Ms. Letitia Paige

Caregivers who work directly with children shall, in addition to preservice and orientation training required in subsections A through D of this section, annually attend at least 16 hours of training, to include the department’s health and safety update course.

“Assistant provider #2 did not complete the department’s annual health and safety update course.”

Rule 8VAC20-790-250-F.

The provider shall orient the substitute provider and assistant by the end of their first week of assuming job responsibilities.

“There was no documentation of the assistant provider #2 receiving orientation training.”

Rule 8VAC20-800-200-A.

8VAC20-800-60-B

“Children’s records are required to contain the parents contact information, the name, phone number, and address of two emergency contacts, and medical insurance policy information. The record for Child #1 was missing one of the two required emergency contacts. The record for child #4 did not contain the mother’s contact information and the medical insurance policy for the child.”

Rule 8VAC20-800-60-B.

Emergency telephone numbers are to be posted in a visible area close to the phone.

“The emergency numbers had been moved and were not posted during this inspection.”

Rule 8VAC20-800-790.

Documentation of additional immunizations is required every six months until a child is two years of age.

“The records for child #3 and #5 did not contain updated immunization documentation. Both of the updates were overdue by at least six months.”

Rule 8VAC20-800-90-C.

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

“The most recent central registry check for staff #2 was overdue by three months.”

Rule 22.1-289.035-A.

Providers shall have current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

“Staff #2 did not have current certification in cardiopulmonary resuscitation. Their certification had been expired for four months.”

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

Providers shall have current certification in first aid.

“Staff #2 did not have current certification in first aid. Their certification had been expired for four months.”

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

The record for each child should contain all of the required information.

“The record for child #2 did not contain the contact information for their mother’s employer and medical insurance policy number. The record for child #4 did not contain the medical insurance policy number and one of the two emergency contacts. The record for child #5 did not contain the contact information for their parent(s), the contact information for their parent’s employer, medical insurance policy number, the address for one of the two emergency contacts. All three children above were in care during this inspection.”

Rule 8VAC20-800-60-B.

Before attendance, documentation of immunizations is to be obtained for each child.

“There was no documentation of immunizations for child #1, who was in care during the inspection and had been in care for two weeks.”

Rule 8VAC20-800-90-A.

The license and any other documents required shall be posted in a conspicuous place on the licensed premises.

“The findings from the most recent inspection, dated 8/20/2024, were not posted in a conspicuous place on the premises.”

Rule 22.1-289.011-F.

Children’s records are required to contain the policy number of the child’s medical insurance and the name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached.

Rule 8VAC20-800-60-B.

When meals or snacks are provided by the family day home, the menu for the current one-week period shall be posted.

“There was no menu posted during this inspection.”

Rule 8VAC20-800-920.

22.1-289.035-B-4

Rule 22.1-289.035-B-4.

8VAC20-800-120-B

“Based on record review and interview it was determined the provider did not ensure that the assistant’s record contained all of the required information. Evidence: 1. The record for assistant #2 did not contain documentation of two references being checked prior to hire. 2. Staff confirmed that this documentation was not available during this inspection.”

Rule 8VAC20-800-120-B.

8VAC20-800-200-A

“Based on record review and interview it was determined the provider did not ensure the assistant provider completed orientation by the end of their first week of assuming job responsibilities. Evidence: 1. The record for assistant provider #2 (hired 7/25/23) did not contain documentation of completing orientation. 2. Assistant #2 present during inspection confirmed they had not completed orientation.”

Rule 8VAC20-800-200-A.

8VAC20-800-530-A

“Based on observation and interview it was determined the provider did not ensure that cots when being used for sleeping or napping by children other than infants had linens consisting of a top cover and a bottom cover or a one-piece covering that is open on three edges. Evidence: 1. The cots being utilized by children during this inspection did not have bottom covers. 2. Provider confirmed that they had not been using bottom covers.”

Rule 8VAC20-800-530-A.

8VAC20-800-570-A

“Based on observation and interview it was determined the provider exceeded the 16 points per caregiver. Evidence: 1. There were 10 napping children in care with the substitute provider totaling 22 points at the time of the inspector’s arrival. 2. The provider confirmed that there were 22 points in care with the substitute until her return.”

