ensure that trampolines may not be used. Evidence: There was a small trampoline observed in the large activity room. Staff 2 stated that it was for Child 4. Staff 2 verified that the trampoline has been used by Child 4.
Plan of Correction:	The trampoline will be removed. Plan to apply for an allowable variance.
Standard #:	8VAC20-780-510-B
Description:	SYSTEMIC VIOLATION Based on document review and staff interviews, the center failed to ensure that prescription and nonprescription medication shall be given to a child only with written authorization from the parent. Evidence: 1. Staff 5 stated that Medication 2 was administered daily to Child 5 during the summer months; the medication authorization form for Medication 2 was not signed by a parent. 2. The medication administration log for Child 5 contained documentation that Child 5 had been administered Medication 7 on 07/31/2023. There was not written authorization for the administration of Medication 7 available for Child 5. 3. The medication administration log for Child 6 contained documentation that Child 6 had been administered Medication 4 on 08/01/2023 and 08/02/2023. There was not written authorization for the administration of Medication 4 available for Child 6. 4. The medication administration log for Child 6 contained documentation that Child 6 had been administered Medication 9 on 07/26/2023 and 08/07/2023. There was not written authorization for the administration of Medication 9 available for Child 6. 5. The medication administration log for Child 6 contained documentation that Child 6 had been administered Medication 8 on 07/26/2023. There was not written authorization for the administration of Medication 8 available for Child 6.
Plan of Correction:	Will get the medication authorization forms signed before administering medication.
Standard #:	8VAC20-780-510-I
Description:	SYSTEMIC VIOLATION Based on document review and staff interviews, the center failed to ensure that medication is administered by a staff member who has satisfactorily completed a medication administration training course. Evidence: The medication administration log for Child 7 contained documentation that Medication 5 had been administered by Staff 2. Staff 5 verified that Staff 2 has not satisfactorily completed a medication administration training course.
Plan of Correction:	Will meet with the staff and check all medications.
Standard #:	8VAC20-780-510-L
Description:	SYSTEMIC VIOLATION Based on staff interviews and observations, the center failed to ensure that medications shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: Staff 1 stated that Child 1 had medications in their diaper bag. There was a total of 5 medications in the diaper bag. The diaper bag was sitting on a waist high counter in the infant room; the diaper bag was not locked to prevent access by children.
Plan of Correction:	The diaper bag will be locked daily.
Standard #:	8VAC20-780-510-N
Description:	SYSTEMIC VIOLATION Based on staff interviews and document review, the center failed to ensure that centers shall keep a record of medications given to children which shall include all of the elements required by the standards. Evidence: Staff 5 verified that Medication 1 is administered every day that Child 1 is in care. The record for Child 1 has a documented start date of 08/16/2023. There were only 7 days of documented medication administration on medication administration log. Staff 5 verified that they often forget to document the administration of the medication.
Plan of Correction:	Will document all medication administration.
Standard #:	8VAC20-780-550-D
Description:	SYSTEMIC VIOLATION Based on document review and staff interviews, the center failed to implement a monthly practice evacuation drill. Evidence: There was not a monthly evacuation drill conducted in August 2023 or September 2023. Staff 5 verified that the drills had not been conducted.
Plan of Correction:	Will put reminders on the calendar to make sure the drills are done.