VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Hazel River Assembly of God Church
14383 Hazel River Church Road
Culpeper, VA 22701
(540) 937-6041

VDSS Contact: Amy Tomblin (804) 629-3923

Inspection Date: Aug. 27, 2019 and Sept. 16, 2019

Complaint Related: Yes

Areas Reviewed:

63.2(17) License & Registration Procedures

Comments:

Thank you for your cooperation during the unannounced inspection conducted from 9:54 AM to 12:25 PM on August 27, 2019 and from 12:16 PM to 1:42 PM on September 16, 2019 for the purpose of investigating a complaint regarding staffing, appropriate supervision and behavior management, and maintenance of the environment. After completion of observations at the center, pertinent interviews, and a review of relevant records, it was determined that the only complaint issue that was valid was staffing ratios. In addition, there was a violation regarding an immunization record that was not reported as part of the initial complaint which was found in noncompliance. We discussed your plans for correction. Let me know if you have any questions. 540/430-9259

Violations:

Standard #:	63.2(17)-1716-A-3
Complaint related:	No
Description:	Based on observation of the staff and children grouped in their classroom areas, and an interview with administrative staff, the center did not ensure that the supervisory personnel maintained compliance with staff-to-children ratios in all age groups. Evidence: During the morning of August 27, 2019, there were periods when one of two staff were not present in each of the two preK groups. Close to 11:00 AM, staff member 2 was observed alone with the PreK A group of twelve four year old children (requiring a 1:10 ratio of staff to children) and two five year old children (requiring a 1:20 ratio). Staff member 1 was with the inspector during the previous hour, the tour of the center, and while returning downstairs to the office. Staff member 1 indicated that she was usually supervising the PreK A group as a teacher and thought she was needed to assist the staff of the VA Department of Social Services. After 11:00 AM, staff member 3 was observed alone with a group of eleven four year old children (requiring a 1:10 ratio) and three five year old children (requiring a 1:20 ratio). Staff member 1 indicated that she directed staff member 4, a teacher in this group, to go obtain staff files needed for a review during the inspection. When the licensing inspector went downstairs, staff member 4 was in the office and then she went to the main church building for records.
Plan of Correction:	The director will make sure no supervising teachers who are needed to meet staffing requirements leave the children for other tasks unless an additional staff person is available as a substitute for the teacher. The director will make arrangements for the associate pastor to assist if available. Also, an additional staff person will be hired, allowing for more flexibility with tasks needed that do not involve the supervision of children.
Standard #:	63.2(17)-1716-B-4
Complaint related:	No
Description:	Based on a review of four records for children, and interviews conducted with administrative staff, the center failed to ensure that all children in the center were in compliance with the provisions of the Code of Virginia regarding the immunization of children against certain diseases. Evidence: During record reviews on August 27, 2019 and September 16, 2019, and a separate interview on September 17, 2019, only an incomplete Virginia religious exempt form was in the file of child 1. The form did not have a notarized parent signature. Interviews confirmed that child 1 was not exempt from immunizations.
Plan of Correction:	The director will make sure all children have an immunization record signed by a health care provider before they begin attending the center. Only the parents of children who seek exemption from immunizations will submit a notarized form for their child. The director has been going through each child's record to make sure the immunization records were correct.