Lil’ Angels Day Care Inc.

Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment.

“Staff #4 TB was dated two months prior to date of employment and has been employed for 21 days.”

Rule 8VAC20-780-160-A.

The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition.

“On the preschool playground, one bucket holding cement to anchor poles was cracked exposing sharp plastic that could entangle clothing or snag skin.”

Rule 8VAC20-780-270-A.

Repeat Violation: Staff records shall be kept for each staff person that includes all required information.

“Staff #4 had two references completed one day after date of employment.”

Rule 8VAC20-780-70.

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.

“In classroom #4, a bottle of bleach was observed in an unlocked cabinet, within reach of children. In the hallway bathroom used by children, a bottle of disinfectant wipes were observed in an unlocked cabinet, out of reach of children.”

Rule 8VAC20-780-280-B.

Injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services.

“There were no injury prevention procedures to observe at the time of inspection.”

Rule 8VAC20-780-40-J.

The center may administer prescription medication that would normally be administered by a parent or guardian to a child provided the center has obtained written authorization from a parent or guardian.

“Prescription medication for child #6 was administered to the child without written parent permission. Child #8 had prescription medication on site without written parent permission.”

Rule 8VAC20-780-510-I.

Documentation of at least 2 references to character, reputation, and competency are to be checked prior to employment.

“Staff #5, who has been actively working at the center for the past five months, did not have any completed reference verifications on file.”

Rule 8VAC20-780-70.

The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition.

“On the preschool playground, two buckets holding cement to anchor poles were cracked and broken with sharp edges that could pinch skin. Two scooters were broken, leaving plastic sharp edges. Children were observed playing in the area at the time of inspection.”

Rule 8VAC20-780-270-A.

8VAC20-780-520-C

“If diaper ointment or cream is used, written parent authorization noting any known adverse reactions shall be obtained. Child #4 and child #5 did not have written parent authorization for their diaper ointment that was on site.”

Rule 8VAC20-780-520-C.

The center shall maintain a written record of children’s serious and minor injuries in which entries are made the day of occurrence. The record shall include all required information.

“Two of five written injury reports did not include date/time the parents were notified. One of five reports did not include documentation of how the parent was notified.”

Rule 8VAC20-780-550-P.

Prior to working alone with children and within seven days of the first day of employment, staff shall be provided in writing with the center’s information listed in 8VAC20-780-420.A and the following: precautions in transporting children.

“Staff #1, staff #2, staff #3, staff #4, staff #5, staff #6, staff #8, staff #9, staff #10 was not provided in writing precautions in transporting children.”

Rule 8VAC20-780-240-D.

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

“On 05/05/2025, staff #7 was driving the center’s van to pick up children from school. The van was not put in park. The van’s door was open and the van went into reverse and bumped child #1 to the ground. First aid was administered to child #1.”

Rule 8VAC20-780-340-A.

Before the child’s first day of attending, parents shall be provided in writing the center’s transportation policy.

“The center did not provide in writing the center’s transportation policy for child #1.”

Rule 8VAC20-780-420-A.

Any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles and shall be kept in satisfactory condition to assure the safety of children.

“Bus #1, that is used daily to transport children, had a state inspection that expired seven days ago.”

Rule 8VAC20-780-580-B.

Parental permission for transportation and field trips shall be secured before the scheduled activity.

“On 05/05/2025, the center transported child #1 and did not have parental permission to transport. The center transports children to and from school daily.”

Rule 8VAC20-780-580-L.

Physical examinations completed by a physician shall be obtained prior to the first day of attendance or within 30 days after the first day of attendance.

“There was no physical examination in the record of child #1, who had been enrolled for 18 months.”

Rule 8VAC20-780-140-A.

The center shall implement a monthly practice evacuation drill.

“There was no documentation of monthly evacuation drills for October 2024, November 2024, December 2024.”

Rule 8VAC20-780-550-D.

Lockdown procedures shall be practiced at least annually.

“There was no documentation that the annual lockdown drill had been completed in 2024.”

Rule 8VAC20-780-550-F.

22.1-289.035-B-2

“Based on a review of staff records and interview, the center did not ensure one staff member completed a national fingerprint check prior to the first day of employment. Evidence: 1. The national fingerprint check for Staff #1, employed 05/19/2023, contained results that were dated 05/23/2023. 2. Director confirmed the hire date of the staff is correct and acknowledged the results were late.”

Rule 22.1-289.035-B-2.

Based on review of staff records and interview, the center did not ensure to obtain a copy of the results of a search of the central registry prior to employment and by the end of 30th Day.

“Evidence: 1. Staff #1 (DOH 05/19/2023) had a central registry result on file dated 03/26/2024. 2. Leadership acknowledged there was no other documentation on record.”

Rule 22.1-289.035-B-3.

8VAC20-780-130-E

“8VAC20-780-130-E Based on a review of children’s records, the center did not ensure that each child’s record contained documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1. Child #1, 14 months of age, had immunization records dated 08/08/2023, 10/05/2023 and 07/23/2024. Child’s first day of attendance was 08/14/2023. 2. Child #5, 9 months of age, had one immunization record dated 01/18/2024. Child’s first day of attendance was 01/29/2024.”

