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Ms. Geneva Collins-Harris
3247 Dunkirk Avenue
Norfolk, VA 23509
(757) 618-6156

Current Inspector: Trisha Brown (757) 404-2601

Inspection Date: April 18, 2018

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Household Members
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-111 Transportation
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
Today we discussed the importance of ensuring systems are in place to ensure the ability to demonstrate compliance is maintained in the absence of the licensed provider.

Comments:
An unannounced renewal inspection was conducted today from 10am through 2:30pm. At the onset to the inspection there were 10 children present with three caregivers. The family day home is licensed for nine children. The licensed provider was out-of-state on vacation during the inspection. The children present for care ranged in age from 2 months through 3? years old. The total points present equaled 29 points. Children were observed engaged in activities including outside play, snack, rest room routines, hand washing, diaper changing, lunch and nap. Violations were observed regarding operational responsibility, capacity, children's records, physicals, immunizations, caregiver records, background checks, qualifications, record keeping, first aid and cardiopulmonary resuscitation (CPR) training, rest time, hand washing and transportation. The violations may be reviewed on the violation notices. The violations were reviewed with staff present in the home and provider via telephone at the conclusion of the inspection.

Violations:
Standard #: 22VAC40-111-1010
Description: Based on interview the provider failed to ensure that during transportation of children each child is in an appropriate restraint in the accordance with Virginia law. Evidence: 1 - Staff 2 reports that she transports child 8 and 9 twice daily, to and from public school, in her personal vehicle. However, staff 2 stated that she does not have or use booster seats for the two children being transported. a. Child 8 is six years old. b. Child 9 is seven years old.

Plan of Correction: Transportation has been terminated.

Standard #: 22VAC40-111-990-B
Description: Based on interview the provider failed to ensure that the required information and emergency supplies are in the vehicle during transportation. Evidence: Staff 2 explained that she was using her personal vehicle to transport 2 children daily while the licensee is away on vacation. 1 - Staff 2 stated when transporting children in care she did not travel with the name, address and telephone number of the family day home in the vehicle. 2 - Staff 2 stated when transporting children in care she did not travel with a copy of the parents written permission to transport the child. 3 - Staff 2 stated when transporting children in care she did not travel with a copy of each child's emergency contact information. 4 - Staff 2 stated that she does not have a first aid kit in the vehicle she is using to transport children to and from public school this week.

Plan of Correction: Transportation has been terminated.

Standard #: 22VAC40-111-100-A
Description: Based on record review and interview the provider failed to obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence: 1 - The records for children 1, 4 and 5 do not have documentation of a physical examination and the documented first day of attendance was more than 30 days prior to today's inspection. a. Child 1 has a documented first date of attendance as 2/26/2018. b. Child 4 has a documented first date of attendance as 1/16/2018. c. Child 5 has a documented first date of attendance as 10/11/2017. 2 - Child 1, 4 and 5 were present for care during the inspection today. 3 - Staff 1 confirmed that the records for child 1, 4 and 5 do not contain documentation of physical examinations.

Plan of Correction: The provider will reread sections A and B for 22 VAC 40-111-100 Physical examinations for children. (4/18/2018) The provider will contact all parents to ensure that all children in care have documentation of physical and or health record. (4/18/18) (a-d) The provider will highlight every required space on the application that requires documentation to ensure that all documentation is attached. To prevent this from happening in the future, the provider will send a written notice and make verbal contact with parents when children need an updated physical based on the time frames outlined in section B of standard 22 VAC 40-111-100. (ongoing) The provider will highlight the back of page 2 of the ?Child?s Record? form to ensure that all children have the required documentation on record for review. In the future the provider will ensure that all children have all required documentation per page 2 of the Child Record form prior accepting that child in care.

Standard #: 22VAC40-111-120-A
Description: Based on record review and interview the provider failed to maintain a r cord for each caregiver. Evidence: 1 - There are not any records in the family day home for staff 2 and 3. a - Staff 2 and 3 were present and providing direct care to children in the family day home during the inspection today. 2 - Staff 1 confirmed that there were not any records for staff 2 and 3 available for review in the family day home during today's inspection. 3 ? Staff 2 reported beginning work on April 16, 2018.

