Children of America - Lee’s Hill, LLC

Behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

Rule 8VAC20-780-400-B.

The following actions or threats thereof are forbidden: roughly handling a child.

Rule 8VAC20-780-410-1.

The center shall obtain documentation of additional immunizations once every six months for children under the age of two years.

“The additional immunizations in the record of Child #5 (14-months-old), who had been enrolled for 11 months, were obtained four months late.”

Rule 8VAC20-780-130-E.

(Complaint Related) The required ratio for children ages 3 years old up to 5 years old is one staff per 10 children.

“On 04/13/26, Staff #1 left the classroom to pursue a child who exited the room and ran out the center’s front door. Staff #1 was out of the classroom for approximately 2 to 5 minutes. During this time, one staff member remained in the classroom supervising 17 children until Staff #1 returned. The youngest child in the room was three years old.”

Rule 8VAC20-780-350-B-4. From a complaint.

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

Rule 8VAC20-780-340-A. From a complaint.

For each infant, the center shall post a daily record which can be easily accessed by both the parent and the staff working with the child.

“Staff #1 reported Child #1 (9-month-old) was asleep from 1:45pm to approximately 2:45pm, but the amount of time the child slept was not in the child’s daily sheet. The child was given a bottle between 12:52pm and 3:12pm, but the amount consumed and the time was not in the child’s daily sheet.”

Rule 8VAC20-780-420-E-1. From a complaint.

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

“On 02/23/26, staff observed “carpet marks” on the child’s arms and forehead; red spots on her back and head; redness across her back and swelling on the top of her back. Written statements documenting the observed injuries were dated 02/24/26.”

Rule 8VAC20-780-550-P. From a complaint.

The center shall inform the department’s representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurs while the child is under the supervision of the center and requires outside medical attention.

“Child #1 (9-months-old) sustained injuries at the center on 02/23/26 for which they sought medical attention. The center was made aware on 02/23/26, but the center did not inform the department’s representatives.”

Rule 8VAC20-780-80-B-2. From a complaint.

The center shall obtain documentation of additional immunizations once every six months for children under the age of two years.

“The record of Child #5 (22-month-old), who has been enrolled for 21 months, did not have documentation of additional immunizations since the child was enrolled. The record of Child #8 (15-month-old), who has been enrolled for 12 months, did not have documentation of additional immunizations since the child was enrolled.”

Rule 8VAC20-780-130-E.

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 #5, who has been enrolled for 21 months.”

Rule 8VAC20-780-140-A.

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

“On 10/08/25, Staff #1 gave Child #1 (5-month-old) breastmilk that belonged to another child. Child #1 drank approximately 3 ounces of the wrong breastmilk. Staff #1 acknowledged she did not check the labeling on the breastmilk bag and mistakenly emptied Child #2?s breastmilk into Child #1?s bottle.”

Rule 8VAC20-780-340-A.

8VAC20-780-340-A

Rule 8VAC20-780-340-A.

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

Rule 8VAC20-780-340-A. From a complaint.

When children are in ongoing mixed age groups, the staff-to-children ratio and group size applicable to the youngest child in the group shall apply to the entire group.

“On 01/21/2025, Staff #1 was the only staff member in a classroom with 16 children. The youngest child in care was two years old, therefore the applicable staff-to-child ratio was one staff to eight children. It is estimated that Staff #1 was out of ratio for approximately 35 minutes, from 6:55am until 7:30am, when two additional staff members arrived. Staff reported the center regularly combines classrooms in the mornings.”

Rule 8VAC20-780-350-C. From a complaint.

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

“On 12/11/24, after dropping children off at the center and parking, Staff #1 exited the bus and did not realize Child #1 (6-year-old) had fallen asleep and was still on the bus. Child #1 was out of sight and sound supervision of staff for approximately 30 minutes.”

Rule 8VAC20-780-340-F. From a complaint.

The center is required to ensure the center’s own policies and procedures that are required by these standards are in compliance.

Rule 8VAC20-780-40-E. From a complaint.

Staff shall verify that all children have been removed from the vehicle at the conclusion of any trip.

“On 12/11/24, after dropping children off at the center and parking, Staff #1 exited the bus after turning off the child checkmate system. Staff #1 stated they did not conduct a ?visual sweep? to ensure all the children were off the bus after the children were dropped off at the center. As a result, Child #1 (6-year-old) had fallen asleep and was left behind on the bus for approximately 30 minutes.”

Rule 8VAC20-780-580-K. From a complaint.

A tuberculosis (TB) screening is required every two years from the last screening.

“The updated TB screening for Staff #3 was obtained 15 days after the previous one expired. The updated TB screening for Staff #5 was obtained 20 days after the previous one expired. The updated TB screening for Staff #7 was obtained five days after the previous one expired.”

Rule 8VAC20-780-160-C.

When an authorization for medication expires, the facility shall notify parents that the medication must be picked up within 14 days of the authorization expiring or that a new authorization should be completed.

“Medication for Child #3 was onsite, but the medication authorization had expired over 30 days ago. The medication had not been administered past the expiration of the authorization. The authorization had not been renewed and the medication was not returned or disposed of as required.”

