The Learning Experience

8VAC20-780-340-A

Rule 8VAC20-780-340-A.

8VAC20-780-340-F

Rule 8VAC20-780-340-F.

8VAC20-780-40-E

Rule 8VAC20-780-40-E.

Staff are to complete the VDOE-sponsored orientation course within 90 calendar days of employment.

“Staff #1, who has been employed for over three months, has not completed the VDOE-sponsored orientation course. Staff #2 completed the training 19 days late.”

Rule 8VAC20-780-240-A.

(Repeat Violation) Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information.

“The record of Child #5, who has been enrolled for over two months, did not contain the name, address, and phone number of a second designated emergency contact.”

Rule 8VAC20-780-60-A.

A record shall be kept for each staff person that contains the required information.

“The records of Staff #1, employed for over three months, Staff #2, employed for over a month, and Staff #5, employed for nine days, did not contain documentation to show the staff obtained the required orientation training.”

Rule 8VAC20-780-70.

The center must request a search of the central registry prior to the employee’s first day of employment.

“The central registry search for Staff #4, who has been employed for three months, has not been requested to date.”

Rule 22.1-289.035-B-3.

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 #3, who has been enrolled for 37 days.”

Rule 8VAC20-780-140-A.

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

“The center’s medication policy states: “The Medication Administration Authorization Form must be completed in full with the name of the medication, prescribed dosage, and times to be given. The medication is to be in the original container with the child’s name and dosage instructions on the pharmacy label and must not be expired.” A prescription medication for Child #8 was observed on-site. The medication expired on 09/30/25.”

Rule 8VAC20-780-40-E.

Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information.

“The record of Child #2, enrolled for over five months, was missing documentation of viewing proof of the child’s identity and age.”

Rule 8VAC20-780-60-A.

The center must request a search of the central registry prior to the employee’s first day of employment.

“The central registry search for Staff #1 was requested six days after the day of employment.”

Rule 22.1-289.035-B-3.

The center is required to have every agent of an applicant for licensure as a child day center undergo a background check every five years.

“The most recent national criminal background check for Agent #2 was overdue by nine months.”

Rule 22.1-289.036-A.

The center shall notify the parent by the end of the day of any known minor injuries.

“On 11/26/24 at approximately 4:15pm, Child #1 (3-year-old) sustained an injury on the playground. Staff #1 witnessed the injury, but did not notify the child’s parent when the child was picked up.”

Rule 8VAC20-780-550-O.

(Repeat Violation) Based on a review of eight staff records and interviews, the center did not ensure three staff members shall submit documentation of a negative tuberculosis screening within the required time frames.

Rule 8VAC20-780-160-A.

Based on a review of documentation and interviews, the center did not maintain compliance with the center’s own policies and procedures that are required by these standards regarding discipline policies.

Rule 8VAC20-780-40-E.

Based on interviews and a review of documentation, the center did not ensure that 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.

Based on interviews and a review of documentation, the center did not ensure that the following actions of physical punishment or striking a child are forbidden.

Rule 8VAC20-780-410-1.

Based on a review of nine staff records and interview, the vendor did not ensure five staff members had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of the date of employment.

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

Based on a review of nine staff records and interview, the vendor did not ensure five staff members had current certification in first aid appropriate to the ages of children in care within 90 days of the date of employment.

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

Based on a review of nine staff records and interview, the vendor did not ensure two staff members who work directly with children completed the department’s health and safety update course annually.

“Evidence: The records of Staff #5, employed on 04/11/22, and Staff #8, employed on 08/07/09, did not have documentation that the staff completed the department’s health and safety update course annually. During interview, a member of management reported the documentation that the staff completed the course could not be located.”

Rule 8VAC20-790-600-F.

(Repeat Violation) Based on a review of nine staff records and interviews, the center did not ensure one staff had a completed sworn statement or affirmation prior to employment.

