VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Babette Mayfield
467 Wyatt's Mill Road
Jarratt, VA 23867
(434) 535-8159

Current Inspector: Rene Old (757) 404-1784

Inspection Date: Feb. 26, 2024

Complaint Related: No

Areas Reviewed:

8VAC20-800 Administration 8VAC20-800 Personnel 8VAC20-800 Household Members 8VAC20-800 Physical Health of Caregivers and Household members 8VAC20-800 Caregiver Training 8VAC20-800 Physical Equipment and Environment 8VAC20-800 Care of Children 8VAC20-800 Preventing the Spread of Disease 8VAC20-800 Medication Administration 8VAC20-800 Emergencies 8VAC20-800 Nutrition 8VAC20-820 THE LICENSE 8VAC20-770 Background Checks 20 Access to minor?s records 22.1 Background Checks Code, Carbon Monoxide 54.1 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect

Technical Assistance:

The following standards were reviewed with the provider: *Supervision of children and points to include direct care and supervision of children at all times; *Use of media shall be limited to not more than a total of two hours per day; *Daily activities for all children to include outdoor play; *Crib sheets; *Annual training; *Authorization for diaper ointment. *Standard 900.B - Children shall not be allowed to eat or drink while walking, running, playing, lying down, or riding in vehicles.

Comments:

An unannounced monitoring inspection was initiated on 02/26/2023 at 11:20 am and concluded on 02/26/2024 at 1:50 pm. There were 9 children present, ranging in ages from 5 months - 3 years, with 2 caregivers. Children were observed watching television, singing songs and preparing for nap / napping. Records were reviewed for two caregivers and nine children. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the provider.

Violations:

Standard #:	8VAC20-800-750-B
Description:	Based on observation, the provider failed to ensure that topical skin products shall be inaccessible to children. Evidence: 1. Two tubes of diaper ointments were observed stored on a low shelf, located in an open closet, in the children's nap room. a. This closet was not closed and is within easy reach of a preschool age child observed napping in this room.
Plan of Correction:	Ointments were removed and put up out of children's reach.
Standard #:	8VAC20-800-890
Description:	Based on observation, the provider failed to ensure that when food is brought from home the food container shall be clearly labeled in a way that identified the owner. Evidence: 1. 1 of 3 lunch containers lacked any child name label or identification. 2. The provider stated that these lunch containers were for 3 different children who had brought their lunch on the date of the inspection.
Plan of Correction:	All containers has been labeled accordingly.
Standard #:	8VAC20-800-920
Description:	Based on review and interview, the provider failed to ensure when meals or snacks are provided by the family day home, the menu for the current one-week period shall be dated: Evidence: 1. The posted menu was dated "August 2023." a. The provider confirmed that the posted menu was not dated with the current date.
Plan of Correction:	Menu has been updated.
Standard #:	8VAC20-800-960-E
Description:	Based on observation and interview, the provider failed to ensure that bottles shall be labeled with the child's full name and the date, if more than one infant is in care. Evidence: 1. Two bottles, for child 1, lacked a date label. A third bottle for child 1 was not labeled with the date or name of child 1. 2. One bottle for child 2 were not labeled with the child's name or date. 3. The provider confirmed that these bottles were not labeled or dated as required.
Plan of Correction:	All outside food & bottles are labeled and dated as needed.
Standard #:	8VAC20-800-100-A
Description:	Repeat Violation 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. A documented physical exam was not on file for child 7 who has an enrollment date of 09/06/2022, and was in care during the inspection. 2. A documented physical exam was not on file for child 3 who has an enrollment date of 11/07/2022 and was in care during the inspection. 2. The provider verified that a written physical exam was not on file for child 3 and child 7.
Plan of Correction:	All files were/are being updated.
Standard #:	8VAC20-800-50-A
Description:	Based on record review and interview, the provider failed to keep a written record of children in attendance each day. Evidence: 1. Four children in care, child 3, 4, 5 and 6, were not listed on the attendance record for the FDH where viewed by the inspector at 11:30 am. 2. The provider confirmed that these four children had not been marked as present on the attendance record.
Plan of Correction:	Always sign children in ASAP.
Standard #:	8VAC20-800-60-B
Description:	Repeat Violation Based on record review and interview, the provider failed to ensure that children's records contain all required documentation. Evidence: 1. The enrollment record for child 3 lacked the following required information: a. Home address for each parent who has custody; b. Address for each parent's place of employment; c. Name, address and telephone number of two designated persons to contact in case of emergency if the parent cannot be reached; d. Name and policy number of the child's medical insurance; e. Names of persons other than the custodial parents who are authorized to pick up the child. 2. The enrollment record for child 8 lacked written authorization for emergency medical care. 3. The provider confirmed that this information was not on file for child 3 and child 8.
Plan of Correction:	All files has been/are being updated.
Standard #:	8VAC20-800-80-A
Description:	Based on record review and interview, the provider failed to ensure that within seven business days of the child's first day of attendance at the family day home, the provider shall obtain from the parent verification of the identity and age of the child. Evidence: 1. Child 7, enrollment date 09/06/2022, lacked documentation of verification of age and identity. 2. The provider confirmed that documentation of viewing the birth certificate for child 7 was not on file for child 7.
Plan of Correction:	All files has been/being updated.
Standard #:	8VAC20-800-90-A
Description:	Repeat Violation Based on record review and interview, the provider failed to obtain documentation that the child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations before a child may attend the family day home. Evidence: 1. Child 7, who was in care during the inspection, lacked written documentation of required immunizations. a. Child 7 has an enrollment date of 04/06/2022. 2. The provider confirmed that an immunization record was not on file for child 7.
Plan of Correction:	All files for each child has been updated or in process of updating.
Standard #:	8VAC20-800-90-C
Description:	Based on record review and interview, the provider failed to obtain documentation of additional immunizations for children once every six months for children under the age of two years. Evidence: 1. Child 3, age two years, lacked documentation of additional immunizations once every six months for children under the age of two years. a. The most recent immunization record for child 3 indicated that immunizations were last administered on 05/27/2022. 2. The provider confirmed that an updated immunization record had not been obtained for child 3 once every six months before he turned two years of age.
Plan of Correction:	All files has been/being updated.
Standard #:	8VAC20-800-210-A
Description:	Based on record review and interview, the provider failed to ensure that caregivers obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1. Caregiver 1 did not obtain 16 hours of annual training during the past 12 month period as demonstrated by training certificates indicating a total of 10 hours of training for the past 12 month period. 2. The provider confirmed that she had only obtained 10 hours of annual training within the past 12 months.
Plan of Correction:	Training hours been begun.
Standard #:	8VAC20-800-240-A
