Tammy Brown

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

“The Tuberculosis Screening for Caregiver #2 was overdue by 4 months.”

Rule 8VAC20-800-180-A.

The home shall provide each child with adequate space to allow free movement and active play indoors and out.

“On 6/03/2026, 11 children were observed in a small area of the living room between three chairs and in front of the television between 10:15 a.m. and 2:30 p.m. There was not adequate space to allow free movement and active play indoors. Children were observed tripping over toys and each other.”

Rule 8VAC20-800-380.

The provider shall ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home.

“Attendance records on 5/19/26 and 5/20/26 document 14 children in the home between 3:15 p.m. and 3:45 p.m. The licensed capacity is 12 children.”

Rule 8VAC20-800-40-A.

Daily age-appropriate activities shall include opportunities for vigorous outdoor play daily, depending upon the weather, the ages, and the health of the children.

“On 06/03/2026, 11 children (age range 23 months to 7 years) were present during the inspection. When asked about their daily schedule and outdoor time Caregiver #2 said they ?aren’t usually outside?. Caregiver #2 also said they wouldn’t go out that day because the grass in the back yard had not been mowed. The weather on 6/03/2026 was sunny and comfortable.”

Rule 8VAC20-800-580-C.

Toddlers shall be provided with opportunities to receive individual attention from caregivers including, but not limited to holding and cuddling,

“On 6/03/2026, Child #2 (age 23 months) was observed standing by himself, crying off and on through the morning. Caregiver #1 remained seated and did not stand up to pick up or comfort the child.”

Rule 8VAC20-800-600-A.

Caregivers shall use positive methods of discipline. Discipline shall be constructive in nature and include techniques such as modeling and redirecting children to acceptable behavior and arranging equipment, materials, activities, and schedules in a way that promotes desirable behavior.

“On 6/03/26 between 10:15 a.m. and 1:43 p.m., Caregiver #1 remained seated and did not physically intervene with the 11 children present to model or redirect behavior or arrange structured activities in a way that promoted desirable behavior. During this time children were observed yelling and fighting over a toy. Caregiver #1 tried to stop the fighting by yelling, ?Do I need to call your daddy?? Children were also observed crying, throwing and tripping over toys, tripping over each other, and licking and biting toys.”

Rule 8VAC20-800-630-A.

Caregivers shall ensure that children’s hands are washed with liquid soap and warm running water after toileting or diapering.

“Caregiver #2 was observed using wipes to clean a child’s hands after diapering on 6/03/2026.”

Rule 8VAC20-800-680-B.

8VAC20-770-40-D-5

“Household members 14 years of age and older must obtain the results of a central registry search within 30 days of a person in the home becoming 14 years old. The central registry results for Household Member #1 were overdue by more than two months.”

Rule 8VAC20-770-40-D-5.

8VAC20-800-460-D

“The provider shall maintain documentation of the current rabies vaccination. The rabies vaccination for one of the provider’s dogs (dog #1) expired on 4/05/25.”

Rule 8VAC20-800-460-D.

8VAC20-800-780-B

“Annually, the provider shall review with the parent the emergency contact information required in each child’s record to ensure the information is correct and shall obtain the parents signed acknowledgment of the review. Records for children #2 and #3 did not have a parent’s signature for an annual review of the emergency contact information.”

Rule 8VAC20-800-780-B.

8VAC20-800-830-C

Rule 8VAC20-800-830-C.

8VAC20-800-110-B

“The immunization report shall include the date of the physical examination and dates immunizations were received and shall be signed by a licensed physician, the physician’s designee, or an official of a local health department. The immunization report for Child #1 did not include the date of the physical examination or the physician’s signature. The immunization report for Child #2 did not include the physician’s signature.”

Rule 8VAC20-800-110-B.

(Repeat Violation) Based on observation, the caregiver failed to maintain areas of the family day home in a clean and safe condition.

Rule 8VAC20-800-240-A.

Based on observation, the caregiver failed to keep items that could pose a risk of suffocation out of reach of children under five years of age.

