Pamela Shands

Children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision shall not have access to stairs.

“The stairs leading to the upstairs portion of the home and the stairs leading to the lower level of the home did not have a gate to prevent access. There were 3 children under the age of 2 present.”

Rule 8VAC20-800-430-A.

Infants shall be placed on their backs when sleeping or napping unless otherwise ordered by a written statement signed by the child’s physician.

“Child #5, age 9 months, fell asleep on a mat on the floor. The provider picked child #5 up and moved the child to their crib placing them on their stomach in the crib.”

Rule 8VAC20-800-590-A.

Toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use.

“There was a toilet chair in the restroom that was half full with urine.”

Rule 8VAC20-800-690-L.

The emergency evacuation procedures shall be practiced monthly.

“The emergency evacuation procedures were not practiced in June 2025.”

Rule 8VAC20-800-830-A.

Within seven business days of the child’s first day of attendance, the provider shall obtain from the parent verification of the identity and age of the child.

“The record for child #4, enrolled for 6 months, did not contain documentation of viewing the identity and age of the child.”

Rule 8VAC20-800-80-A.

8VAC20-800-290

“Based on observation, the provider failed to ensure that sharp kitchen utensils and other sharp objects shall be inaccessible to children unless being used by the caregiver or with children under close supervision. Evidence: There was a knife block with knives in it on the counter in the kitchen.”

Rule 8VAC20-800-290.

8VAC20-800-320-G

“Based on observation, and interview, the provider failed to ensure that wood burning stoves and fireplaces shall be inspected annually. Evidence: Documentation review revealed that the woodburning fireplace was inspected on 07/19/2022. Interview with the provider confirmed that the fireplace has not had an annual inspection since 07/19/2022.”

Rule 8VAC20-800-320-G.

8VAC20-800-730-D

“Based on observation, the provider failed to ensure that medication shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: The first aid kit was in a low unlocked cabinet. There was a packet of Tylenol, a packet of Motrin, and a container of Benadryl cream in the first aid kit.”

Rule 8VAC20-800-730-D.

8VAC20-790-250-F

“Based on record review the provider failed to ensure that caregivers who work directly with children shall attend the department’s health and safety update course annually. Evidence: The record for caregiver #1, date of employment 9/4/18, contained documentation of the departments health and safety update course dated 06/08/21. The annual course was due on 06/08/2022 and 06/08/23.”

Rule 8VAC20-790-250-F.

22.1-289.035-A

“Based on record review, and interview, the provider failed to obtain the results of central registry background check every five years for all caregivers. Evidence: The record for caregiver #1, date of employment 9/4/2018, contained a central registry background check dated 12/12/18. A repeat central registry background check was due on or before 12/12/23. The provider confirmed that a repeat central registry background check was not obtained for caregiver #1.”

Rule 22.1-289.035-A.

8VAC20-800-210-A

“Based on record review, and interview, the provider failed to ensure that caregivers shall obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: The record for caregiver #1 did not contain documentation of a minimum of sixteen clock hours of training annually. The provider confirmed that caregiver #1 did not have the required sixteen annual clock hours of training.”

Rule 8VAC20-800-210-A.

8VAC20-790-180-B

Rule 8VAC20-790-180-B.

8VAC20-800-110-B

“Based on a review of children’s records on April 11, 2022, the provider did not ensure that immunizations received shall be signed by a licensed physician, the physician’s designee, or an official of a local health department. Evidence: The record of child #3 (enrolled 3/14/22) contained documentation of immunizations that were not signed by a licensed physician, the physician’s designee, or an official of a local health department.”

Rule 8VAC20-800-110-B.

8VAC20-800-320-G

“Based on an interview on April 11, 2022, the provider did not ensure the fireplace would be inspected annually by a knowledgeable inspector to verify that the devices were properly installed, maintained, and cleaned as needed. Evidence: The provider stated the fireplace had not been annually inspected.”

Rule 8VAC20-800-320-G.

8VAC20-800-70-A

“Based on a review of children’s records and interview on April 11, 2022, the provider failed to ensure that parents were provided the required information for parents before the child’s first day of attendance. Evidence: 1. The record of child #3 (enrolled 3/14/22) did not contain the parent’s written acknowledgement of receipt of information regarding the liability insurance declaration. 2. The provider acknowledged the insurance paperwork wasn’t signed.”

Rule 8VAC20-800-70-A.

8VAC20-800-730-D

“Based on observation on April 11, 2022, the provider did not ensure medication, except for those prescriptions designated otherwise by a written physician’s order, including refrigerated medication and medications for caregivers and household members, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: Prescription medication was located in an unlocked medicine cabinet in the bathroom used by children.”

Rule 8VAC20-800-730-D.

8VAC20-800-800-B

“Based on a review of the emergency preparedness plan and interview on April 11, 2022, the provider did not ensure that documentation of an annual review of the emergency preparedness plan was completed. Evidence: Written documentation indicated the emergency preparedness plan was last reviewed on 6/21/17. The provider confirmed that she had reviewed the plan but had not documented the review.”

Rule 8VAC20-800-800-B.