“Evidence: The sworn statement in the record of Staff #4, employed on 09/25/23, was dated 09/26/23. During interview, a member of management confirmed the sworn statement was dated after employment but was unsure if it was completed after employment.”

Rule 8VAC20-770-60-B.

(Repeat Violation) Based on a review of nine staff records and interviews, the center did not ensure one staff had a central registry finding within 30 days of employment.

“Evidence: The central registry finding in the record of Staff #5, employed on 04/11/22, was dated 08/02/23. During interview, a member of management confirmed the results of the central registry finding for Staff #5 were not received within 30 days of employment. The center did not have documentation of following up with the Office of Background Investigation within 30 days of employment.”

Rule 8VAC20-770-60-C-2.

(Repeat Violation) Based on a review of nine staff records and interview, the center did not ensure three staff members had documentation of a negative tuberculosis (TB) screening within the required time frames.

Rule 8VAC20-780-160-A.

(Repeat Violation) Based on a review of nine staff records and interview, the center did not ensure five staff completed the Virginia Department of Education-sponsored (VDOE) orientation course within 90 calendar days of employment.

“Evidence: The following staff records did not contain documentation that the staff completed the VDOE-sponsored orientation course - Staff #1 (DOE: 09/12/23); Staff #3 (DOE: 04/26/23); Staff #4 (DOE: 09/25/23); and Staff #5 (DOE: 04/11/22). During interview, a member of management reported the center did not have documentation that the staff completed the VDOE-sponsored orientation course. The certificate of completion of the VDOE-sponsored orientation course in record of Staff #6 (DOE: 06/19/23) was dated 11/28/23, exceeding 90 calendar days of employment.”

Rule 8VAC20-780-240-A.

(Repeat Violation) Based on a review of documentation, the center did not ensure that written injury records contained the required information.

Rule 8VAC20-780-550-P.

Based on a review of nine children’s records and interview, the center did not ensure that one child with a diagnosed food allergy had a written care plan, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

“Evidence: The record of Child #4 indicated the child has a diagnosed food allergy, but the center did not have a written allergy care plan for the child. During interview, a member of management confirmed the child’s record indicated a food allergy, but a written allergy care plan had not been obtained for the child.”

Rule 8VAC20-780-60-A-8.

Based on a review of ten staff records and interview, the vendor did not ensure one staff completed the Virginia Preservice Training for Child Care Staff within the first 90 days of employment.

“Evidence: 1) The record of Staff #1, employed 06/01/21, did not contain documentation that the staff completed the Virginia Preservice Training for Child Care Staff. 2) During interview, a member of management confirmed the Virginia Preservice Training for Staff #1 could not be located. Subsidy vendor staff that were hired prior to 10/13/2021 were required to complete the Virginia Preservice Training for Child Care Staff within the first 90 days of employment.”

Rule 8VAC20-790-600-B.

Based on a review of ten staff records and interview, the vendor did not ensure four staff members had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of the date of employment.

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

Based on a review of ten staff records and interview, the vendor did not ensure four staff members had current certification in first aid appropriate to the ages of children in care within 90 days of the date of employment.

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

Based on a review of ten staff records and interview, the vendor did not ensure three staff members who work directly with children completed the department’s health and safety update course annually.

Rule 8VAC20-790-600-F.

Based on a review of ten staff records and interview, the center did not obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which one individual had resided in the preceding five years within the required timeframe.

Rule 22.1-289.035-B-4.

Based on a review of ten staff records and interview, the center did not ensure one staff had a completed sworn statement or affirmation prior to employment.

“Evidence: 1) The record of Staff #10, employed on 02/13/23, did not contain a completed sworn statement or affirmation. 2) During interview, a member of management confirmed the center did not have a completed sworn statement or affirmation on file for Staff #10.”

Rule 8VAC20-770-60-B.

Based on a review of ten staff records and interview, the center did not ensure seven staff members had a central registry finding within 30 days of employment.

Rule 8VAC20-770-60-C-2.