“Evidence: A plastic grocery bag was observed on the kitchen floor accessible to children. One child under five years was observed in the kitchen during the inspection.”

Rule 8VAC20-800-250-E.

Based on observation, the caregiver failed to install child-resistant protective covers on all unused surge protectors accessible to children under five years of age.

“Evidence: A power strip plugged with multiple cords and one empty outlet was accessible to children in the living room posing a risk of shock.”

Rule 8VAC20-800-320-B.

Based on observation, the caregiver did not keep the bathroom that the children use clean.

“Evidence: The bathroom floor was observed to be dirty with bits of trash, lint, and hair. Children under five years were observed going into the bathroom during the inspection.”

Rule 8VAC20-800-340-C.

Based on observation and interview, the caregiver has allowed children to have access to the front porch which does not have a protective barrier.

“Evidence: In an interview on 8/26/24, the provider reported that the children have been permitted to play on the front porch with chalk. The porch which is approximately two feet off the ground was observed not to have a protective railing to prevent a child from falling off.”

Rule 8VAC20-800-440-A.

Based on observation, the children have access to the food and water bowls of the caregiver’s dogs.

“Evidence: The dogs? food and water bowls are on the floor in the kitchen and accessible to children. One child under 5 years was observed in the kitchen during the inspection.”

Rule 8VAC20-800-460-I.

Based on an interview, the provider did not inform the inspector as soon as practicable, but not to exceed one business day of the suspension of child care services for more than 24 hours as a result of an emergency situation.

“Evidence: The provider reported that the Family Day Home was closed from 4/01/24-4/05/24 due to a family emergency in a phone interview on 6/20/24.”

Rule 8VAC20-790-220-A-3.

Based on review of four caregiver’s records and interview, the provider did not obtain background checks every 5 years.

“Evidence: The record for caregiver #1 contained the results of a central registry search dated 6/13/19, exceeding 5 years. The provider acknowledged that a request to update the central registry search for caregiver #1 had not been sent in and that the most recent results for caregiver #1 exceeded 5 years.”

Rule 22.1-289.036-A.

Based on observations and interview, the provider did not maintain areas in the back yard in a safe condition.

“Evidence: In the children’s outdoor play area in the backyard, there was a large, rusted barrel. Also in the children’s outdoor play area in the backyard, there was a section of lattice under the steps that was broken and splintered. The provider acknowledged that the lattice needed to be repaired and that the barrel needed to be removed.”

Rule 8VAC20-800-240-A.

Based on the review of 5 children’s records and interview, the provider did not conduct an annual review of emergency contact information in each child’s record and obtain the parent’s signed acknowledgment of the review.

“Evidence: The provider did not request at least annually parent confirmation that the required information in the children’s files was up to date. Parent confirmation of the information in the files for the children was dated 4/17/23 for Child #1, 5/02/23 for Child #2, 9/02/20 for Child #4, and 3/22/22 for Child #5. The provider acknowledged that she did not have the parents confirm that the information in the children’s files was up to date annually.”

Rule 8VAC20-800-780-B.

Based on review of caregiver records, the provider did not ensure caregivers completed, in addition to 16 hours of training, the department’s health and safety update course annually.

“Evidence: 1. The record of caregiver #1 had documentation of completing the department’s health and safety updated course on 02/02/2023. There was no documentation of the annual health and safety course for the 2024 year. 2. The record of caregiver #2 had documentation of completing the department’s health and safety updated course on 02/02/2023. There was no documentation of the annual health and safety course for the 2024 year.”

Rule 8VAC20-790-250-F.

Based on review of documentation, the provider did not maintain documentation of the current rabies vaccination.

“Evidence: The vaccine record for Konahu (canine) stated the rabies vaccine expired 08/29/2023. There was no additional documentation of a current rabies vaccine.”

Rule 8VAC20-800-460-D.

Based on review of ten children’s records, the provider did not 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.

“Evidence: 1. The record of child #9, enrolled 04/20/2023, contained a school health form with the date of a physical, however the form did not contain the results of the physical nor a signature of a physician. 2. The provider acknowledged the form was not complete or signed by a physician.”

