VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Young Men's Christian Association of the Virginia Peninsulas - L
259 James Street
Smithfield, VA 23430
(757) 365-4060

Current Inspector: Melinda Popkin (757) 802-5281

Inspection Date: Dec. 1, 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. 8VAC20-820 HEARINGS PROCEDURES. 8VAC20-770 Background Checks 20 Access to minor's records 22.1 Early Childhood Care and Education 63.2 Child Abuse & Neglect

Technical Assistance:

Today we discussed several issues that were not Violations, but which could easily become a situation where a serious violation might result: - Supervision and communication between groups of children with separate staff outdoors simultaneously and organized supervision of children going to and from the outdoor restrooms. - Face to name verification at transitions (using a child roster designated for each separate group) to verify that all children remain in sight and sound supervision of the assigned staff person. - Medication that has expired (but not been administered since expiration) and the likelihood that this medication could inadvertently be administered if it is kept on site past expiration date.

Comments:

An unannounced monitoring inspection was conducted on 12/1/2023 from 11:20am-4:00pm. At the time of entrance, 64 children, ages 4 to 11 years old, were in care with 5 staff members present. The sample size consisted of 6 children?s records and 6 staff records. Children were observed during snack time, engaged in group activities to include art and games, and playing outdoors on the open fields and in the fenced play yard for the program that operates in a facility across the street. Medication administration was not observed. However medications stored on site were reviewed with regard to storage, labeling, written authorizations and required documentation. 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

Violations:

Standard #:	8VAC20-780-70
Description:	Based on a review of staff records and interview, the licensee was unable to demonstrate that each staff person had a staff record containing the required documentation. Evidence: Staff records were randomly requested based on staff present during the inspection. Six staff records were requested to be reviewed. Staff #5 and staff #6 did not have records on site at the program. The record for staff #5 was emailed to the inspector for review on 12/4/2023. However, a file for staff #6 was not made available for review.
Plan of Correction:	The record for staff #6 will be requested of the Human Resources office and maintained where it is accessible for review. All staff records will either be kept physically or stored digitally so that they may be reviewed as requested by the inspector.
Standard #:	8VAC20-780-240-A
Description:	Based on a review of records, the licensee did not ensure that each staff completes the Virginia Department of Education-sponsored orientation course within 90 calendar days of employment. Evidence: Five staff records were reviewed. The record for staff #3 (hired 5/10/2023) and staff #4 (hired 9/3/2023) did not contain documentation of the Virginia Department of Education-sponsored orientation course having been completed. The staff person in charge verified that this documentation as not in the staff records.
Plan of Correction:	Staff #3 and staff #4 will be required to complete the Virginia Preservice Training and submit their certificate of completion to be placed in their staff record within 30 days.
Standard #:	8VAC20-780-510-G
Description:	Based on a review of the medication stored on site at the program, the licensee did not ensure that each medication was labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given. Evidence: There was one EpiPen stored on site that had the child's name hand written on the container. However, the box with the prescription label verifying the child to whom, it as prescribed, the dosage amount and times to be administered was not available. The staff in charge at the time of the inspection was unable to locate the medication box for the Epi-pen.
Plan of Correction:	The parent will be asked today to bring the medication box with the prescription label for the EpiPen stored on site, verifying the child to whom it as prescribed and indicating the dosage amount and times to be administered.
Standard #:	8VAC20-780-510-P
Description:	Based on a review of medications and authorization forms present at the program, the licensee did not ensure that when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet. Evidence: There was an albuterol inhaler stored at the center for emergency use that had the most recent written authorization to administer which was dated for the previous school year. The medication, which was also expired 10/2023, had not been administered but had not been sent home or disposed of within 14 days of the authorization expiration. The staff in charge at the time of the inspection acknowledged that the written authorization for this medication was expired.
Plan of Correction:	The staff person in charge (Staff #1) stated that the parent would be asked today to update the authorization form or take the medication back until a new authorization could be obtained. Parents will be contacted when medication authorizations are close to expiring, so that appropriate actions can be taken to have the medication available, as needed.