VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tiny Toes Creative Learning Center II
10817 Tidewater Trail #200
Fredericksburg, VA 22408
(540) 371-8770

Current Inspector: Florence Martus (804) 389-0157

Inspection Date: Oct. 7, 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. 8VAC20-820 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 During the inspection, the inspector reviewed the areas listed above. Unless otherwise noted as a violation within this inspection report, the provider was in compliance with the standards reviewed. If there were any serious injuries or fatalities related to a violation, the details will be included in the description of the violation.

Technical Assistance:

Effective January 1, 2025, the VDOE will begin determining compliance with ? 22.1-289.057 of the Code of Virginia, which is legislation passed by the General Assembly in 2020. The law requires all licensed child day programs, religious exempt child day centers that serve preschool age children, and certified preschools to test potable drinking water. The law requires that programs submit their plans and test results to the Virginia Department of Health Office of Drinking Water (VDH ODW) and the Superintendent. If the results of the testing indicate elevated lead levels, the program shall remediate, retest, and resubmit results to VDH ODW and the Superintendent. There is an additional alternative bottled water option that comes with additional requirements. The statutory requirement can be found online at https://law.lis.virginia.gov/vacode/title22.1/chapter14.1/section22.1-289.057/. Resources are now available for providers on the "What's New" webpage on the ChildCareVA website at https://www.childcare.virginia.gov/providers/what-s-new.

Comments:

An unannounced, on-site monitoring inspection was initiated on 10/07/24 and completed on 10/15/24, as a part of the licensure period. The on-site inspection began at 9:45am and ended at 1:00pm. The inspector reviewed compliance in the areas listed above. There were 35 children present and 10 staff. The inspector reviewed five children?s records and five staff records on-site. Additional staff records were reviewed electronically on 10/15/24. This inspection included document review, tour of the facility, interviews, and observations. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations are documented on the violation notice issued to the program.

Violations:

Standard #:	8VAC20-780-130-A
Description:	The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Child #1, who had been attending for more than eight weeks, did not have documentation of an immunization record on file.
Plan of Correction:	The missing immunizations were requested and will be filed upon receipt.
Standard #:	8VAC20-780-130-E
Description:	The center shall obtain documentation of additional immunizations once every six months for children under the age of two years. Child #2, who had been in attendance for more than one year prior to turning two years old, did not have documentation of additional immunizations once every six months.
Plan of Correction:	Child is now over 2 years old. In the future, immunization updates will be requested and maintained on file.
Standard #:	8VAC20-780-140-A
Description:	Physical examinations completed by a physician shall be obtained prior to the first day of attendance or within 30 days after the first day of attendance. There was no physical examination in the record of Child #2, who had been in attendance for more than one year.
Plan of Correction:	The missing physical examination was requested.
Standard #:	8VAC20-780-160-A
Description:	Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment. The TB screening for Staff #2 was completed 18 days after the date of employment. Staff #4 had two TB screenings on file - one screening was completed more than one year prior to date of employment and the second screening was completed 11 days after the date of employment.
Plan of Correction:	Moving forward, staff will be required to provide a TB screening at the time of employment and will not be dated more than 30 days prior to employment.
Standard #:	8VAC20-780-70
Description:	The center did not maintain the required information for each staff person. The record of Staff #2, who was identified as a program leader, did not contain documentation to demonstrate that the staff member possessed the education required by the job position.
Plan of Correction:	The missing education documentation was requested and will be filed. In the future, the center will maintain the required documentation to ensure all staff members have the required documentation to meet their job description.
Standard #:	8VAC20-780-245-L
Description:	There shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. During the on-site inspection on 10/07/24, there were no staff on duty with daily health observation training.
Plan of Correction:	All staff will be required to obtain the daily health observation training to ensure there is always a staff on duty with the required training.
Standard #:	8VAC20-780-540-C
Description:	The required first aid kits did not contain the minimum requirements. The center's first aid kits and the first aid kit used during transportation did not have triangular bandages.
Plan of Correction:	Triangular bandages were ordered and will be placed in the first aid kits.
Standard #:	8VAC20-780-550-H
Description:	The center shall maintain a record of the dates of the practice drills for one year. The center did not have documentation of the emergency evacuation drill practiced during the month of May 2024.
Plan of Correction:	The center will maintain future documentation of emergency practice drills.