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Belinda Lewis
1692 South Coolwell Road
Madison heights, VA 24572
(434) 929-1160

Current Inspector: Victoria E Dawson (540) 309-2674

Inspection Date: Aug. 2, 2019

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
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks for Child Welfare Agencies
63.2 Licensure and Registration Procedures

Comments:
An unannounced renewal inspection was completed on 8/2/19. There were six children present with the provider and caregiver present. The point total was 11. Eight children's records, the provider's record, one caregiver's record, and one household member's records were reviewed. The provider does not administer medications. The inspector arrived at the center at 10:05 am and departed at 2:00 pm. The children were observed during free play times, during lunch, and during nap. All infant activities were observed. There was discussion with the provider about the following: having written permission for application of any over-the-counter products used such as diaper ointment that was observed but not used according to the provider, the required training updated for subsidy.

Violations:
Standard #: 22VAC40-111-730-D
Description: Based on observation and interview, the provider failed to ensure that all medication was kept in a locked place. Evidence: 1. There was a prescription medication in pill form observed in a side drawer of the provider's desk in the child care area. The provider was observed to open the drawer without a lock and the drawer was approximately two feet from the floor level. The bottle was noticed to be a orange prescription bottle with a pharmacy label. The provider identified it as her own personal medication. 2. The inspector asked the provider about the medication and the provider stated that she was not aware that her own personal medication needed to be locked.

Plan of Correction: This was corrected during discussion with the provider about the medication. The provider placed the medication on her person. The provider further stated that she would use a lock box for any medication that was kept in the child care area.

Standard #: 22VAC40-111-790
Description: Based on observation and interview, the provider failed to ensure that all required emergency numbers were posted near the telephone. Evidence: 1. The emergency numbers required to be posted near the telephone were not observed. The provider was asked about the numbers and found them laying on the computer desk under a stack of papers. The emergency back-up caregivers number was not on the list of emergency number. s

Plan of Correction: The provider will add the person responsible for emergency back-up care to the list of emergency numbers. The provider posted the other emergency numbers during the inspection at the phone.

Standard #: 22VAC40-111-870-G
Description: Based on observation, the provider failed to ensure that tables were cleaned after each use. Evidence: 1. The table in the child care area was observed at arrival to have spots from what appeared to be food/drink. There were also crumbs observed on the table. The provider then used the table to provide all of the children and staff records for the inspector. The inspector was provided this table to use for record review and a work space from arrival until right before lunch. The table was not cleaned prior to use by the children for eating lunch.

Plan of Correction: The provider will make sure the table is cleaned after each activity.

Standard #: 22VAC40-111-960-B
Description: Based on observation, the provider failed to ensure that infants who cannot hold their own bottles shall be picked up and held for bottle feeding. Evidence: 1. A six month old infant who was observed not able to hold their own bottle was placed in a high chair to feed. A caregiver held the infant for a few minutes then placed the infant in the high chair to continue feeding. The caregiver was heard to say to the infant that the child needed to learn to hold their bottle to feed their own self. The caregiver was heard to say this twice to the child. The caregiver was also heard to say that the infant thought that the caregiver was only there to hold the bottle.

Plan of Correction: The provider will make sure the infant is held until the infant learns to feed herself.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the provider failed to ensure that all children's records contained documentation of all required information. Evidence: 1. The records for children #1, #5, #6, and #7 did not have the parent's signed acknowledgement of the receipt of the information required by 22 VAC 40-111-70. The parents are required to sign notification of the provider's policies for the administration of medications. The second page that contains the parent's signature to acknowledge this notification was not in the records for the four children. The first page with the provider's policy for medication was in the four children's records and provided notification of three different polices. 2. The record for child #5 did not have documentation of annual review by the parent of information in the child's record. The child was enrolled 4/30/18 and this was the last parent signed confirmation of information for the child. There was no documented updated for 2019 for the information in child #5's record. 3. There was no documentation of the first date of attendance for child #3.

Plan of Correction: The provider will complete both page one and two of the medication policy form and have the parents sign the second page. The provider documented the first date of attendance during the inspection for child #3. The provider will have the parent of child #5 review and sign for updating the child's record.

Standard #: 22VAC40-111-540-A
Description: Based on observation, the provider failed to ensure that when infant carrier seats, swings, strollers, feeding or activity tables, and high chairs were occupied by a child, a safety strap shall be used and securely fastened. Evidence: 1. A six month old infant was observed being placed in a high chair two times. The high chair safety strap was not used for the infant. The infant was placed in the high chair the first time for a few minutes while a caregiver prepared a bottle directly beside the high chair. The infant was placed in the high chair a second time while the caregiver sat beside the high chair to hold the bottle for the infant. The safety strap was not used for the infant on either time it was occupied by the child.

Plan of Correction: The provider notified the caregiver to use the safety strap during the inspection and it was fastened at that time.

Standard #: 22VAC40-111-610-A
Description: Based on observation, the use of media was not limited to two hours per day and was not limited to programs produced for children or suitable for children. Evidence: 1. The television (TV) in the child care area was observed to be on a local channel during the entire inspection (more than three hours). The TV was observed to have a talk shows about current affairs including political discussions and local news broadcast. There was discussion between the provider and the caregiver present about the current affairs and shocking behaviors of people being reported on in the news. Adult issues were discussed on the TV such as illegal activities including use of weapons of those being discussed on the shows and news. There were children ages 20 months, three, five, six, and eight years of age at the lunch table during this discussion beside the provider and caregiver. Two children, ages 20 months and four years, were observed to be placed on their mats to take a nap in front of the TV while a talk show was being televised.

Plan of Correction: The provider and caregiver will not discuss the topics on TV if not age appropriate for the children. The provider will have music on for the children.

Standard #: 22VAC40-111-680-A
Description: Based on observation, the provider failed to ensure that caregivers hands were washed as required. Evidence: 1. A caregiver was observed to assist a child with eating. The caregiver was also observed to use her personal cell phone with her hands. The caregiver was observed to make the children sandwiches after these activities. The caregiver used her bare hands to serve the sandwiches to the children. The caregiver did not wash her hands after activities involving other children and equipment and prior to preparing or serving the food to the children. 2. The provider was observed to change the diaper of a child. The provider was not observed to wash her hands after diapering. The inspector asked the provider about the lack of hand washing and the provider confirmed that she had forgotten to wash her hands after diapering.

Plan of Correction: The provider will make sure hand washing is practiced as required.

Standard #: 22VAC40-111-680-B
Description: Based on observation, the provider failed to ensure that children's hands were washed as required. Evidence: 1. A six month old was observed to be fed a bottle. The infant did not have their hands washed prior to eating.

Plan of Correction: The provider will ensure that children's hands are washed as required.

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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