VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tiny Toes Creative Learning Center
4540 Plank Road
Suite E
Fredericksburg, VA 22407
(540) 412-0771

Current Inspector: Donna Liberman (540) 359-5244

Inspection Date: Feb. 21, 2024

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 (8VAC20-770) 22.1 Background Checks Code, Carbon Monoxide

Technical Assistance:

Provided consultation on standard: 1) 560F: when centers provide meals or snacks, they shall follow the most recent age-appropriate nutritional requirements of the USDA. Cookies are not typically considered to meet nutritional requirements.

Comments:

An unannounced monitoring inspection was conducted from 3:15 - 5:30pm with the center director. There were 41 children, ranging from five months to ten years of age, present with eight staff supervising. Infant care was observed and older children were observed eating snack, playing a group game, reading books, and coming inside from the playground. Four child records and four staff records were reviewed, along with the emergency drill log, written daily attendance, written allergy list, menu, and the required posted information. Please complete the columns for "Plan of Correction" and "Date to be Corrected" for each violation cited on the violation notice, and then return a signed and dated copy to the licensing office by 4:00pm on Friday, 3/29/2024. If you have further questions about this inspection, please contact Donna Liberman at 540-359-5244 or Donna.Liberman@doe.virginia.gov.

Violations:

Standard #:	22.1-289.035-A
Description:	Based on record review, the facility failed to obtain an updated Sworn Statement or repeat Virginia Child Abuse and Neglect Central Registry search results every 5 years, as required, for all staff. Evidence: the record for staff #2 had Central Registry Search results dated: 7/30/2018 and a sworn statement dated: 7/13/2018.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-130-A
Description:	Based on record review, the facility did not obtain documentation that each child has received immunizations required by the State Board of Health before the child can attend the center. Evidence: the record for child #4 (start date: 10/19/2023) did not contain documentation of immunizations.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-140-A
Description:	Based on record review, the facility did not obtain documentation of a physical examination within 30 days after the first day of attendance. Evidence: the record for child #3 (start date: 5/16/2022) did not contain documentation of a physical examination.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-160-C
Description:	Based on record review, not all staff had documentation of a negative Tuberculosis (TB) test/screening at least every two years from the date of the initial test/screening. Evidence: The record for staff #2 had documentation of a negative TB test/screening dated: 6/23/2021.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-40-M
Description:	Based on review of documentation, the facility failed to maintain a current written list of children?s allergies, sensitivities and dietary restrictions as required. Evidence: the allergy list was dated: 8/17/2023, and did not include all children with allergies, sensitivities, and dietary restrictions. The allergy list in the school-age classroom was posted outside of the class, and not kept confidential.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-60-A
Description:	Based on record review, not all records contained all required information. Evidence: the records for child #2 and child #3, with diagnosed food allergies, did not contain a written care plan that included instructions from a physician regarding the steps to be taken in the event of a suspected or confirmed allergic reaction.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-80-A
Description:	Based on review of documentation, and staff interview, the facility failed to maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: there was no attendance record in the school age classroom, and ten children observed in the classroom.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-270-A
Description:	Based on observation, it was determined that not all areas inside the center were maintained in a safe and operable condition. Evidence: In the infant classroom, there were three cribs with loose fitting sheets. Loose crib sheets are a suffocation hazard and increase the risk of sudden unexplained infant death.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-330-B
Description:	Based on observation, the facility did not ensure that resilient surfacing is under all climbing apparatus and playground equipment with moving parts. Evidence: there was less than 2? of resilient surfacing under and around the playground equipment. The bicycle ring did not have a fall zone of 6 feet with resilient surfacing.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-500-A
Description:	Based on observation, the facility failed to ensure that children wash their hands as required. Evidence: In the school-age classroom, children didn?t wash their hands after eating snack.
Plan of Correction:	Not available online. Contact Inspector for more information.