Plan of Correction: The provider will develop folders for each of the assistance/caregivers mentioned in the violation description. The provider will complete an Assistant/Substitute Provider Record for each caregiver/assistant. The provider will complete all required documentation for each assistant/substitute providing care to children within the home. The provider will print and use the staff check off list to ensure that all staff members have correct required documentation. The provider will create and label each staff members folder and house the correct required documentation as cited in the violation description. Each staff member will have his/her own folder with personal information and all required documentation.

Standard #: 22VAC40-111-120-C
Description: Based on record review and interview the provider failed to maintain documentation of the time of arrivals and departures of the substitute provider. Evidence: The family day home was open and operating from April 16th through April 24 from 7am to 5:30pm. During those times during those times staff 1,2, and 3 were placed in the roll of substitute provider 1 - The substitute prover, staff1, did not have a log sheet indicating the time she arrived and departed each day in the absence of the licensee. a. Staff 1 was present and functioning as the substitute provider in the absence of the licensee on April 16th through April 24.

Plan of Correction: Upon my absence a substitute will sign a substitute sheet upon arrival and departures. The provider will keep a substitute sign in and out sheet in the back of the assistant sign in book and it will be available and substitutes will be required to sign in and out during provider?s absence.

Standard #: 22VAC40-111-30-A
Description: Based upon observation and interviews, the licensee has not demonstrated operational responsibility regarding ensuring compliance with these standards and the terms of the current license issued by the department and with relevant federal, state or local and other relevant regulation Evidence: 1 ? Nineteen violations were found in seven out of the eleven area the standards for licensed family day care homes, and the Code of Virginia, including administration, personnel, caregiver training, physical environment and equipment, preventing the spread of disease, emergencies, transportation and background checks. 2 ? The licensee was not present in the home during the inspection as she was out-of-state on vacation beginning on the evening of April 16th and returned on the evening of April 24th. 3 - Violations cited in the areas of administration, personnel, caregiver training, physical environment and equipment, preventing the spread of disease, emergencies, transportation and background checks require a level of responsibility and knowledge beyond those an assistant or substitute provider.

Plan of Correction: 1- Provider will read standards daily to ensure that she is sure that she understands the standards and that she is able prevent further violations in the areas listed in the description of the violations indicated by the inspector. 1 - The provider will review all caregiver?s records to ensure that the correct requirements are present, and that each caregiver is eligible to provide care to young children. (4/25/2018) 2- While the provider will continue to notify parents prior to any vacation taken. The provider will continue to provide emergency numbers to the parents in case of emergencies while out of town. The provider will continue to have assistance and designated substitute providers sign in and out daily in the assistant/substitute provider booklet. 3- Provider will continue to review the standards daily to ensure compliance. Provider will also ensure that all assistants and substitute providers are trained and understand the standards and/or job responsibilities. To ensure that they are aware of the standards the provider will require assistants/substitute providers to complete the 10hr preservice training to ensure that they are knowledge. This will help close any gaps missed during orientation/assistant training. In addition, all assistants/substitute providers have completed the background checks and they are eligible to work around children. Future plan of action: 1- The provider will reread the following areas of licensing, Part II Administration, Part III Personnel, and Part V to ensure that all caregivers are eligible to provide care to children in a family day home setting. 1 - The provider and staff will continuously review the following areas of the of the Standards for a Family Day Home on a weekly basis. (Part VI Caregiver training, Part VII Care for Children, Part IX Preventing the spread of disease, and Part XI Emergencies) 3- The provider will ensure that all background checks are completed and that individuals are eligible to work around children prior to working at the daycare.

Standard #: 22VAC40-111-40-A
Description: Based on observation and interview the provider failed to ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home. Evidence: 1 ? Upon arrival to the family day home at 10am through 11am there were 10 children in care. However, the maximum licensed capacity is not to exceed nine children at any one time. 2 ? Staff 1, 2, and 3 confirmed that there were 10 children present in the home.

