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KinderCare Learning Center - Parham
2240 East Parham Road
Henrico, VA 23228
(804) 264-8729

Current Inspector: Lynn Powers (804) 662-9790

Inspection Date: Sept. 20, 2017 and Sept. 21, 2017

Complaint Related: Yes

Areas Reviewed:
22VAC40-185 ADMINISTRATION.
22VAC40-185 STAFF QUALIFICATIONS AND TRAINING.
22VAC40-185 PHYSICAL PLANT.
22VAC40-185 STAFFING AND SUPERVISION.
22VAC40-185 PROGRAMS.
22VAC40-185 SPECIAL SERVICES.

Comments:
The licensing inspector completed an inspection in response to a complaint regarding staff inappropriately handling a child. The Department was notified on 09/15/17. The licensing inspector was on site at the facility on 09/20/17 from approximately 12:00 PM to 3:00 PM and 09/21/17 from approximately 1:50 PM to 3:10 PM. During the inspection, interviews with staff were completed, documentation was reviewed and classroom observations were conducted. Additional written policies and procedures for the center were provided to the licensing inspector on 10/05/17. The preponderance of the evidence gathered during the investigation supports the allegation and therefore the complaint is determined valid. See the violation notice for additional details. Please complete the 'plan of correction' and 'date to be corrected' for each violation cited on the violation notice and return it to me within 5 business days from date of receipt. You will need to specify how the deficient practice will be or has been corrected. Just writing the word 'corrected' is not acceptable. Your plan of correction should contain: 1) steps to correct the noncompliance with the standards, 2) measures to prevent the noncompliance from occurring again, and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s). If you have any questions about this inspection, please contact the licensing inspector, Lynn Powers at (804) 662-9790.

Violations:
Standard #: 22VAC40-185-40-E
Complaint related: Yes
Description: Based on interviews and review of center policies, the facility did not ensure they complied with their own policies and procedures required by the Child Day Center Standards regarding food policies. Evidence: 1. The facility's Bottle Feeding and Infant Mealtime policies and procedures state the following: *To grow and thrive, infants require one-to-one bonding during feeding. Staff members should hold infants while bottle feeding, even when infants are able to hold bottles on their own. Additionally, holding a child during feeding prevents choking, aids in digestion, and promotes adult/child interaction. *Older infants who are able to hold their own bottles may do so while feeding, but should not be allowed to play, lie down, or walk around while holding bottles. * For children eating baby food and sitting up on their own, individual low-chairs, `me do?/1st, or high chairs at a low table should be provided. 2. During staff interviews, various staff stated they have seen Staff #1 feed infants while they lay on the floor.

Plan of Correction: Staff #1, as issued a documented warning in reference to the complaint, with explicit expectations against any future complaint regarding the lack of use of low-chairs, or high-chairs, or a low table for children eating baby food and sitting up on their own. Staff #1 was retrained on 10/20/17 regarding the use of low chairs/high chairs or a low table for children who are able to sit independently. Verification of the training will be filed in their personnel file. A mandatory training regarding expectations and policies for feeding younger than 2 years of age will be held October 30, with a follow up meeting November 9th 2017. This training will be facilitated by center management. Additionally, we will be reaching out to Child Protective Services to set up re-training on mandated reporting procedures. The target date will be to align this follow up training scheduled for November 9, 2017. The required participants will include all infant and toddler room staff in order to help establish accountability for all staff members. Verification of the training will be filed in their personnel file. Center director along with the assistant director will monitor the infant classroom on a daily basis for two months to ensure all teachers are following proper feeding of children. Additionally training on the proper feeding of infants and young children will take place again in January 2018.

