Gedell Gresham

Areas and furnishings of the family day home, inside and outside, shall be maintained in a clean, safe, and operable condition.

“1. The wooden jungle gym had splintered wood that was raised above the surface that could snag the skin of a child in care. 2. The caterpillar play tunnel and the plastic water table were broken in multiple areas. 3. The spring rocking horse stabilizing frame had one broken leg.”

Rule 8VAC20-800-240-A.

Hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.

“1. In the bathroom children use, one container of mouthwash was sitting on the sink counter and two cans of air freshener were stored in reach of children. 2. One container of antifreeze was being stored on the floor of the deck leading to the outdoor play area.”

Rule 8VAC20-800-280.

The family day home shall keep a written record of children in attendance each day.

“The provider did not have documentation of attendance for one of the five children.”

Rule 8VAC20-800-50-A.

Caregivers shall ensure that children’s hands are washed with liquid soap and warm running water after contact with any body fluids.

“Caregiver #1 removed a soiled diaper and did not wash their hands.”

Rule 8VAC20-800-680-B.

Soiled disposable diapers and wipes shall be disposed of in a leak-proof or plastic-lined storage system that is either foot operated or used in such a way that neither the caregiver’s hand nor the soiled diaper or wipe touches the exterior surface of the storage system during disposal.

“A soiled diaper was sitting on a baby Exersaucer activity table when the inspector arrived.”

Rule 8VAC20-800-690-E.

Equipment and materials used by a child shall be appropriate to the age, size, ability, and interest of the child.

“Child #1 (20 months old) and child #2 (23 months old) were napping in infant bouncy seats.”

Rule 8VAC20-790-480-B.

All flammable materials shall be stored in an area inaccessible to children.

“One gas can and one pressure washer were in the yard where children play.”

Rule 8VAC20-800-320-H.

Caregivers who work directly with children shall annually attend the department’s health and safety update course.

“1. Caregiver #3, employed for over two years did not attend the department’s health and safety update course.”

Rule 8VAC20-790-250-F.

The provider shall 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.

“The record for child #1 did not contain documentation of a physical examination.”

Rule 8VAC20-800-100-A.

The provider shall obtain for each caregiver a current Report of Tuberculosis Screening (TB) form, in accordance with the requirements in 8VAC20-800-170, every two years from the date of the first screening.

“Caregiver #3 did not have an updated TB screening.”

Rule 8VAC20-800-180-B.

Bottles shall be refrigerated and labeled with the child’s full name and the date, if more than one infant is in care.

“The bottles for child #1 and child #2 did not have a name or date.”

Rule 8VAC20-800-960-E.

Based on review of two household member’s records and interview, the provider did not obtain a current central registry check every five years from the initial central registry check for each household member.

“Evidence: 1. The most recent central registry check for household member #1 was dated 03/11/2018, exceeding five years. 2. The most recent central registry check for household member #2 was dated 03/06/2018, exceeding five years. 3. The provider had documentation of where an updated central registry check had been requested for household member #1 and #2, however the results of the central registry check had not been received and a follow-up to the status of the background check had not been conducted”

Rule 22.1-289.036-A.

Based on observation, the provider did not ensure Infant carrier seats, swings, strollers, feeding or activity tables, and high chairs were used according to the manufacturer’s instructions and when occupied by a child, a safety strap was securely fastened.

“Evidence: Child #4, 11 months in age, was observed sleeping in a bouncer without the safety strap fastened. The provider stated the seat belt was not fastened.”

Rule 8VAC20-800-540-A.

Based on review of eight children’s records, the provider did not obtain documentation of the child’s physical prior to the child’s attendance or within 30 days after the first day of attendance for two children’s records.

“Evidence: 1. The record of Child #3, enrolled 01/23/2023, did not have documentation of a physical exceeding 30 days from the first day of attendance. 2. The record of Child #6, enrolled 01/03/2023, did not have documentation of a physical exceeding 30 days from the first day of attendance.”

Rule 8VAC20-800-100-A.

Based on observation, the provider did not ensure areas and furnishing of the family day home, inside and outside, were maintained in a clean, safe, and operable condition.

“Evidence: Two sheets of wooden latus were observed on the ground near the slide. The latus had multiple nails that were protruding upward and posed a risk of puncturing a child in care.”

Rule 8VAC20-800-240-A.