Rule 8VAC20-780-130-E.

8VAC20-780-140-A

“Based on a review of children’s records, the center did not ensure that each child have a physical examination by or under the direction of a physician before the child’s attendance; or within 30 days after the first day of attendance. Evidence: 1. Child #2, first day of attendance 04/22/2024, did not have a physical examination in the file. 2. Director acknowledged the physical was missing from the file.”

Rule 8VAC20-780-140-A.

8VAC20-780-160-A

“Based on review of staff records, the center did not ensure documentation of tuberculosis screening was completed at the time of employment and prior to coming into contact with children. Evidence: 1. The documentation for staff #1, employed 05/19/2023, was dated for 05/21/2023.”

Rule 8VAC20-780-160-A.

8VAC20-780-130-A

“Description: Based on record review, the center did not ensure to obtain documentation that each child received immunizations required by the State Board of Health before the first day of attendance. Evidence: The record of child #3 (DOE 12/13/23) contained an immunization record date 3/14/24.”

Rule 8VAC20-780-130-A.

8VAC20-780-130-E

“Description: Based on record review, the center did not obtain additional immunizations once every six months for children under the age of two years. Evidence: 1. Child #4 (DOE 3/16/21) had one immunization record dated 2/26/21. 2. Child #6 (DOE 4/26/21) had one immunization record dated 4/23/21 and a late immunization update dated 2/18/22. 3. Child #5 (DOE 7/17/23) had one immunization record dated 6/26/23 and a late immunization update dated 3/6/24.”

Rule 8VAC20-780-130-E.

8VAC20-780-240-C

“Description: Based on record review, the center did not ensure that the orientation training included all required topics. Evidence: The record for Staff #6 had documentation of an orientation training that did not include prevention of sudden infant death syndrome and use of safe sleep practices, prevention of shaken baby syndrome and abusive head trauma.”

Rule 8VAC20-780-240-C.

8VAC20-780-270-A

“Description: Based on observation, the outside area of the center was not maintained in a clean, safe and operable condition. Evidence: 1. There was a total of 4 sets of coat hooks hanging from the fences outside that were all rusted. 2. A broken chair was found with multiple cracks that could entangle clothes or pinch skin.”

Rule 8VAC20-780-270-A.

8VAC20-780-340-A

“Description: Based on observation, staff did not always ensure the care and protection of children. Evidence: 7 out of 7 booster seats in the center’s vehicle were expired. The expiration dates ranged from December 2010-December 2013.”

Rule 8VAC20-780-340-A.

8VAC20-780-340-F

“Description: Based on observation, the center failed to ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff. Evidence: A child from the preschool room was observed walking unsupervised to another classroom to use the restroom.”

Rule 8VAC20-780-340-F.

8VAC20-780-370-5

“Description: Based on observation, the infant plays spaces indoors and outside did not cumulatively offer equipment and toys that support large motor development. Evidence: 1. The infant room play space indoors did not have any equipment and toys that support large motor development. 2. The outside play area for infant room did not have any equipment and toys that support large motor development.”

Rule 8VAC20-780-370-5.

8VAC20-780-500-A

“Description: Based on observation, staff failed to wash their hands before and after a diaper change and to ensure children’s hands were washed after toileting. Evidence: 1. Staff #6 was observed putting on gloves to change an infant diaper without washing hands, changed the infant diaper, and did not wash hands after diapering the child. 2. In the infant room, the hands of two children were not washed after their diapers were changed.”

Rule 8VAC20-780-500-A.

8VAC20-780-500-B

“Description: Based on observation, staff failed to sanitize the diapering surface after each use. Evidence: Staff #6 did not sanitize the diapering surface after the surface was cleaned.”

Rule 8VAC20-780-500-B.

8VAC20-780-60-A

“Description: Based on child record review, the provider failed to ensure that two out of six child records contained required documentation. Evidence: Child #4 and Child #6 did not contain documentation of child updates and confirmation of up-to-date information in the child’s record as required by 8VAC20-780-420-E-3.”

Rule 8VAC20-780-60-A.

Based on review of five children’s records and interview, the center did not ensure to obtain documentation of additional immunizations once every six months for one child under the age of two years as required.

“Evidence: 1. The record of child #4 (enrolled: 4/26/21) contained an immunization record dated 4/23/21 and 2/18/22. Child #4 was required to have an documentation of additional immunization once every six months. 2. Administration acknowledged that the immunization update was missing.”

Rule 8VAC20-780-130-E.

Based on a review of staff records, the center did not ensure that subsequent communicable tuberculosis (TB) screenings were conducted at least every two years from the date of the initial screening.

“Evidence: 1. The record for staff #3 (date of last TB screening 8/26/21) did not contain updated TB screening results as of 02/15/2024.”

Rule 8VAC20-780-160-C.

Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition.

“Evidence: On the preschool playground, there are 9 buckets holding cement to anchor poles of the shelter play area. The 9 buckets were cracked, had sharp edges, and areas where a child could pinch skin.”