Rule 8VAC20-800-570-A.

22.1-289.058

“Based on observation and interview it was determined the provider did not ensure the home had at least one carbon monoxide detector. Evidence: 1. There was no carbon monoxide detector in the home. 2. Provider confirmed that there was no carbon monoxide detector present during this inspection.”

Rule 22.1-289.058.

8VAC20-800-140-B-3

“Based on record review and interview it was determined the provider did not ensure that the assistant provider had current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care. Evidence: 1. The record for assistant provider did not contain documentation of current certification in cardiopulmonary resuscitation (CPR). The documentation available expired 10.23.21 2. The assistant provider confirmed that their certification had expired.”

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

8VAC20-800-140-B-4

“Based on record review and interview it was determined the provider did not ensure that the assistant provider had current certification in first aid, as appropriate to the age of the children in care. Evidence: 1. The record for assistant provider did not contain documentation of current certification in first aid. The documentation available expired 10.23.21 2. The assistant provider confirmed that their certification had expired.”

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

8VAC20-800-240-A

“Based on observation it was determined the provider did not ensure that all areas and furnishings of the family day home, inside and outside, were maintained in a clean, safe, and operable condition. Evidence: 1. There are small of broken, exposed plaster and peeling paint in the main childcare room. 2. One of the components of the play kitchen rocked when pulled on, presenting a potential tip hazard.”

Rule 8VAC20-800-240-A.

8VAC20-800-430-A

“Based on observation and interview it was determined the provider did not ensure that 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. Evidence: 1. There was no barrier preventing access to the stairs to the second floor. 2. Provider confirmed that they had not installed the gate to prevent access to the stairs.”

Rule 8VAC20-800-430-A.

8VAC20-800-830-C

“Based on record review and interview it was determined the provider did not ensure that documentation of emergency evacuation and shelter-in-place drills was maintained. Evidence: 1. The last shelter in place drill recorded was July 2021. 2. Provider and assistant reported that the drill had been completed but not recorded.”

Rule 8VAC20-800-830-C.

8VAC20-800-180-A

“Based on record review and interview it was determined the provider did not obtain an updated Report of Tuberculosis Screening form, in accordance with the requirements in 8VAC20-800-170, every two years from the date of the first screening or more frequently as recommended by a physician or the local health department. Evidence: 1. The TB screening documentation available for the provider and assistant provider was dated 12/15/19 and 9/23/19 respectively. 2. The provider confirmed updated TB screening forms were not available during this inspection.”

Rule 8VAC20-800-180-A.

8VAC20-800-830-A

“Based on record review and interview it was determined the provider did not ensure emergency evacuation procedures were practiced monthly with all caregivers and children in care during all shifts that children are in care. Evidence: 1. The emergency evacuation drill log did not contain documentation for July 2022. 2. Provider confirmed an emergency evacuation drill was not practiced in July.”

Rule 8VAC20-800-830-A.

8VAC20-800-100-A

“Based on record review and interview it was determined 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 for child #2(enrolled 4/6/21) did not contain documentation of a physical exam. 2. Provider confirmed that this documentation was not available during this inspection.”

Rule 8VAC20-800-100-A.

8VAC20-800-140-B-3

“Based on record review and interview it was determined the provider and assistant provider did not have current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care. Evidence: 1. The documentation available showed that the provider’s certification in CPR expired 6/24/20 and the assistant provider’s expired 10/23/21. 2. The provider and assistant provider confirmed they did not have current certification in CPR.”

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

8VAC20-800-140-B-4

“Based on record review and interview it was determined the provider and assistant provider did not have current certification in in first aid. Evidence: 1. The documentation available showed that the provider’s certification in first aid expired 6/24/20 and the assistant provider’s expired 10/23/21. 2. The provider and assistant provider confirmed they did not have current certification in first aid.”

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

8VAC20-800-320-E

“Based on observation it was determined the provider did not ensure that portable electric heaters in areas accessible to children had barriers. Evidence: There was an electric heater in use in the childcare area with no barrier.”

Rule 8VAC20-800-320-E.