Based on review of eight children’s records, the provider did not annually obtain the parents signed acknowledgement of the emergency contact information review.

“Evidence: 1. The most recent acknowledgement of the emergency contact information for child #4 was dated 03/18/2018, exceeding the annual requirements. 2. The most recent acknowledgement of the emergency contact information for child #8 was dated 04/03/2017, exceeding the annual requirements.”

Rule 8VAC20-800-780-B.

Based on review of two household member’s records and interview, the provider did not obtain a current central registry check every five years from the initial central registry check for one household member.

“Evidence: 1. The most recent central registry check for household member #2 was dated 02/20/2018. 2. The provider stated she had not requested an updated central registry for household member #2.”

Rule 22.1-289.036-A.

Based on observation, the provider did not ensure the water of the aboveground swimming pool was not accessible to children in care.

“Evidence: The privacy fencing surrounding the raised deck of the aboveground pool had a rear gate that was missing a piece and could not be secured shut. The open area was approximately four feet off the ground and had no steps leading the pool however there was a pool pump that could be used to climb onto the deck and access the water. The entrance gate to the pool was locked.”

Rule 8VAC20-800-260-A.

Based on review of six children’s records, the provider did not obtain all required documentation for each child’s record.

Rule 8VAC20-800-60-B.

Based on observation, the provider did not ensure medication was kept in a locked place using a safe locking method that prevents access by children.

“Evidence: A box containing children’s Tylenol was observed sitting on the table in the den. Child #6, age 11 years, in care as observed in the den with access to the medication.”

Rule 8VAC20-800-730-D.

Based on review of six children’s records, the provided did not obtain documentation that a child was adequately immunized, before the child attended the family day home.

“Evidence: The record of child #6, enrolled 04/24/2023, did not contain documentation of immunizations exceeding the first day of attendance.”

Rule 8VAC20-800-90-A.

22.1-289.035-A

“Based on review of records and interview, the provider did not ensure that the background checks for one of two employees were updated every five years. Evidence: Staff #3’s last Central Registry was done on 02-22-17 and was due to be repeated no later than 02-22-22. When interviewed the provider stated that she had mailed the request on 05-16-22 but never received the results.”

Rule 22.1-289.035-A.

22.1-289.036-A

“Based on review of records and interview, the provider did not ensure that the background checks for one of two licensees/household members were updated every five years. Evidence: 1) Staff #1’s last Central Registry was done on 11-2-16 and was due to be repeated no later than 11-2-21. When interviewed the provider stated that she had mailed the request on 05-16- 22 but never received the results.”

Rule 22.1-289.036-A.

8VAC20-800-100-A

“Based on a review of records, the provider did not obtain documentation of a physical examination within 30 days of a child’s attendance for one of five children. Evidence: Child #5?s file, date of enrollment 11-15-21, did not contain a physical.”

Rule 8VAC20-800-100-A.

8VAC20-800-180-A

“Based on a review of records, and interview, the provider did not ensure that each caregiver obtains an updated TB every two years. Evidence: 1) Staff #2’s last TB was done on 04/01/20. The updated test results should have been completed on or before 04/01/2022. 2) Staff #3’s last TB was done on 04-24-19. The updated test results should have been completed on or before 04-24-21. When interviewed, the provider stated that she was unaware that staff #3 was due for updates.”

Rule 8VAC20-800-180-A.

Based on a review of caregiver records and interview, the provider did not obtain the required repeat background checks for one caregiver every five years.

“Evidence: The most recent central registry check for caregiver #1 was dated 11/02/2016 and expired on 11/02/2021. The provider stated she requested an updated central registry check in November 2021 however she had not received the results and had not followed up to obtain the status of the request.”

Rule 22.1-289.036-A.

Based on review of household member records, the provider did not ensure household member #2 obtained a current report of tuberculosis screening every two years from the date of the first screening.

“Evidence: Documentation of a tuberculosis screening for household member #2 was dated 04/24/2019, exceeding the two year allowance.”

Rule 8VAC20-800-180-A.

Based on observation and interview, the provider did not ensure the aboveground swimming pool was locked in a manner to prevent access to the water by children in care.

“Evidence: The gate to the aboveground swimming pool was closed but was not locked in a manner that would prevent access by children in care. The provider stated the lock was not in place as they had been working on the pool over the weekend.”

Rule 8VAC20-800-260-A.