Based on a review of ten staff records and interview, the center did not ensure seven staff members submitted documentation of a negative tuberculosis (TB) screening within the required timeframe.

Rule 8VAC20-780-160-A.

Based on a review of ten staff records and interview, the center did not ensure one staff obtained the results of a follow-up tuberculosis (TB) screening at least every two years from the date of the first initial screening or testing.

“Evidence: 1) The most recent TB screening in the record of Staff #1, employed on 06/01/21, was completed on 05/19/21 and expired on 05/19/23. 2) During interview, a member of management confirmed the center does not have documentation of a current negative TB screening on file for Staff #1.”

Rule 8VAC20-780-160-C.

Based on a review of ten staff records and interview, the center did not ensure five staff completed the Virginia Department of Education-sponsored (VDOE) orientation course within 90 calendar days of employment.

“Evidence: 1) The following staff records did not contain documentation that the staff completed the VDOE-sponsored orientation course - Staff #2 (DOE: 04/25/22); Staff #7 (DOE: 08/22/22); Staff #8 (DOE: 11/01/22); Staff #9 (DOE: 11/21/22); and Staff #10 (DOE: 02/13/23). 2) During interview, a member of management reported the center did not have documentation that the staff completed the VDOE-sponsored orientation course.”

Rule 8VAC20-780-240-A.

Based on a review of ten staff records, the center did not ensure four staff completed orientation training prior to the staff members working alone with children and no later than seven days of the date of assuming job responsibilities.

“Evidence: 1) The orientation training in the record of Staff #2, employed on 04/25/22, was completed on 12/29/22. 2) The orientation training in the record of Staff #8, employed on 11/01/22, was completed on 11/11/22. 3) The orientation training in the record of Staff #9, employed on 11/21/22, was completed on 06/15/23. 4) The orientation training in the record of Staff #10, employed on 02/13/23, was completed on 02/28/23.”

Rule 8VAC20-780-240-B.

Based on a review of ten staff records, the center did not ensure one staff completed orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care within 30 days of the first day of employment.

“Evidence: Staff #2, employed on 04/25/22, completed the first and CPR orientation training on 12/29/22.”

Rule 8VAC20-780-240-E.

Based on a review of ten staff records, the center did not ensure two staff completed annually a minimum of 16 hours of training appropriate to the age of children in care.

“Evidence: 1) The documentation of training in the record of Staff #1, employed on 06/01/21, did not contain sufficient documentation to show the staff completed 16 hours of annual training from 06/2022-06/2023. 2) The documentation of training in the record of Staff #2, employed on 04/25/22, did not contain sufficient documentation to show the staff completed 16 hours of annual training from 04/2022-04/2023.”

Rule 8VAC20-780-245-A.

Based on observations, the center did not ensure 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: 1) In the Preppers classroom, a bottle of bleach/water solution was observed in an unlocked cabinet. 2) In the PreK-1 classroom, two bottles of cleaning materials were observed in an unlocked cabinet.”

Rule 8VAC20-780-280-B.

Based on observation and interview, the center did not ensure purses were not accessible to children.

“Evidence: 1) In the Preschool 2 classroom, two staff purses were observed on a countertop within the reach of children. 2) In the School Age classroom, a staff purse was observed in an area that was accessible to children. 3) A member of management acknowledged the purses belonged to staff members and they should have been locked to ensure cosmetics, medications, or other harmful agents were not accessible to children.”

Rule 8VAC20-780-280-H.

Based on observation, the center did not ensure electrical outlets shall have protective covers that are of a size that cannot be swallowed by children.

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

Based on observation, and interview, the center did not ensure the diapering area in one classroom had a nonabsorbent surface for diapering or changing.

“Evidence: 1) The top portion of the diaper changing pad in the Twaddler classroom had a tear on it, therefore it is no longer non-absorbent. 2) During interview, a member of management confirmed the diaper changing pad in the Twaddler classroom is torn.”

Rule 8VAC20-780-500-B.

