Little Blessings Child Care, Inc.

Staff who do not work with a group of children at the center shall only be required to complete annual training in emergency preparedness and response, child abuse and neglect, and mandated reporter requirements.

“Staff 1, employed for two years, did not complete the required annual training in emergency preparedness and response, child abuse and neglect, and mandated reporter in 2025; the most recent training took place in September 2024.”

Rule 8VAC20-780-245-C.

When staff are supervising children, they shall always ensure their care, protection and guidance.

Rule 8VAC20-780-340-A.

Repeat violation

Rule 8VAC20-780-340-F.

A first aid kit shall be on field trips and wherever children are in care.

“08/12/2026, Staff 2 used Vehicle 2 to transport Child 1 (age 4 years) to a public school; there was not a first aid kit on Vehicle 2.”

Rule 8VAC20-780-540-A.

The center shall prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc. that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as pick up or drop off of children to or from schools. This document must be kept in vehicles that centers use to transport children to and from the center.

“08/12/2026, Staff 2 used Vehicle 2 to transport Child 1 (age 4 years) to a public school; Vehicle 2 did not contain the required document.”

Rule 8VAC20-780-550-K.

The following information is required to be in transportation vehicles: emergency numbers as specified by the standards; the center’s name, address and phone number; and a list of the names of the children being transported.

“08/12/2026, Staff 2 used Vehicle 2 to transport Child 1 (age 4 years) to a public school; Vehicle 2 did not contain the required emergency numbers, the center’s name, address and phone number, and a list of the names of the children being transported.”

Rule 8VAC20-780-580-C.

Repeat violation

“Children under 10 years of age always shall be within actual sight and sound supervision of staff. Staff 3 was the only staff member supervising the children in Classroom 1. Staff 3 left the classroom leaving the children alone and out of the actual sight and sound supervision of staff.”

Rule 8VAC20-780-340-F.

Medication shall be labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given.

“Medication 2 was not labeled to indicate the dosage amount or time/times to be given.”

Rule 8VAC20-780-510-G.

When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days, or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center.

“The medication administration authorization form for Medication 3 has been expired for over five months; the medication was on-site during the inspection.”

Rule 8VAC20-780-510-P.

A written care plan is required for each child with a diagnosed food allergy, to include instruction from a physician regarding food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

“Child 2 (age 3 years), enrolled for more than two years, has a diagnosed food allergy; there was not a written care plan available. Child 3 (age 3 years), enrolled for more than one year, has a diagnosed food allergy; there was not a written care plan available.”

Rule 8VAC20-780-60-A-8.

For each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child as it occurs.

“There were 14 children present in Classroom 2, but only 11 children were marked present on the attendance record. There were 16 children present in Classroom 3, but there were 18 children marked present on the attendance record.”

Rule 8VAC20-780-80-A.

The center is required to have employees undergo a background check every five years.

“The central registry for Staff 3 is overdue by one month. The sworn statement for Staff 4 is overdue by 10 months.”

Rule 22.1-289.035-A.

Children under 10 years of age always shall be within actual sight and sound supervision of staff.

“Staff 5 was the only staff member supervising the pre-k class. Staff 5 left the group of children to use the restroom. The children were not within actual sight and sound supervision of staff during the time Staff 5 was in the restroom.”

Rule 8VAC20-780-340-F.

Repeat violation

“Based on record review, the center failed to ensure that no person shall be hired for compensated employment prior to the facility obtaining an employment eligibility letter upon the completion of a fingerprint background check as required by the Code of Virginia. Evidence: The record for Staff 3 contained a documented hire date of 10/11/2023. The eligibility letter for Staff 3 was dated 10/13/2023.”

Rule 22.1-289.035-B-2.

Based on record review, the center failed to obtain a copy of the child abuse and neglect registry check from any state in which the individual has resided in the preceding five years.

“Evidence: The record for Staff 3 contained evidence that Staff 3 had resided outside of the state of Virginia within the preceding five years. The record for Staff 3 contained a documented hire date of 10/11/2023. There was not a child abuse and neglect registry check from all of the states in which the individual had resided in the preceding five years available for review during the inspection. Staff 3 was observed working during the inspection.”

