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Two By Two Learning Center, Inc.
2499 W. Beverley Street
Staunton, VA 24401
(540) 213-2292

Current Inspector: Barbara Workman

Inspection Date: May 24, 2017

Complaint Related: No

Areas Reviewed:
32.1 Report by person other than physician
63.2 General Provisions.
63.2 Child Abuse and Neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..

Technical Assistance:
We discussed the requirements for medication storage, sight supervision, hand washing after diaper changes, labeling spray bottles, immunization and physical examination records. The risk assessments for violations were provided. We reviewed requirements for children on formula. Also, you told of your plans to revise the playground safety plan since the new used composite structure was installed two weeks ago. We talked about drainage issues and the need to contact the manufacturer about the maintenance needs of the coating on the decks and bridge.

Thank you for your assistance during today's unannounced monitoring inspection conducted from 9:37 AM to 4:30 PM. Today, there were eighty-four children, ages infancy through five, with sixteen staff. I viewed program activities, supervision, staffing, interactions with children, daily routines, posted information, menu/nutrition, injury records, emergency supplies and drill records, agency reports, infant care and records, diapering procedures, equipment, five records for children, medication, six staff records, staff training, staff qualifications, indoor and outdoor areas. The children have enjoyed activities and discussions about butterflies and insects and spiders. Older preschoolers were preparing for a graduation celebration. Parent conferences will be available this week. Staff were observed providing frequent interactions with the children in their group. Let me know if you need any assistance. 540/430-9259

Standard #: 22VAC40-185-130-A
Description: Based on a review of five records for children, and an interview with administrative staff, the immunization report for child 4 was not obtained before the first date of attendance. Evidence: The start date was February 6, 2017 and the report was obtained on February 14, 2017.

Plan of Correction: The administrative staff who communicate with parents of enrolling children will make sure they request immunization reports prior to children attending the center. The signed reports will be received at the center by the beginning of care.

Standard #: 22VAC40-185-140-A
Description: Based on a review of five records for children, and an interview with administrative staff, the physical examination reports for child 1 and 3 were not obtained within one month of initial attendance. Evidence. Child 1 started on November 23, 2016 and the physical examination report was obtained January 4, 2017. Child 3 started on February 7, 2017 and the report was obtained on April 11, 2017.

Plan of Correction: Administrative staff who conduct enrollment with the parents of new children will communicate the need for the physical examination records within the first month of attendance. The administrative staff will use a system for tracking the need for the physical examination reports when children begin attending so that the required information is requested and obtained on time.

Standard #: 22VAC40-185-280-B
Description: Based on observation of the indoor classrooms, and an interview with staff, there were unlocked hazardous substances on the sink counter of the younger toddler area. Evidence: A can of Lysol spray, Germ X hand sanitizer and a spray bottle containing bleach and water were seen during the morning activities prior to lunch. The staff indicated they were there since the prior day.

Plan of Correction: A teacher immediately moved the Lysol spray and bleach spray to a locked cabinet. The Germ X was discarded. The teachers will put all cleaning agents and toxic substances in locked storage areas when substances are left out from the previous evening and whenever they are not in use. Administrative staff will conduct walk throughs of the rooms to ensure that all cleaning substances are kept locked.

Standard #: 22VAC40-185-280-G
Description: Based on observation of spray bottles used for sanitizing, and interviews with staff, there was not a label to clearly indicate the contents of the bottle in the older toddler room. Evidence. The spray bottle only had the age range written on the container to indicate the room. Staff indicated that the contents was bleach and water.

Plan of Correction: The teacher will make sure the contents of the spray bottle is labeled. The staff in each room will make sure that containers of any hazardous substance are clearly written to indicate the contents when using spray bottles that are not the original container.

Standard #: 22VAC40-185-340-F
Description: Based on observation of staff with children's indoor activities, and interviews with staff, there were two incidents of preschool age children briefly without sight supervision. Evidence: At 9:37 AM a teacher was seen talking on a phone with the back gym door held open and then briefly inside the door when it was closed. As the teacher finished the phone conversation, the licensing inspector entered the gym from the back parking lot and there were five of eight children, ages four and five, playing in two different activity centers that could not be seen from the back door area. No more than two minutes later, the licensing inspector was entering the upstairs hall from the stairwell and a teacher was latching the teacher room door. The inspector went into class 1 with the teacher where five children. ages two and three, were playing in activity centers and could not be seen while the teacher was gone to the teacher room. The teacher indicated that she was obtaining copies of color sheets from the printer.

Plan of Correction: The administrative staff talked to the teachers about calling the office for assistance whenever they need to attend to something and would not be within sight and sound of all of the children in a room. The teachers will make sure they provide sight and sound supervision to all children in their care. Administrative staff will conduct periodic observations of the indoor activities and training regarding supervision requirements for children as needed.

Standard #: 22VAC40-185-500-A
Description: Based on observation of the diaper changes after lunch in the older infant room, and interviews with staff, the caregiver and children's hands were not washed after each diaper change. Evidence: After changing the diapers of each of two children, each child was immediately placed in their assigned crib and the blankets, a stuffed toy were obtained from the drawers under each crib. Then the teacher disposed of used gloves and and diaper surface paper after settling each child and preparing for the next diaper change. There was not any use of the hand sink with soap and water.

Plan of Correction: The staff person will be instructed to wash their hands and each individual child's hands with soap and running water prior to placing children in their cribs and obtaining items for use in the room. The administrative staff or assigned teacher will review the diaper changing procedures with the teacher to make sure all practices are used to prevent the spread of illness. Administrative staff will make sure orientation training includes all required procedures and that there are follow-up observations to check on the diapering practices of staff.

Standard #: 22VAC40-185-510-J
Description: Based on observation of medication stored in the infant/toddler building office, and interviews with staff, there was unlocked prescription medication which has been administered to a child during the past week. Evidence: An open bag with a box containing breathing treatment vials was on the desk and visible. The staff indicated that the bag was too large to store in the designated medication box.

Plan of Correction: The M.A.T. certified teacher moved the prescription medication to a locked cabinet in the classroom. The staff will communicate with the parent about the locked storage location for the medication. The administrative staff will review the applicable licensing standards for medication with all staff who are assigned to oversee medication needs of children.


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.