Based on a review of documentation, medication review, observation, and interview, the center did not ensure when an authorization for medication expired, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization.

Rule 8VAC20-780-510-P.

Based on observation and interview, the center did not ensure all requirements were met when diaper ointment or cream is used.

Rule 8VAC20-780-520-C.

Based on observation, a review of records, and interview, the center did not ensure at least one staff in each classroom or area where children are present shall have current certification in cardiopulmonary resuscitation (CPR) and first aid as appropriate to the age of the children in care.

Rule 8VAC20-780-530-A.

Based on a review of documentation and interview, the center did not ensure shelter-in-place procedures shall be practiced a minimum of twice per year.

“Evidence: 1) The center’s emergency drill log for 2022 was reviewed. The most recent shelter-in-place procedures were practiced on 07/29/22. 2) During interview, a member of management reported the shelter-in-place procedures were not practiced a second time in 2022.”

Rule 8VAC20-780-550-E.

Based on a review of documentation and interview, the center did not maintain documentation of an emergency evacuation drill that included the required components.

Rule 8VAC20-780-550-G.

Based on a review of documentation,, the center did not ensure that written injury records contained the required information.

Rule 8VAC20-780-550-P.

Based on a review of ten staff records and interview, the center did not ensure two staff records contained the required information.

“Evidence: 1) During interview, Staff #2 was identified as a program leader, but the staff record did not contain documentation that the staff possesses the education, certification, and experience required by the job position. 2) During interview, Staff #8 was identified as a program leader, but the staff record did not contain documentation that the staff possesses the education, certification, and experience required by the job position.”

Rule 8VAC20-780-70.

Based on a review of five staff records and interview, the vendor did not ensure two staff members who works directly with children completed the department’s health and safety update course annually.

“Evidence: 1) The record of Staff #2, employed on 12/06/21, did not have documentation of the department’s health and safety update course. 2) The record of Staff #5, employed on 08/07/09, did not have documentation of the department’s health and safety update course. 3) During interview, management reported the center does not have documentation that the staff completed the training.”

Rule 8VAC20-790-600-F.

Based on a review of eight staff records, the center did not obtain a required repeat background check for one staff member every five years.

“Evidence: The most recent central registry finding in the record of Staff #4, employed on 02/17/14, was dated 05/12/22. The previous central registry finding was dated 04/21/17.”

Rule 22.1-289.035-A.

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

“Evidence: 1) The most recent immunization documentation in the record of Child #2 (19-month-old), date of attendance 05/02/22, is dated 04/18/22. 2) During interview, management confirmed the records did not contain additional immunizations.”

Rule 8VAC20-780-130-E.

Based on a review of eight staff records and interview, the center did not ensure two staff members had documentation of a negative tuberculosis (TB) screening within the required time frames.

“Evidence: 1) The record of Staff #7, employed on 11/21/22, did not contain documentation of a negative TB screening. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. 2) The TB screening in the record of Staff #8, employed on 10/31/22, was dated 11/16/21. The documentation shall have been completed within the last 30 calendar days of the date of employment. 3) During interview, management confirmed the documentation was not received within the required time frame.”

Rule 8VAC20-780-160-A.

Based on a review of eight staff records and interview, the center did not ensure one staff submitted the results of a follow-up tuberculosis (TB) screening at least every two years from the date of the first initial screening or testing.

“Evidence: 1) The most recent TB screening in the record of Staff #4, employed on 02/17/14, was dated 05/29/20. The TB screening expired on 05/29/22. 2) During interview, management confirmed Staff #4 does not have an updated TB screening on file.”

Rule 8VAC20-780-160-C.

Based on a review of medications and interview, the center did not ensure non-prescription drugs and over-the-counter skin products were kept or used beyond the expiration date of the product.

“Evidence: 1) An over-the-counter medication for Child #13 was observed at the center on 12/06/2022. The medication expired on 10/2022 and it had not been returned to the child’s parent. 2) During interview, management acknowledged the medication was expired, but reported it had not been administered to Child #13.”