Rule 8VAC20-780-270-A.

Based on interviews, the center did not ensure to follow the required ratio for children from birth to the age of 16 months: one staff member for every four children.

“Evidence: 1. Staff #1 was left alone to supervise 7 infant children in room #1 for approximately four minutes while staff #2 cleaned the highchairs in the cafeteria area outside of room #1.”

Rule 8VAC20-780-350-B-1.

Repeat Violation Based on observation and interview, the center did not ensure to maintain a current written list of all children’s allergies, sensitivities, and dietary restrictions which is dated and kept confidential in each room or area where children are present.

“Evidence: In room #1, the allergy list was not posted. Child A is enrolled in room #1 and has allergies to specific foods.”

Rule 8VAC20-780-40-M.

Based on record review, the licensee did not ensure that there was a minimum of one lockdown drill practiced, yearly.

“Evidence: The facility did not have documentation of a lockdown drill for 2023.”

Rule 8VAC20-780-550-F.

Based on a review of children’s records, the center did not ensure that each record contains all required information.

“Evidence: 1. The record for child #2 had a list of foods from an allergy test that documented the allergies and sensitives to specific foods. The record did not have a written care plan that included instructions from a physician regarding the foot to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. 2. The administrator stated that the record did not have a written care plan.”

Rule 8VAC20-780-60-A.

8VAC20-790-600-F

“Based on records review, the center failed to ensure that staff who work directly with children, shall annually attend the departments 3 hour health and safety update course. Evidence: The record for staff #3, date of employment 04/04/13, contained a 3 hour health and safety course certificate dated 07/16/2021. There was not an updated training for 2022.”

Rule 8VAC20-790-600-F.

8VAC20-780-40-M

Rule 8VAC20-780-40-M.

8VAC20-790-600-D-1

“Based on records review, and interview, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR). Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in CPR. The Director acknowledged that staff #2 did not have current certification in CPR.”

Rule 8VAC20-790-600-D-1.

8VAC20-790-600-D-2

“Based on records review, and interview, the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in First Aid. Evidence: The record for staff #2, date of employment 10/11/22, did not contain documentation of current certification in First Aid. The Director acknowledged that staff #2 did not have current certification in First Aid.”

Rule 8VAC20-790-600-D-2.

8VAC20-780-160-A

“Based on record review, the center failed to ensure that each staff member submits documentation of a negative tuberculosis screening no more than 30 calendar days prior to the date of employment. Evidence: The record for staff #2, date of employment 10/11/22, contained documentation of tuberculosis screening dated 8/20/21.”

Rule 8VAC20-780-160-A.

8VAC20-780-550-D

“Based on documentation review, and interview, the center failed to document monthly practice evacuation drills. Evidence: Review of the evacuation drill documentation revealed no drills were documented for the months of August, September, October, November, or December of 2022. The Director acknowledged that the drills were not documented for those months.”

Rule 8VAC20-780-550-D.

22.1-289.035-B-2

“Based on records review, and interview, the center did not ensure that the national background check was completed on staff #5 prior to employment. Evidence: Staff #5?s file (employed-07/25/22) did not contain documentation of completion of a national background check. Staff #5 was seen working in the classroom. When interviewed the Director stated that the fingerprints results were sent but that she didn’t know where she had placed them.”

Rule 22.1-289.035-B-2.

8VAC20-780-550-P

“Based on a review of records, the center did not ensure that injury reports contain the date that the parent was notified of the injury, how the parent was notified, or future action to prevent recurrence. Evidence: 5 out of 5 injury reports reviewed did not contain a space for this information.”

Rule 8VAC20-780-550-P.

8VAC20-780-570-E

“Based on observation, the center did not ensure that prepared infant formula was dated. Evidence: 3 out of 6 bottles had no date written on the bottle.”

Rule 8VAC20-780-570-E.

8VAC20-780-70

“Based on observation, the center did not ensure to have two or more references as to character and reputation as well as competency checked before employment. Evidence: 2 out of 5 staff records reviewed did not include reference checks.”

Rule 8VAC20-780-70.

Based on review, the facility did not ensure staff complete the annual Health and Safety Update Training for subsidy vendors.

“Evidence: 1. The records for staff #1 and staff #2 did not have documentation of the Annual Virginia Health and Safety Update training course at the time of the inspection.”

Rule 8VAC20-790-600-F.

Based on observation, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition.

“Evidence: 1. At the bottom of the stairs leading to classroom #4, there was a hole in the wall with exposed dry wall. 2. The Director stated that she was aware of the hole in the drywall.”

Rule 8VAC20-780-270-A.

Based on observation, the center did not ensure that all 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.

“Evidence: In bathroom #1, there was one container of Clorox labeled ?Caution? and ?Hazard?, one container of air wick lavender spray labeled ?Keep Out of Reach of Children,? ?Caution,? and ?Hazard?, and one bottle of Isopropyl Alcohol labeled ?Flammable,? Caution,? and ?Keep Out of Reach of Children? in a cabinet accessible by children”

Rule 8VAC20-780-280-B.