VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Bianca Bland
201 Deanes Station Road
Suffolk, VA 23435
(951) 442-1590

Current Inspector: Melinda Popkin (757) 802-5281

Inspection Date: March 18, 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 8VAC20-800 Transportation 8VAC20-800 Nighttime Care 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 54.1 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect

Technical Assistance:

Today we discussed the requirement that infants who are able to turn over on their own must be placed in the crib on their back and allowed to reposition themself independently. If a very young infant is already able to turn over on their own, it may be helpful to document this developmental milestone for reference. If equipment such as high chairs, infant seats, infant swings have safety belts, the safety belt must be engaged per the manufacturer instructions.

Comments:

An unannounced monitoring inspection was conducted on 3/18/2024 from 12:45 pm to 2:40 pm. At the time of entrance, 11 children, ages 3 months to 2 years old, for a total of 29 points, were in care with 2 care providers present. The sample size consisted of 5 children?s records and 3 provider / assistant / household member records. Children were observed having an afternoon snack, watching a children's program on the television and playing with toys. Medication administration was not observed and the licensee states that no medication is administered to children in care. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program

Violations:

Standard #:	22.1-289.036-A
Description:	Based on a review of records, the licensee did not obtain an updated Criminal History Record Check for providers and adult household members every five years following the initial Criminal Background Checks completed. Evidence: Three provider, assistant, adult household member records were reviewed. The records for Provider #1 and adult Household Member #3 contained the most recent Criminal Record results which were dated 9/15/2018 (#1) and 12/27/2018 (#3). The results were more than 5 years old and required updating.
Plan of Correction:	The licensee immediately made appointments for updated background checks to be obtained. The results of the criminal record checks for provider #1 and Household Member #3 were obtained and forwarded to the licensing inspector on 3/22/2024.
Standard #:	8VAC20-800-110-B
Description:	Based on a review of records and interview, the licensee was unable to demonstrate that she always obtains documentation of a physical examination and immunization record for enrolled children which is signed by a licensed physician, the physician's designee, or an official of a local health department. Evidence: Five children's records were reviewed. The record for child #1, enrolled 11/13/2023 contained the results of a physical exam that was not signed by a licensed physician, the physician's designee, or an official of a local health department. The record for child #3, enrolled 2/5/2024, contained the results of a physical exam and an immunization record that were not signed by a licensed physician, the physician's designee, or an official of a local health department. The licensee acknowledged that the reports were not signed by a licensed physician, the physician's designee, or an official of a local health department.
Plan of Correction:	The licensee stated that she was unaware that she could not accept the children's Physical or Immunization records without an actual signature, stamp, or digital signature, of a licensed physician, the physician's designee, or an official of a local health department. She will request that parents obtain a signed copy of the immunizations and physical for their children within 30 days.
Standard #:	8VAC20-800-90-A
Description:	Based on a review of records, the licensee did not ensure that before a child may attend the family day home, the provider obtains 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. Evidence: Five children's records were reviewed. The record for child #1, enrolled 11/13/2023, did not contain documentation to demonstrate adequate immunization of the child. The record for child #3, enrolled 2/5/2024, did not contain documentation to demonstrate adequate immunization of the child. The provider acknowledged that the reports were not present in the children's records at the time of the inspection.
Plan of Correction:	The licensee stated that she was unaware that she could not accept the children's Physical or Immunization records without an actual signature, stamp, or digital signature, of a licensed physician, the physician's designee, or an official of a local health department. She will request that parents obtain a signed copy of the immunizations and physical for their children within 30 days.
Standard #:	8VAC20-800-140-B-3
Description:	Based on a review of records and interview, the licensee did not obtain Current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department; Evidence: The record for the licensee contained documentation of completion of cardiopulmonary resuscitation (CPR) training which was not conducted by an approved vendor and did not include a hands on component / skill demonstration of CPR. The licensee confirmed that the training she completed was completed online and did not have a hands on component.
Plan of Correction:	The licensee stated that she was not aware that the First Aid and CPR Training course she took online did not satisfy the requirements for required certification. The licensee will begin looking for available classes and will plan to attend First Aid and CPR Certification courses through an approved vendor within 30 days.
Standard #:	8VAC20-800-140-B-4
Description:	Based on a review of records and interview, the licensee did not obtain Current First Aid certification from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department. Evidence: The record for the licensee contained documentation of completion First Aid training which was not conducted by an approved vendor and did not include a hands on component / skill demonstration of First Aid techniques. The licensee confirmed that the training she completed was completed online and did not have a hands on component.
Plan of Correction:	The licensee stated that she was not aware that the First Aid and CPR Training course she took online did not satisfy the requirements for required certification. The licensee will begin looking for available classes and will plan to attend First Aid and CPR Certification courses through an approved vendor within 30 days.
Standard #:	8VAC20-800-280
Description:	Based upon observation, the licensee failed to ensure that potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates shall be stored away from food in areas inaccessible to children. Evidence: A tube of E6000 Industrial Strength Contact Adhesive was lying on the surface of a changing table located in the designated childcare area where 11 infants and children under 2 years of age were in care. The adhesive contained a label that said "Keep out of reach of children" and had additional warnings to include contacting poison control if swallowed. The licensee acknowledged that the adhesive contained these warning label and was accessible to children at he time of the inspection.
Plan of Correction:	The licensee removed the tube of adhesive from the diapering table when it was brought to her attention during the inspection. The licensee stated that this was an oversight and inadvertently left out after use. Items with warning labels will always be considered dangerous to children and will be kept in areas that are inaccessible to the children in care.
Standard #:	8VAC20-800-540-A
Description:	Based on observation, the licensee did not ensure that Infant carrier seats, swings, strollers, feeding or activity tables, and high chairs are used according to the manufacturer's instructions and when occupied by a child, a safety strap is used and securely fastened. Evidence: A 17 month old child was observed sitting in a high chair eating afternoon snack. The licensing agent observed that the safety strap on the occupied high chair was not fastened. The licensee confirmed that the safety strap had not been fastened.
Plan of Correction:	The licensee stated that she was not aware that her assistant had not fastened the safety strap on the high chair when she placed a child in the seat. She removed the child from the highchair and discussed this requirement with the assistant at the time that it was brought to her attention by the inspector during the inspection on 3/28/2024. Safety straps will be fastened on any infant equipment when a safety strap is installed and a child occupies the equipment.