Plan of Correction: Provider will reread standards pertaining to capacity and to prevent exceeding maximum capacity. IN addition, prior to allowing any other children into the daycare, the provider will do a count to ensure that she will not exceed maximum capacity. Provider reviewed maximum licensed capacity of the home is 9. The provider and all assistants/ substitute providers will review the standards relating to capacity. (4/26/18) To prevent further violations the provider will not accept children into care if she is at maximum capacity.

Standard #: 22VAC40-111-60-A
Description: Based on record review and interview the provider failed to ensure that an up-to-date record is maintained for each child. Evidence: 1 - There is not any record available for review for child 2 who was present for care during the entire inspection today. 2 - Staff 1 stated that there no record for child 2. a. Staff 1 stated that child 2?s first date of attendance was Monday, April 16, 2018 3 ? Staff 1 stated that the parent of child 2 was supposed to bring the information back today but had not done so.

Plan of Correction: Provider will ensure that every child in attendance at the daycare has a completed and up-to-date record. The provider and assistance will review the records of each enrolled child to ensure that each record is maintained and up-to-date. This will be completed monthly. The provider will ensure that all child?s records are maintained and up to date by reviewing each child?s record. If a child?s record needs updating, the parent will be notified with a written notice and by verbal contact. (4/18/2018) Provider will ensure that every child in attendance at the daycare has a completed and up-to-date record in the future to prevent future violations. To prevent this from happening in the future the provider will develop student pre-enrollment packets with the required documents for enrollment. (4/26/2018) To prevent future violations the provider will review the child?s record and all required documents, prior to the child?s first date of attendance.

Standard #: 22VAC40-111-90-A
Description: Based on record review and interview the provider failed to ensure that before a child may attend the family day home, the provider will obtain documentation that the child has been adequately immunized. Evidence: 1 - The records for children 1, 2, 3 and 4 do not have documentation of immunizations as required. a. Child 1 has a documented first date of attendance as 2/26/2018. b. Child 2 has a reported first date of attendance as 4/16/2018. c. Child 3 has a documented first date of attendance as 4/16/2018. d. Child 4 has a documented first date of attendance as 1/16/2018. 2 - Child 1, 2, 3, and 4 were present for care during all or part of the inspection today. 3 - Staff 1 confirmed that the records for child 1, 2, 3 and 4 do not have immunization documentation.

Plan of Correction: The provider will contact the parents of those children whose immunizations are not up to date and require parents to bring an up-to-date copy of the immunization record. (4/18/2018) (a-d) The provider will highlight every required space on the application that requires documentation to ensure that all documentation is attached. The provider will reread section C of 22VAC 40-111-90. Immunizations for children which provides a timeline for how often immunizations need to be updated. (4/18/2018) The provider will ensure that all child?s records are maintained and up to date by reviewing each child?s record. If a child?s record needs updating, the parent will be notified with a written notice and by verbal contact. (4/18/2018) (a-d) The provider will highlight every required space on the application that requires documentation to ensure that all documentation is attached. In the future the provider will create a record sheet to track documentation of immunizations and health records. (developed 4/25/18)

Standard #: 22VAC40-111-140-B-3
Description: Based on record review the provider failed to ensure that substitute providers employed after June 30, 2010 have current CPR training which is required for substitute providers. Evidence: 1 ? Children were left in the care of three persons for a week, none of whom meets all of the substitute provider requirements including lack of CPR training. a. The record for staff 1, there was not any documentation that CPR training was completed. b. As there were not any records available, for review, for staff 2 and 3 there was not any documentation of CPR for staff 2 and 3. c. Staff 1, 2, and 3 report arriving and leaving the family day home at different times of the homes hours of operation making in necessary for each caregiver to be trained in first aid during those times when they are providing care independently.

Plan of Correction: The provider will ensure that all substitute providers will have a current CPR certification prior to working alone with children. All current assistants/substitute providers have current a current CPR CERTIFICATION. In the future the provider will ask upon hiring (during interview) if future assistants/substitute has a current CPR Certification prior to being starting work. To prevent this from happening again all the current assistants/providers will receive CPR training within the first 30 days of employment.