Rule 8VAC20-780-520-A.

Based on a review of record, the center did not ensure that one child with a diagnosed food allergy had a written care plan, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

“Evidence: The record of Child #9 indicated the child has a diagnosed food allergy. The written allergy care plan in the record did not include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.”

Rule 8VAC20-780-60-A-8.

Based on a review of eight staff records and interview, the center did not ensure that one staff record contained all the required information.

“Evidence: 1) The record of Staff #1, employed on 07/25/22, did not contain documentation to demonstrate that the individual possesses the education required by the job position. 2) During interview, Staff #1 was identified as a program leader. Management acknowledged documentation of the staff member’s education was not on file.”

Rule 8VAC20-780-70.

Based on a review of ten staff records, the vendor did not ensure one staff who works directly with children had current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of employment.

“Evidence: 1) The record for Staff #3, hired on 11/08/21, did not contain current CPR certification.”

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

Based on a review of ten staff records, the vendor did not ensure one staff who works directly with children had current certification in first aid appropriate to the ages of children in care within 90 days of employment.

“Evidence: 1) The record for Staff #3, hired on 11/08/21, did not contain current first aid certification.”

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

Based on a review of ten staff records, the vendor did not ensure one staff who works directly with children completed the department’s health and safety update course annually.

“Evidence: 1) The record for Staff #5, hired on 03/22/21, did not contain documentation that the staff has completed the department’s health and safety update course.”

Rule 8VAC20-790-600-F.

Based on a review of ten staff records and interview, the center did not ensure that one out of ten staff obtained fingerprint results prior to hire.

“Evidence: 1) The record for Staff #3, hired on 11/08/21, had fingerprint results that were dated 06/09/21. 2) During interview, a member of management reported Staff #3 was terminated from employment in October 2021 and rehired on 11/08/21, but new fingerprint results were not obtained.”

Rule 22.1-289.035-B-2.

Based on a review of ten staff records, the center did not obtain the results of a criminal history record information check and a search of the child abuse and neglect registry or equivalent registry from any state in which two staff members had resided in the preceding five years within the required time frame.

Rule 22.1-289.035-B-4.

Based on a review of ten staff records and interview, the center did not obtain a completed sworn statement or affirmation for two staff members prior to hire.

“Evidence: 1) The record for Staff #3, hired on 11/08/21, did not contain a sworn statement. 2) The sworn statement in the record for Staff #9, hired on 01/04/22, was dated 01/07/22. 3) During interview, a member of management reported the sworn statement for Staff #3 could not be located and the sworn statement for Staff #9 was completed after hire.”

Rule 8VAC20-770-60-B.

Based on a review of ten staff records and interviews, the center did not ensure that three staff members had a central registry finding within 30 days of employment.

Rule 8VAC20-770-60-C-2.

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

“Evidence: 1) The most recent immunization documentation in the record for Child #4 (12-month-old), enrolled on 08/16/21, is dated 09/27/21. 2) During interview, a member of management confirmed the records did not contain additional immunizations.”

Rule 8VAC20-780-130-E.

Based on a review of ten staff records and interview, the center did not ensure two staff members had documentation of a negative tuberculosis (TB) screening within the required time frames.

“Evidence: 1) The TB screening in the record for Staff #2, hired on 04/11/22, was dated 04/13/22. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children. 2) The TB screening in the record for Staff #10, hired on 04/18/22, was dated 12/14/21. The documentation shall have been completed within the last 30 calendar days of the date of employment. 3) During interview, a member of management confirmed the documentation was not received within the required time frame.”

Rule 8VAC20-780-160-A.

Based on a review of ten staff records and interviews, the center did not ensure one staff had completed the Virginia Department of Education-sponsored orientation course within 90 calendar days of employment.

