VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tiffany's Learning Center
12140 Amos Lane
Fredericksburg, VA 22407
(540) 845-1829

Current Inspector: Laura Brindle (540) 905-2062

Inspection Date: Dec. 14, 2023

Complaint Related: No

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies. 8VAC20-780 Special Services.

Technical Assistance:

Technical Assistance was provided to the owner regarding USDA meal requirements, and the storage of blankets in the Infant room so as not to give the impression of using the blankets in the cribs, which does not comply with Safe Sleep.

Comments:

An unannounced monitoring inspection was conducted on 12/14/23 from 9:05am to 1:45pm with the owner. There were 46 children in care, ranging in age from three-months to five-years-old, supervised by nine staff. The children were observed having free play, practicing color flashcards with the teacher, eating a morning snack, playing with blocks and cars, and reading books and singing songs. Morning snack for some children was bananas and water; for others, it was oranges and milk. Five child records were reviewed. The Center has 12 staff with current certification in CPR and First Aid, and two staff trained in Daily Health Observation. Twelve medications and authorization forms were reviewed, and the center has eight staff current in Medication Administration Training (MAT). Required postings were observed. The attendance, menu, and emergency drill log were reviewed. The most recent Fire Inspection on file was dated 12/28/22 and the most recent Health Inspection on file was dated 11/30/22. If you have questions regarding this inspection, please contact the Licensing Inspector, Laura Brindle, at laura.brindle@doe.virginia.gov or 540-905-2062. Please complete the "Plan of Correction" and "Date to be Corrected" areas on the Violation Notice for each violation cited and return to me by close of business on 12/22/23. Plans of correction should include steps to correct the noncompliance with the standard, and measures to prevent the noncompliance from occurring again.

Violations:

Standard #:	8VAC20-780-80-A
Description:	(REPEAT VIOLATION) Based on observation and review of documentation, the center did not ensure that a written record of attendance that documented the arrival and departure of each child in care as it occurred was maintained for each group of children. Evidence: On 12/14/23 at approximately 9:37am, there were 10 children in care in the ?Threes? classroom. The written attendance did not contain documentation of any children in care and the online attendance contained documentation of only six children in care.
Plan of Correction:	During the time of inspection, the lead teacher was observed by the state VQB5 program. Four additional children arrived who were not marked on the paper attendance sheet and the parents did not check them in on procare. The teacher was told to make sure attendance is marked right away on a paper attendance sheet.
Standard #:	8VAC20-780-200-A
Description:	Based on interview, the center did not have a qualified program director or a qualified back-up program director who met one of the director qualifications who was on site at least 50% of the center's hours of operation. Evidence: Staff #2 is being referred to as the Director by the center, but the staff does not meet the director qualifications at this time.
Plan of Correction:	The upcoming director has 20 years of experience in childcare as well as assistant director experience. The upcoming director is waiting on the state to come to complete an in class observation for her CDA degree. The CDA degree is the only thing which disqualifies her as a director. The center has been following up and has not been given a date. If for any reason, her observation is not complete by 1/20/24, the center has another employee who will be acting director during this time of transition.
Standard #:	8VAC20-780-260-B
Description:	Based on review of documentation and interview, the center did not provide annual approval from the health department. Evidence: The most recent health inspection provided from the center was dated 11/30/22 and the owner confirmed that was the most recent completed health inspection.
Plan of Correction:	The center was waiting for the health department inspection to take place. The health department has an unannounced inspection. The health department came on 12/19/23. There were no violations. The center has a current health department inspection.
Standard #:	8VAC20-780-510-E
Description:	(REPEAT VIOLATION) Based on review of 12 medications and medication authorization forms, the center did not follow the policy for administration of medication in that the duration of the parent?s authorization shall expire or be renewed after 10 work days, or long-term medication authorization may be allowed with written authorization from the child?s physician and parent. Evidence: 1. One medication authorization form from the parent of Child A was dated 9/26/23. The doctor?s authorization was documented as expiring on 10/31/23. Without the extended authorization from the doctor, the parent?s authorization was also expired. The medication authorization form for a second medication for Child A was dated 10/27/22 by the parent and 10/31/22 by the doctor and the authorization was documented as expiring on 10/31/23. 2. Three medication authorization forms from the parent of Child C did not contain dates that the forms were signed by the parent, in order to determine duration of authorization.
Plan of Correction:	Child A: Parents were notified upon pick up, the parents have contacted the doctor. We are just waiting on an updated form. Child C: Parents were notified upon pick up and signed/dated the forms.
Standard #:	8VAC20-780-530-A-1
Description:	Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in CPR.
Plan of Correction:	All classrooms have teachers and aides that are CPR and Mat trained. The violation is for the driver who has expired CPR. The violation was corrected on the same day by having another staff member ride with the driver. The driver and upcoming driver have been scheduled for CPR training on 12/28/23.
Standard #:	8VAC20-780-530-A-2
Description:	Based on review of documentation and interview, the center did not ensure that in each classroom or area where children are present, at least one staff member had current certification in first aid. Evidence: Staff #1 currently drives the center van to take children to and from public school. Staff #1 does not have current certification in first aid.
Plan of Correction:	The violation is for the driver who has expired CPR. The violation was corrected on the same day by having another staff member ride with the driver. The driver and upcoming driver have been scheduled for CPR training on 12/28/23.
Standard #:	8VAC20-780-560-F
Description:	Based on observation and review of documentation, the center did not ensure that when they provide meals or snacks, that they followed the most recent age-appropriate nutritional requirements of the Child and Adult Care Food Program (CACFP) of the United States Department of Agriculture (USDA). Evidence: Snack served to some classes on 12/14/23 consisted of a banana and water. On the menu for December, water was listed as the second component of a snack 15 times. The USDA does not recognize water as a component for snacks and requires two other components when water is served. Fruit snacks were also listed as a component for snack and fruit snacks are not considered a credible component by the USDA.
Plan of Correction:	After talking with the Licensing the Center decided to do milk with all meals. The violation was fixed during the inspection. The center gave milk instead of water for the second component. The center will change the snack menu to reflect milk instead of water effective January 1, 2024.