Rule 8VAC20-780-510-P.

Behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

“On July 25, 2024, Staff #1 grabbed Child #1 (10-year-old) by the shoulders, threw them out of a chair and into a bookshelf after Child #1 was accused of pulling Staff #1?s hair.”

Rule 8VAC20-780-400-B.

The following actions or threats thereof are forbidden: physical punishment, striking a child, roughly handling or shaking a child.

“On July 25, 2024, Child #1 (10-year-old) was accused of pulling Staff #1?s hair. Staff #1 was observed by another staff member saying to Child #1 ?do not touch me ugly little girl,? grabbing the child by the shoulders, and throwing them out of a chair and into a bookshelf.”

Rule 8VAC20-780-410-1.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“REPEAT VIOLATION Based on observation, not all potentially hazardous substances were stored in a locked place. Evidence: 1. In the three and four’s class, there was a bottle of sanitizer stored in an unlocked cabinet above the sink in the classroom. 2. In the two and three year olds (Preschool 1A ) classroom, there was a container labeled `comet cleaner with bleach with multiple hazards on the label stored under an unlocked cabinet in the bathroom.”

Rule 8VAC20-780-280-B.

8VAC20-780-500-B

“Based on observation, not all diapering areas were equipped with required items. In the toddler classroom, there is no leakproof receptable for soiled linens.”

Rule 8VAC20-780-500-B.

8VAC20-780-570-A

“Based on observation, the center failed to ensure that a high chair, infant carrier seat or feeding table utilized for all children under the age of 12 months when eating and that the straps are securely fastened. Evidence: An eight month old child was observed in an infant swing, drinking a bottle without the safety straps fastened as required.”

Rule 8VAC20-780-570-A.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Based on observation, not all hazardous substances such as cleaning materials were kept in a locked place. Evidence: A bucket of cleaning supplies was stored on top of the cabinet in the two’s room.”

Rule 8VAC20-780-280-B.

8VAC20-780-440-E

“Based on observation, there was not at least 12 inches of space between occupied cots. Evidence: In the two’s room, there were six cots that were in such close proximity to one another that the linens were touching. In the three’s classroom, there were eight cots that were not spaced and were touching other cots.”

Rule 8VAC20-780-440-E.

22.1-289.035-A

“Based on review of documentation, the center failed to obtain repeat sworn statement every five years as required. Evidence: Staff #6 most recent sworn statement was dated 4/18/2017.”

Rule 22.1-289.035-A.

22.1-289.035-B-2

“Based on review of documentation, the center failed to obtain fingerprint background results by the first day of employment. Evidence: Staff #4, start date 4/14/2021, fingerprint background check was dated 5/3/2021.”

Rule 22.1-289.035-B-2.

8VAC20-780-160-C

“Based on review of documentation, the center did not obtain documentation of Tuberculosis (TB) screening every two years as required. Evidence: Staff #3 most recent TB screening was dated 8/12/2019.”

Rule 8VAC20-780-160-C.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“In the Preschool 2B class, there was a commercial grade sanitizer cleaning agent under the unlocked sink accessible to children. In the infant a classroom, there was a commercial grade sanitizer and disinfectant wipes that were unlocked. In Preschool 1A, under the sink in the bathroom a commercial grade sanitizer cleaning agent and a second cleaning agent were unlocked and accessible to children.”

Rule 8VAC20-780-280-B.

8VAC20-780-290-A-2

“Based on observation, fans were not kept out of reach of children and the cord was not secured so as not to create a tripping hazard. Evidence: In the Preschool 2B class, a box fan was plugged in at the back of the classroom and positioned on the floor accessible to children in care.”

Rule 8VAC20-780-290-A-2.

8VAC20-780-290-A-3

“Based on observation, not all electrical outlets were equipped with protective covers. Evidence: In the PreK classroom, there were three uncovered outlets: one on the far back wall, one under the cubbies and one on the wall by the sink and table in the front of the room.”

Rule 8VAC20-780-290-A-3.

8VAC20-780-340-A

“Based on observation, when supervising children, staff did not always ensure their care, protection and guidance. Evidence: In Preschool 1A, there were 15 children ages 2.5 years old under the care and supervision of 2 staff. One child was observed climbing the chalk easel. The director had to intervene and get the child down. The child then climbed the easel again. Another child was observed pinching another child on the arm. The classroom staff did not intervene in these incidents until prompted by the li or director.”

Rule 8VAC20-780-340-A.

8VAC20-780-350-B-3

“Based on observation, the center failed to follow required staff to children ratios in the two year old classroom of one staff with no more than eight children. Evidence: On September 26, 2022: 1. In the two’s classroom, one staff member was observed with 13 two year old children. 2. In the Preschool 2A classroom, one staff member was observed with 12 children ages two through three years old.”

Rule 8VAC20-780-350-B-3.