Standard #: 22VAC40-111-140-B-4
Description: Based on record review the provider failed to ensure that substitute providers employed after June 30, 2010 have current first aid training which is required for substitute providers. Evidence: 1 ? Children were left in the care of three persons for a week, none of whom meets all of the substitute provider requirements including lack of first aid training. a. The record for staff 1, there was not any documentation that first aid training was completed. b. As there were not any records available, for review, for staff 2 and 3 there was not any documentation of first aid training for staff 2 and 3. c. Staff 1, 2, and 3 report arriving and leaving the family day home at different times of the homes hours of operation making in necessary for each caregiver to be trained in first aid during those times when they are providing care independently.

Plan of Correction: The provider will ensure that all substitute providers will have a current First Aid certification prior to working alone with children. All current assistants/substitute providers have a current FIRST AID TRAINING CERTIFICATION. In the future the provider will ask upon hiring (during interview) if future assistants/substitute has a current First Aid Certification prior to being starting work. To prevent this from happening again all the current assistants/providers will receive First Aid training within the first 30 days of employment.

Standard #: 22VAC40-111-150-D-1
Description: Based on record review and interview the provider failed to ensure that an assistant 18 years of age or older who is left alone with children in care will have current cardiopulmonary resuscitation and first aid training. Evidence: 1 - There were not any records to review for staff 2 or 3 during the inspection; therefore, there was not any first aid or CPR documentation available for review. a. Staff 1 stated that there was not any documentation on site available for review today. 2 - Both staff 2 and 3 were observed caring for children alone during the inspection. a. Staff 2 was outside with 8 of the 10 children in care during? the first 40 minutes of the inspection. 3 - Staff 2 confirmed that she alone provided transportation.

Plan of Correction: The provider will ensure that all substitute providers/assistants over the age of 18 will have current CPR and first aid training prior to being left alone with kids. All assistant/substitutes who are left alone with children have a current CPR/First Aid Training Certificate. To prevent this from happening in the future the provider will ensure that all staff required documentation will be on site and available for review by the inspector. 2- To prevent this from happening again all current assistants/providers will receive First Aid training certification prior to being left alone with children. 3- Provider has stopped all transportation

Standard #: 22VAC40-111-540-A
Description: Based on observation the provider failed to ensure that safety strap is securely fastened when the infant carrier seat is occupied by a child. Evidence: Staff 3 placed child 3, who is eight weeks old, in the multipurpose infant seat on the floor and walked away without first engaging the safety strap in the seat.

Plan of Correction: The provider will ensure assistants know how to use safety straps on multipurpose seats or any other equipment requiring safety straps. The provider will post a sign stating, ?Please ensure that ALL CHILDREN are strapped in and wearing seat belts in multipurpose seats or other equipment. This sign will be posted in the classroom.

Standard #: 22VAC40-111-590-B
Description: Based on observation the provider failed to ensure that a child is provided with an individual rest mat for resting or napping. Evidence: 1 ? Child 6 and 7 fell asleep while sitting on the couch in the child care room. The children were laid down on the couch and allowed to sleep on the couch. a. Child 6 is 17 months old. b. Child 7 is 33 months old.

Plan of Correction: The provider and the assistants reviewed the ?Rest Areas standards. To prevent this from happening in the future all children who fall asleep before scheduled nap time will be laid on their designated mat or cot away from activities that are going on.

Standard #: 22VAC40-111-680-A
Description: Based on observation the provider failed to ensure that caregivers wash their hands after diapering a child. Evidence: 1 ? Staff 3 did not wash her hands after diapering child 3. Staff 3 while holding the dirty diaper in one hand and child 3 proceeded to engage in the following tasks while holding the dirty diaper: - touched cloth baskets and items in the baskets looking for plastic bags to dispose of the dirty diaper, - touched the pacifier of child 3 and attempted to put it in his mouth, - touched a safety gate to open it, - touched a cabinet to open it, Picked up a spray bottle of cleaner and began spraying the diaper changing surface.