Rule 8VAC20-800-100-A.

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

“Evidence: 1. The record of caregiver #1 contained documentation of a tuberculosis screening dated 08/30/2021, exceeding two years. 2. The record of caregiver #2 contained documentation of a tuberculosis screening dated 08/30/2021, exceeding two years. 3. The provider stated a current tuberculosis screening had not been obtained for either caregiver.”

Rule 8VAC20-800-180-A.

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

Rule 8VAC20-800-240-A.

Based on observation, the provider did not ensure infant walkers shall not be used.

“Evidence: An infant walker with wheels was observed folded-up sitting next to a crib.”

Rule 8VAC20-800-540-B.

Based on review of two caregiver’s records, the provider did not obtain background checks every five years.

“Evidence: 1. The record for caregiver #1 contained the results of a fingerprint national criminal record check dated 05/30/2018, exceeding five years. 2. The record for caregiver #2 contained the results of a fingerprint national criminal record check dated 05/30/2018, exceeding five years.”

Rule 22.1-289.035-A.

Based on review of one household member record, the provider did not obtain the results of a central registry background check within 30 days of one household member becoming 14 years of age.

“Evidence: The record of household Member #1, 14 years in age as of March 19, 2023, was missing results of a central registry background check.”

Rule 8VAC20-770-40-D-5.

Based on review of two caregiver’s records and interview, the provider did not obtained background checks every five years.

“Evidence: 1. The record for caregiver #1 contained the results of a fingerprint national criminal record check dated 05/30/2018, exceeding five years. 2. The record for caregiver #2 contained the results of a fingerprint national criminal record check dated 05/30/2018, exceeding five years. 3. The provider confirmed a request to update the fingerprint national criminal record check had not yet been requested.”

Rule 22.1-289.035-A.

Based on review of eight children’s records, the provider did not 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.

“Evidence: The record of child #7, enrolled 07/19/2022, did not contain documentation of a physical exceeding 30 days from enrollment.”

Rule 8VAC20-800-100-A.

Based on observation and interview, the provider did not ensure firearms were stored in a locked container, compartment, or cabinet and apart from ammunition.

“Evidence: The locked case containing firearms also contained a box of ammunition. The provider confirmed that the ammunition was not stored separate from the firearms.”

Rule 8VAC20-800-270-A.

Based on review of caregiver records, the provider did not ensure caregivers completed, in addition to 16 hours of training, the department’s health and safety update course annually.

“Evidence: 1. The record of caregiver #1 had documentation of completing the department’s health and safety updated course on 05/13/2021. There was no documentation of the annual health and safety course for the 2022 calendar year. 2. The record of caregiver #2 had documentation of completing the department’s health and safety updated course on 05/12/2021. There was no documentation of the annual health and safety course for the 2022 calendar year.”

Rule 8VAC20-790-250-F.

Based on review of two household member records and interview, the provider did not obtain the results of a central registry background check within 30 days of one household member becoming 14 years of age.

“Evidence: The record of household Member #2, 14 years in age as of March 19, 2023, was missing results of a central registry background check. The provider stated she had not requested a central registry background check for household member #2.”

Rule 8VAC20-770-40-D-5.

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

Rule 8VAC20-800-240-A.

Based on observation the provider did not ensure potentially poisonous substances, materials, and supplies such as, but not limited to, cleaning agents, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates were stored away from food in areas inaccessible to children.

“Evidence: 1. Multiple containers of cleaning products were observed on the washing machine located in the bathroom and separated only by a curtain. The cleaning products were accessible to children in care. 2. A canister of air freshener was observed sitting on the ledge of a half wall next to an occupied crib.”

Rule 8VAC20-800-280.

Based on observation, the provider did not ensure sharp kitchen utensils and other sharp objects were inaccessible to children unless being used by the caregiver or with children under close supervision.

“Evidence: The drawer in the kitchen that contain the sharp knives had a child safety lock that was broken creating accesses to the sharp knives by children in care.”

Rule 8VAC20-800-290.