Rule 22.1-289.035-B-4.

Based on record review, the center failed to obtain documentation of additional immunizations once every six months for children under the age of two years.

“Evidence: The record for Child 1contained a documented start date of 10/30/2023. The most recent immunization record in the record for Child 1 was dated 10/03/2023; additional immunizations have not been obtained every 6 months from 10/03/2023 until the time that the child turned 2 years old.”

Rule 8VAC20-780-130-E.

Based on observation, staff interviews, and record review, the center failed to maintain the maximum group size limitations.

“Evidence: There were 20 children observed in the toddler group at approximately 10:00 am participating in free choice activities. The maximum group size for this age, based on an allowable variance for ratio issued to the center, is 18 children.”

Rule 8VAC20-780-350-A.

Based on observation and staff interviews, record review and staff interviews, the center failed to maintain the required staff-to-child ratio for children 16 months up to 24 months.

“Evidence: There were 20 children observed in toddler class. There were 3 staff observed supervising the group of children. Staff 1 identified Child 2 as the youngest child in the group. Child 2 was determined to be 16 months old. The required staff-to-child ratio, based on an allowable variance for ratio issued to the center, for children 16 months up to 24 months is 1:6. A total of 4 staff was required for this group of children.”

Rule 8VAC20-780-350-B-2.

Repeat violation

“Based on observation, the center failed to ensure that the diapering surface shall be cleaned with soap and water and sanitized after each use. Evidence: Staff 3 was observed changing a diaper. Staff 3 did not clean or sanitize the diapering surface after changing a diaper.”

Rule 8VAC20-780-500-B.

Based on observation and staff interviews, the center failed to ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.

Rule 8VAC20-780-80-A.

Based on observation and interview, the center failed to ensure that those drugs that were dispensed from a pharmacy and maintained in the original, labeled container.

“Evidence: In the medicine box, there was one epi pen in a plastic Ziploc labeled with a name and one inhaler in a Ziploc bag labeled with a name.”

Rule 8VAC20-780-510-I.

Based on observation and staff interview, the center failed to ensure that medication, except for those prescriptions designated otherwise by a written physician’s order, including refrigerated medication and staff’s personal medication, shall be kept in a locked place using a safe locking method that prevents access by children.

“Evidence: 1.Staff #4 stated that medication was not administered at the center but that there was medication in the children’s bags from home. 2.Two bags from home contained over-the counter medication. 3.The medications were not kept in a locked place using a safe locking method that prevents access by children. 4.Children were observed in the area wherethe bags were located.”

Rule 8VAC20-780-510-L.

Based on observation the center failed to keep all diaper cream inaccessible to children.

“Evidence: Observed diaper cream in a child’s cubby in classroom #3. This cubby was accessible to children. Children were observed in this area.”

Rule 8VAC20-780-520-C.

Based on document review and staff interviews, the center failed to ensure that no person shall be hired for compensated employment prior to the facility obtaining an employment eligibility letter upon the completion of a fingerprint background check as required by the Code of Virginia.

“Evidence: The record for Staff 4 contained a documented hire date of 01/17/2023. The eligibility letter for Staff 4 was dated 01/23/2023.”

Rule 22.1-289.035-B-2.

Based on observation, the center failed to ensure that areas and equipment, inside and outside, shall be maintained in a clean, safe and operable condition.

Rule 8VAC20-780-270-A.

Based on observation, the center failed to ensure that where playground equipment is provided, resilient surfacing shall comply with minimum safety standards and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles.

Rule 8VAC20-780-330-B.

Based on observation, the center failed to ensure that the S-hooks on play equipment shall not be open more than the thickness of a penny.

“Evidence: The opening of the S-hooks on the swing set on the Pre-K playground were open greater than the thickness of a penny.”

Rule 8VAC20-780-430-C.

Based on observations, the center failed to ensure that tables shall be sanitized before and after each use for feeding.

“Evidence: The Toddler/2 year old class was observed sitting down to eat their lunch after the Pre-K class. One of the tables used by the children was not sanitized between the lunch service of the Pre-K class and the toddler/2 year old class.”

Rule 8VAC20-780-560-J.