8VAC20-780-350-B-4

“Based on observation, the center failed to follow required staff to children ratios for three, four and five year olds of one staff with no more than 10 children. Evidence: On September 26, 2022: 1. In the Preschool 2B classroom, one staff member was observed with 11 three and four year old children. 2. In the PreK class, there was 1 staff member with 14 children ages four and five.”

Rule 8VAC20-780-350-B-4.

8VAC20-780-370-1

“Based on observation, the center failed to ensure that the safe sleep requirements were met for infants. Evidence: A two month old was observed asleep on their stomach in a tummy time mat on the floor of the infant room.”

Rule 8VAC20-780-370-1.

8VAC20-780-70

“Based on review of documentation, the center failed to obtain references by the date of hire and reference documentation did not include required information. Evidence: Staff #7, start date 8/23/2022, references did not include dates of calls and signatures of the staff making the calls. Staff #4, date of hire 4/14/2021, did not have a second reference”

Rule 8VAC20-780-70.

8VAC20-820-120-E-2

“Based on observation, the facility failed to ensure the findings of the most recent inspection of the facility were posted. Evidence: The most recent inspection results were not posted; an inspection dated 1/31/2018 was posted.”

Rule 8VAC20-820-120-E-2.

8VAC20-780-370-1

“Based on observation, not all infant play spaces in which an infant fell asleep was considered safe. A 6 month old infant was observed asleep propped in a ‘boppy’ brand pillow sleeping on the floor.”

Rule 8VAC20-780-370-1. From a complaint.

8VAC20-780-440-J

“Based on observation, there was not at least 12 inches of space between occupied cribs. Evidence: In the infant b room, three infant cribs were occupied and touching one another.”

Rule 8VAC20-780-440-J. From a complaint.

8VAC20-780-450-A

“Based on observation, not all cots used by children during the designated rest period had linens that consisted of a top cover and bottom cover. Evidence: In the toddler classroom, two children were observed during nap without bottom covers.”

Rule 8VAC20-780-450-A. From a complaint.

8VAC20-780-130-E

“Based on review of documentation, the center did not obtain documentation of additional immunizations as required. Evidence: Child #6, date of birth 7/16/2013, first day of attendance 10/13/2021, most recent immunization was dated 12/4/2013.”

Rule 8VAC20-780-130-E.

8VAC20-780-140-B

“Based on review of documentation, the center failed to obtain documentation of a physical within the required time period. Evidence: A physical on file for a child age enrolled on 10/13/2021 physical was dated 12/4/2014 and was not within the 12 months prior to attendance.”

Rule 8VAC20-780-140-B.

8VAC20-780-340-F

“Based on staff interviews and review of documentation, it was determined that not all children under the age of 10 years old were within actual sight and sound supervision of staff. Evidence: On April 22, 2022, in the two year old classroom, Child A, age two, was left alone in the classroom from approximately 3:30 p.m. to 3:34 p.m.”

Rule 8VAC20-780-340-F.

8VAC20-780-440-E

“Based on observation, not all occupied cots were at least 12 inches apart as required. Evidence: In the Preschool I class, cots were positioned closely and children’s blankets were observed touching.”

Rule 8VAC20-780-440-E.

8VAC20-780-440-J

“Based on observation, there was not at least 12 inches of space between occupied cribs. Evidence: In the infant b room, two infant cribs were occupied and touching, side by side.”

Rule 8VAC20-780-440-J.

8VAC20-780-450-A

“Based on observation, not all cots used by children during the designated rest period had linens that consisted of a top cover and bottom cover. Evidence: In the Preschool II B classroom, two children were observed during nap without bottom covers. In the Preschool I classroom, one child was observed without a bottom cover.”

Rule 8VAC20-780-450-A.

8VAC20-780-500-B

“Based on observation, not all diapering areas were equipped with a leak proof receptacle for soiled linens. Evidence: In the infant room, there was a mesh bag used for soiled linens that is not leak proof. In the Toddler A classroom, the diapering area had no leak proof receptacle for soiled linens.”

Rule 8VAC20-780-500-B.

8VAC20-780-510-E

“Based on staff interview and review of documentation, it was determined that the center did not following it’s procedure for medication. Evidence: Prescription Nystatin was observed in the center and did not have parental authorization.”

Rule 8VAC20-780-510-E.

8VAC20-780-510-G

“Based on observation, not all prescription medication was labeled with the child’s name and medication label. Evidence: A tube of prescription Nystatin was located in the drawer with diaper ointments.”

Rule 8VAC20-780-510-G.

8VAC20-780-570-A

“Based on observation, not all protective belts on infant seats were fastened securely. Evidence: In the infant classroom, a 5 month old was observed in an infant seat without the protective belt secured. The drop in feeding table had one seat that was equipped with straps and the other seats were missing the straps.”

Rule 8VAC20-780-570-A.

22VAC40-185-410-1

“Based on review of video recording and interviews conducted, a staff used the forbidden action of physical punishment of a child to correct the behavior of the child. Evidence: On September 27, 2021 staff A held her right foot over child 1’s head and while the child lay on a cot. The staff used that same foot to roughly move the cot that the child lay on to another position.”

Rule 22VAC40-185-410-1.