Description:	Repeat Violation: Based on observation, the provider failed to ensure that areas and furnishings of the family day home, inside and outside, shall be maintained in a safe and operable condition. Evidence: 1. The playhouse and plastic climber with slide, on the outside playground, have multiple areas of cracked and broken plastic within reach of children. The cracked broken plastic has sharp, jagged edges. 2. The handle of the play house door has broken off leaving a sharp point of plastic that is a protrusion hazard. 3. The roof of the playhouse is loose and could fall off if pushed or pulled on. 4. Three metal bolts on the swing set are protrusion hazards. a. Approximately nine threads are exposed and are within face/chest area of children when using the swing set. 5. There are areas of peeling paint on the metal bar near the pull-up rings on the swing set. 6. A nail was observed protruding from a piece of wood that had been placed on the counter beside the children's hand washing sink adjacent to the large nap room. a. Children were observed using this sink to wash hands during the inspection.
Plan of Correction:	Playhouse and slide has been discarded. Swing set screws has been covered. Peeling paint was removed. (2/26/24) It was a incense holder. Has been removed. (2/26/24)
Standard #:	8VAC20-800-280
Description:	Repeat Violation Based on observation, the provider failed to ensure that potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents and disinfectants shall be stored in areas inaccessible to children. Evidence: 1. A bottle of hand sanitizer and sanitizing wipes were observed placed on the back ledge of the couch when the inspector entered the home at approximately 11:20 am. a. These items were within easy reach of the children who were all sitting on the floor near the couch. 2. A container of sanitizing wipes were observed on an accessible shelf in an open closet located in the small nap room. a. A preschool age child was observed napping in this room. a. The location of the shelf was within reach of the preschool children in care.
Plan of Correction:	All chemicals were put up and stored out of reach of children.
Standard #:	8VAC20-800-530-B
Description:	Based on observation, the provider failed to ensure that cribs when being used by infants shall have a tight-fitting bottom cover. 1. Two cribs, for child 1 and child 2, had loose fitting crib sheets. a. Child 1 was observed napping in his assigned crib during the inspection.
Plan of Correction:	New mattress & sheet have been ordered.
Standard #:	8VAC20-800-570-A
Description:	Based on observation and interview, the provider failed to ensure that a caregiver does not exceed 16 points by using the following point system to determine if an additional caregiver is needed: 1. Children from birth through 15 months of age count as four points each; 2. Children from 16 months through 23 months of age count as three points each; 3. Children from two through four years of age count as two points each. Evidence: 1. When the inspector arrived at approximately 11:20 am caregiver 2 was observed caring for a total of 9 children whose ages counted for a total of 22 points. a. No additional caregivers or adults were in the home; b. Caregiver 2 confirmed she was the only caregiver present with the children. 2. Prior to entering the home, the inspector observed the provider in the front yard, inside of her vehicle, appearing to be returning or leaving the home. a. The provider stated that caregiver 2 was inside of the home with the children and that she had left the home for approximately one hour. b. The provider confirmed that caregiver 2 had been alone with all of the children during this time.
Plan of Correction:	Not leave FDH with only one caregiver according to points.
Standard #:	8VAC20-800-580-A
Description:	Based on observation, the provider failed to promote a child's emotional well-being by provided needed comfort and support. Evidence: 1. The provider failed to provided comfort and support to a crying infant as demonstrated by the following: a. Child 1, age 10 months, was taken out of his stroller and placed on the floor with a bottle. Child 1 began crying and received no support or attention from either caregiver. b. After approximately 5 minutes caregiver 1 picked child 1 up by his hands and told him to "Walk if off." Caregiver 1 took child 1 to his crib where he continued crying for approximately 6 minutes. c. Caregiver 1 removed child 1 from his crib and placed him back on the floor where he continued crying.
Plan of Correction:	The VQB5 observer/trainer has been out to assist.
Standard #:	8VAC20-800-600-A
Description:	Based on observation, the provider failed to provide infants opportunities to pull-up, creep, crawl or walk. Evidence: 1. Child 2, age 5 months, was not provided with any opportunities to pull-up, creep, crawl or walk during the inspection, from 11:20 am - 1:50 pm, as she remained secured in an infant seat with the exception of approximately 10 minutes when she was fed a bottle.
Plan of Correction:	Keep check on time of strap down time. Make time for tummy time and crawling.
Standard #:	8VAC20-800-600-B
Description:	Based on observation, the provider failed to ensure that infants and toddlers Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours, with the exception of mealtimes, confined in a crib, play pen, high chair or other confining piece of equipment. The intervening time period between confinements shall be at least one hour. Evidence: Evidence: 1. The two infants in care were confined in a crib, infant seat and stroller for the majority of the inspection which lasted from 11:20 am - 1:50 pm. a. Child 2, age 5 months, was observed secured in an infant seat when the inspector arrived at 11:20 am. Child 2 remained in the infant seat through out the inspection except for approximately 10 minutes when caregiver 2 fed her a bottle. After the bottle was completed child 2 was placed back in the infant seat where she remained until the conclusion of the inspection at approximately 1:50 pm. b. Child 1, age 10 months, was observed secured in a stroller when the inspector arrived at 11:20 am. Child 1 remained in the stroller until approximately 12:15 pm.
Plan of Correction:	Ensure time frame of confinements.
Standard #:	8VAC20-800-690-L
Description:	Based on observation, the provider failed to ensure that toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use. Evidence: 1. A toilet chair, located in the back bathroom, contained urine. a. The toilet chair was observed at approximately 11:30 am. b. The provider stated she was not aware that the potty chair had not been emptied.
Plan of Correction:	Ensure that the toilet chair is emptied and sanitized after every use.