Standard #: 22VAC40-185-410-5
Complaint related: Yes
Description: Based on interviews and documentation review, the facility did not ensure the forbidden action of force feeding did not occur. Evidence: During the September 20 and 21, 2017 inspection, the licensing inspector interviewed staff regarding feeding infants. Various staff members stated the following: 1. I have seen a baby not want to eat and Staff #1 continues to feed the baby even if the baby is crying. When the babies open their mouth because they are crying, not to eat, she puts spoons of food in their mouth?. 2. ?I have seen Staff #1 continue to feed infants while they are crying. The babies sometimes seem to be crying because they are upset and Staff #1 continues to still try to feed the infants, holding their arms down.? 3. ?Staff #1 can be a little aggressive. She will try to get the babies to eat even if they don?t want to eat. I have told her I don?t think they want it. A couple of weeks ago Infant A was being fed baby food by Staff #1. Infant A began to cry and Staff #1 held the infant?s hands down and kept feeding. Infant A threw up. This not the first time I have seen Staff #1 try to make the babies eat." 4. ?I have seen Staff #1 force feeding infants. I have seen infants kicking and screaming, only reason they open their mouth is to gasp for air. Staff #1 continues to feed infants bottles even when children seem distressed. I saw Staff #1 force feed Infant A. I did not see Infant A throw up from force feeding but I did see Staff #1 wash Infant A in the sink because she was force fed and I was told Infant A threw up on herself.? 5. ?Staff #1 has forcefully fed fussy babies. She has forced spoons of food in their mouths. Infant B has been so worked up the child gags, and throws up. Staff #1 has held infants arms down or holds faces or head back to feed the infants. I have seen her do this to Infant B. I have seen her feed Infant A baby food and kept trying to force feed her until she gagged and spit up and was screaming at the top of her lungs. When I say something to Staff #1 she said they will want it eventually.? 6. ?In the past I have seen Staff #1 forcefully feed infants. In my opinion sometimes they did not want to eat but Staff #1 would hold them down. I have seen Staff #1 sometimes spoon feed the babies while they cry, not every day but at various times over the summer. I have seen Staff #1 hold the infants arms down while they are crying, mainly with Infant B.? 7. Staff #1 stated ?The babies will play with me. They sometimes cry but are still playing with me. I have been feeding one baby and they cry the whole time then look and open their mouth to eat. If a baby has food in their mouth and they cough I always stop. A lot of them are coughing now because of allergies. I have fed Infant B and clasp his hands down with my hand that is holding the baby food to keep them from swatting at the spoon. I never hold the babies? head back to feed them. Infant A did gag on food when she was new at eating. She would cry on occasion. Once when she was eating bananas it flew right out. I think it was because the bananas were thicker. She would cry and whine but kept taking it in. She was not gagging until right then when boom, threw it up. I gave her a nice little bath in the sink area.? Staff #1 stated she has probably held Infant A hands down like Infant B but never held head still.

Plan of Correction: Staff #1, in reference to complaint, was issued a documented warning. She was retrained on the proper feeding of children, with a focus on children younger than two years of age on 10/20/17. A mandatory training regarding expectations and policies for feeding children younger than 2 years of age will be held on October 30, with a follow up meeting on November 9th, 2017. This training will be facilitated by center management. Additionally, we will be reaching out to Child Protective Services to set up a re-training on mandated reporting procedures The target date will be to align this follow up training scheduled for November 9, 2017. The required participants will include all infant and toddler room staff in order to help establish further accountability for all ream members. Verification of the training will be filed in their personnel file. The center director along with the assistant director will monitor the infant classroom on a daily basis for two months to ensure all teachers are following proper feeding of children. Additional training on the propter feeding of infants and young children will take place again in January 2018.

Standard #: 22VAC40-185-570-A
Complaint related: Yes
Description: Based on interviews and documentation review, the facility did not ensure high chairs, infant carrier seats, or feeding tables were used for children under 12 months when the infants were not being held while being fed. Evidence: During the September 20 and 21, 2017 inspection, the licensing inspector interviewed staff regarding feeding infants. Various staff members stated the following: 1. "Staff #1 feeds a lot of the infants on the floor. She will feed them baby food or bottles while they are lying on the floor." 2. ?I have seen Staff #1 lay babies on the floor and feed them. Sometimes she might use a boppy pillow. I have seen her feed Infant A (five months of age) and Infant B (nine months of age) lying flat on the floor. 3. ?Staff #1 has fed babies flat on their back, no boppy pillows or anything.? 4. ?I have seen Staff #1 feed Infant B while he was laying on the floor?. 5. Staff #1 stated "I usually feed bottles to infants while sitting in the rocking chair but occasionally on the floor. We try to feed baby food to the infants while they are in the high chairs. Infant B felt more comfortable being fed on the floor. Sitting in a high chair he would open his mouth and let food roll out. We might feed babies on the floor or on the mats or a boppy behind them, semi-inclined. Depends on if the four high chairs are being used. "

Plan of Correction: Staff #1, as issued a documented warning in reference to the complaint, with explicit expectations against any future complaint regarding the lack of use of low-chairs, or high-chairs, or a low table for children eating baby food and sitting up on their own. Such repeated complaint can result in immediate termination. A mandatory training regarding expectations and policies for feeding younger than 2 years of age will be held October 30, with a follow up meeting November 9th 2017. This training will be facilitated by center management. Additionally, we will be reaching out to Child Protective Services to set up re-training on mandated reporting procedures. The target date will be to align this follow up training scheduled for November 9, 2017. The required participants will include all infant and toddler room staff in order to help establish accountability for all staff members. Verification of the training will be filed in their personnel file.

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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