“Evidence: 1) The record for Staff #8, hired on 02/16/22, did not contain documentation that the staff had completed the Virginia Department of Education-sponsored orientation course. 2) During interviews, a member of management reported Staff #8 did not complete the course within 90 calendar days of employment.”

Rule 8VAC20-780-240-A.

Based on observations at the center on 06/01/22, the center did not ensure to keep all hazardous substances such as cleaning materials in a locked place using a safe locking method that prevents access by children.

“Evidence: 1) In the Preschool 1B classroom, the licensing inspector observed unlocked cleaning supplies. A bottle of bleach/water solution was observed in the bathroom, unlocked.”

Rule 8VAC20-780-280-B.

Based on a review of eight medications and interviews on 06/01/22, the center did not ensure that two medication authorizations were available to staff during the entire time they were effective for three out of five children.

“Evidence: 1) Two medications were observed for Child #2, but no medication authorizations were present for the medications. 2) One of the medications observed for Child #5 did not have a medication authorization present. 3) Two medications were observed for Child #7, but no medication authorizations were present for the medications. 4) During interview, a member of management reported the authorizations for these medications were not present.”

Rule 8VAC20-780-510-F.

Based on a review of documents and interview, the center did not maintain a record of the dates of the practice drills for one year.

“Evidence: 1) The licensing inspector observed the emergency drill log for the year 2021 and 2022. An evacuation drill was not documented for the month of May 2022. 2) During interview, a member of management reported the drill was conducted, but it was not documented as required.”

Rule 8VAC20-780-550-H.

Based on a review of ten children’s records and interview, the center did not ensure one child’s record contained all the required information.

“Evidence: 1) The record for Child #4, enrolled on 04/04/22, did not contain a second emergency. 2) During interview, a member of management confirmed the record did not contain a second emergency contact. Each child record should contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached.”

Rule 8VAC20-780-60-A.

Based on a review of ten staff records and interviews, the center did not ensure that six staff records contained all the required information.

Rule 8VAC20-780-70.

Based on a review of five staff records and interview, the vendor did not ensure one staff had documentation of current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of the date of employment.

“Evidence: 1) The record for Staff #3, hired on 06/14/21, did not contain documentation of current certification in CPR. 2) During interview, a member of management confirmed the record for Staff #3 did not contain documentation of current certification in CPR.”

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

Based on a review of five staff records and interview, the vendor did not ensure one staff had documentation of current certification in first aid appropriate to the ages of children in care within 90 days of the date of employment.

“Evidence: 1) The record for Staff #3, hired on 06/14/21, did not contain documentation of current certification in first aid. 2) During interview, a member of management confirmed the record for Staff #3 did not contain documentation of current certification in first aid.”

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

Based on a review of five staff records and interview, the center did not obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry or equivalent registry from any state in which two staff members had resided in the last five years within the required time frames.

Rule 22.1-289.035-B-4.

Based on a review of five staff records and interviews, the center did not ensure that three staff members had a central registry finding within 30 days of employment.

Rule 8VAC20-770-60-C-2.

Based on interviews and documentation reviewed, the center did not ensure that in order to promote a child’s physical, intellectual, emotional, and social well-being and growth, staff interacted with children and one another to provide needed respect of personal privacy and promote ways of getting along.

Rule 8VAC20-780-400-A. From a complaint.

Based on interviews, the center did not ensure a nonabsorbent surface for diapering or changing was used. For children younger than three years, this surface shall be a changing table or countertop designated for changing.

“Evidence: 1) Staff interviewed reported it was common practice for the children in the Preppers classroom, ages 2 to 3 years old, to have their pull-ups or diapers changed while the children were standing up. Staff reported children would only be changed on a changing station if staff “needed to do anything extensive,” but were otherwise changed while they were standing up.”

Rule 8VAC20-780-500-B. From a complaint.

Based on a review of documentation and interviews, the center did not ensure infants were fed in accordance with parental instructions.

Rule 8VAC20-780-570-D. From a complaint.