Based on interview, the provider did not maintain an up-to-date record at the family day home for each child enrolled.

“Evidence: The provider stated child #4 was enrolled on 04/20/2023 however she did not have a record for child #4 that contained all the required information.”

Rule 8VAC20-800-60-A.

Based on interview, the provider did not obtain the parent’s written acknowledgement of the receipt of the information for parents.

“Evidence: The provider stated she did not have the parent’s signed acknowledgment of the parent information for child #4.”

Rule 8VAC20-800-70-B.

Based on interview, the provider did not maintain a working battery-operated flashlight to be kept in a designated area and available to caregivers at all times.

“Evidence: The provider stated she did not have a flashlight in the family day home.”

Rule 8VAC20-800-770.

Based on review of six children’s records, the provider did not annually obtain the parent’s signed acknowledgment of the review of the parent emergency contact information required to ensure the information is correct.

“Evidence: 1. The record of child #2, enrolled 01/04/2021, was last reviewed by the parent on 03/22/2022 exceeding the annual requirement. 2. The record of child #6, enrolled 02/14/2022, was last reviewed by the parent on 02/14/2022 exceeding the annual requirement.”

Rule 8VAC20-800-780-B.

Based on review of documentation and interview, the provider did not review the emergency plan at least annually and update the plan as needed.

“Evidence: The family day home emergency preparedness plan was last reviewed/ updated on 01/20/2021 exceeding the annual requirement.”

Rule 8VAC20-800-800-B.

Based on review of six children’s records, the provider did not obtain documentation that one child had been adequately immunized before the child attended the family day home.

“Evidence: Child #4, enrolled 04/20/2023, and in attendance on 05/01/2023, did not have documentation of immunization. The provider stated she did not have documentation of immunizations for child #4.”

Rule 8VAC20-800-90-A.

8VAC20-800-140-B-3

“Based on a review of three caregiver records, the provider did not ensure that providers and substitute providers have current certification in cardiopulmonary resuscitation (CPR). Evidence: Staff #1 and Staff #2 had CPR that expired in January of 2022.”

Rule 8VAC20-800-140-B-3.

8VAC20-800-140-B-4

“Based on a review of three caregiver records, the provider did not ensure that providers and substitute providers have current certification in First Aid. Evidence: Staff #1 and Staff #2 had First Aid that expired in January of 2022.”

Rule 8VAC20-800-140-B-4.

8VAC20-800-240-A

“Based on observation and interview, the provider did not ensure that areas of the home, inside and outside, were maintained in a safe and operable condition. Evidence: The back yard contained children’s play equipment that had visible cracks, splinters, breakage, and protruding nails. When asked, the provider stated that she began to tear down the equipment so that she could replace it.”

Rule 8VAC20-800-240-A.

8VAC20-800-460-D

“Based on a review of records, the provider did not ensure to maintain documentation of current rabies vaccination for a one of three dogs in the home. Evidence: Dog #3 had a rabies vaccine that expired 02/10/22.”

Rule 8VAC20-800-460-D.

8VAC20-800-510-A

“Based on observation, the provider did not ensure that each child was provided with an individual cot, rest mat, or bed for resting or napping. Evidence: There were 3 children sleeping directly on the living room floor.”

Rule 8VAC20-800-510-A.

8VAC20-800-530-F

“Based on observation, the provider did not ensure that no soft bedding of any kind shall be used under or around infants including but not limited to pillows, quilts, comforters, sheepskins, or stuffed toys. Evidence: Child #1 (18 months) was sleeping in a crib with a pillow and stuffed animals.”

Rule 8VAC20-800-530-F.

8VAC20-800-900-B

Rule 8VAC20-800-900-B.

Based on observation and interview, the provider did not ensure medications for household members were kept in a locked place using a safe locking method that prevents access by children.

“Evidence: 1. A medication box located in the providers bedroom was not locked at the time of the inspection. The medication box contained medications identified by the provider as being for household members. 2. The provider stated the box was not locked as that time.”

Rule 22VAC40-111-730-D.