Plan of Correction: The provider and assistants will review Diapering standards. The provider will model proper procedures on how to change a diaper with assistant/substitute providers. Assistants/substitute providers reviewed videos on diaper changing provided by department of social services online preservice training. The provider will post the steps for diaper changes in front of the diaper changing table. In the future all staff members will drop all soiled diapers into the trashcan and immediately take the child and themselves and wash their hands. In the future, all new assistants will be required to watch the VDSS preservice videos on diaper changing.

Standard #: 22VAC40-111-680-B
Description: Based on observation the provider failed to ensure that children?s hands are washed with liquid soap and warm running water after diapering. Evidence: After child 3 was diapered his hands were not washed. Staff 3 carried the infant from the changing to an infant seat.

Plan of Correction: The provider and assistants will review Diapering standards. The provider and assistants will reread standard 22 VAC 40-111-680 on Handwashing. (4/25/2018) The provider will review the importance of handwashing and how it helps to prevent the spread of disease. (ongoing) The assistant and or provider will ensure that the infants hands will be properly cleaned before moved to another station. The provider will post a list in the bathroom stating when children and adult?s hands should be washed, per handwashing standard. The provider will post handwashing procedure in the bathroom. (4/25/2018) In the future the provider will include the importance of handwashing the assistant training session. The provider will require all assistants to watch Child care infection control video that is included in the Virginia Preservice Training for Child Care Staff within the first 10 days of hire.

Standard #: 22VAC40-111-690-D
Description: Based on observation the provider failed to ensure that the diapering surface is sanitized after each use. Evidence: 1 - When cleaning the diapering surface staff 3 sprayed the surface bleach water solution and walked away. 2 - Staff 2 sprayed the surface again then immediately wiped the surface dry. There was not a step where the surface was allowed to air dry for any length of time. Therefore, the surface was not sanitized as required.

Plan of Correction: The provider will ensure that the diapering surface is cleaned with soap and water then sanitized with a sanitizing solution and the solution is left on the diapering surface for the appropriate time to ensure the surface is sanitized before wiping and/or letting air dry. IN the future the provider will ensure that diaper changing procedures are followed step by step by placing the diaper changing steps in front of the diaper changing table. The provider will also review/model diaper changing steps with any inexperienced staff member to provide proper diaper changing training.

Standard #: 22VAC40-191-60-B
Description: Based on record review and interview the provider failed to ensure that an employee of a licensed family day home does not employ a person until the home has the person's completed sworn statement or affirmation. Evidence: 1 - There is not record available for review for staff 2 and 3 during the inspection. As a result there is not sworn statement or affirmation available. a. Staff 2 and 3 were present providing direct care to children during the inspection. b. Staff 2 and 3 stated that they began working in the family day home on Monday, April 16, 2018.

Plan of Correction: Provider and all assistance have completed a sworn statement or affirmation and the document is located within each staff member?s file. Provider will ensure that all sworn statement or affirmations are completed prior to beginning work within the daycare. To prevent further violations the provider will create a blank assistant folder with the correct forms and requirement to ensure that there is evidence of the correct required paperwork for everyone hired. (4/28/2018)

Standard #: 63.2-1721.1-E
Description: Based on record review and interview the provider failed to ensure that no person will be involved in the in the day-to-day operations of the family day home or is alone with, in control of or supervising one or more children, without first having completed any required background. Evidence: 1 - The record for staff 1 shows a date of hire as 2/2/18. However, there is not any documentation of a fingerprint check having been completed before staff 1 was allowed to care for children enrolled in the family day home. a. Staff 1 was present caring for children during the inspection today. 2 - There is not any documentation of a date of hire for staff 2 and 3. Additionally, there is not any documentation of a fingerprint check having been completed before staff 2 and 3 were allowed to care for children enrolled in the family day home. a. Staff 2 and 3 stated their first day of employment was Monday, April 16, 2018.

Plan of Correction: 1- Provider and all assistance/substitute providers have completed the background/fingerprint check and are eligible to work around children. Provider will ensure that all background checks are completed and that individuals are eligible to work around children prior to working at the daycare.

Disclaimer:

A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.

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