Based on observation, the center failed to ensure that bottles shall not be used while the child is in their designated sleeping location.

“Evidence: Child 4 was observed lying in their crib while drinking a bottle.”

Rule 8VAC20-780-570-B.

REPEAT VIOLATION Based on document review and discussion with staff, the center failed to ensure that the record for each child on formula shall contain the brand of formula; and the child’s feeding schedule.

“Evidence: Staff 2 stated that there were four children on formula in the infant room. The record for three of the four children on formula did not include the child’s feeding schedule.”

Rule 8VAC20-780-570-C.

Based on document review, the center failed to develop written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices and sudden infant death syndrome awareness.

“Evidence: The written procedure for prevention of shaken baby syndrome or abusive head trauma did not include safe sleeping practices.”

Rule 8VAC20-780-40-K.

Based on observation, the center failed to ensure that children’s hands shall be washed with soap and running water after toileting; that staff shall wash their hands with soap and running water before and after a diaper change; and after any contact with body fluids.

“Evidence: 1. Child 5 was observed during a diaper change. Child 5?s hands were not washed after the diaper change. 2. Staff 1 was observed during a diaper change. Staff 1 did not wash their hands after a diaper change. 3. Staff 1 was observed wiping a child’s nose. Staff 1 did not wash their hands after contact with body fluids. 4. Staff 5 was observed wiping a child’s nose. Staff 5 did not wash their hands after contact with body fluids.”

Rule 8VAC20-780-500-A.

Based on observation, the center failed to ensure that the diapering surface shall be cleaned with soap and water and sanitized after each use.

“Evidence: Staff 1 was observed during a diaper change. The diapering surface was not cleaned with soap and water and was not sanitized after the diaper change.”

Rule 8VAC20-780-500-B.

Based on observation, the center failed to ensure that the first aid kits contain the minimum components as required by the standards.

“Evidence: The first aid kit in the 15 Passenger Van did not contain gauze pads, scissors or tweezers.”

Rule 8VAC20-780-540-C.

Based on document review, the center failed to ensure that the record for each child on formula shall contain the brand of formula; and the child’s feeding schedule.

“Evidence: There were three children on formula in the infant room. The record for each child on formula did not include the child’s feeding schedule.”

Rule 8VAC20-780-570-C.

Based on document review and discussion with staff, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening prior to coming into contact with children and that the documentation shall have been completed within the last 30 calendar days of the date of employment.

“Evidence: 1. The record for Staff 1 did not contain documentation of a negative tuberculosis screening prior to coming into contact with children; the documentation of a tuberculosis screening in the record for Staff 1 did not contain a name to identify who was screened. 2. The record for Staff 4 contained a documented hire date of 01/31/2022. The date on the tuberculosis screening was 08/26/2021. The tuberculosis screening had not been completed within the last 30 calendar days of the date of employment.”

Rule 8VAC20-780-160-A.

Based on observation and discussion with staff, the center failed to ensure that when children are in on-going mixed age groups, the staff-to-children ratio applicable to the youngest child in the group shall apply to the entire group.

Rule 8VAC20-780-350-C.

Based on discussion with staff, the center failed to develop written procedures for prevention of shaken baby syndrome or abusive head trauma.

“Evidence: Staff 6 stated that the center did not have written procedure for prevention of shaken baby syndrome or abusive head trauma.”

Rule 8VAC20-780-40-K.

Based on observation and discussion with staff, the center failed to ensure that children’s hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks.

“Evidence: Child 6 and Child 7 were observed immediately going outside to play upon completing their breakfast. Child 6 and Child 7 did not wash their hands with soap and running water or disposable wipes after eating a meal.”

Rule 8VAC20-780-500-A.

Based on record review and discussion with staff, the center failed to ensure that the separate record for each enrolled child shall contain all of the elements as required by the standards.

“Evidence: The record for Child 2 contained documentation of a diagnosed food allergy. The record for Child 2 did not contain a written care plan, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.”

Rule 8VAC20-780-60-A.

Based on document review and discussion with staff, the center failed to ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.

“Evidence: The written record of daily attendance taken for each group of children did not document the departure of each child as it occurs.”

Rule 8VAC20-780-80-A.