Milestones Child Development Center

8VAC20-780-160-A

“Each staff member and individual from an independent contractor shall submit documentation of a negative tuberculosis screening within the last 30 calendar days of the date of employment. Staff #1, staff #2 and staff #3 submitted a tuberculosis screening that was not within 30 days of employment.”

Rule 8VAC20-780-160-A.

8VAC20-780-245-L

“There shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children. The staff present during the inspection did not have daily health observation training documented in their record.”

Rule 8VAC20-780-245-L.

8VAC20-780-280-B

“Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. The school age room had a bottle of essential oil and a bottle of hand sanitizer unlocked within reach of children. The items had the warning label, ?Keep out of reach of children.?”

Rule 8VAC20-780-280-B.

8VAC20-780-440-H

“Cribs shall meet the following requirements: Cribs manufactured before June 8, 2011 shall not be used. Two of the cribs in the infant room had a manufacture year of 2009.”

Rule 8VAC20-780-440-H.

22.1-289.011-F

“The license and any other documents required shall be posted in a conspicuous place on the licensed premises. The center did not have the most recent inspection violation notice posted.”

Rule 22.1-289.011-F.

22.1-289.035-B-4

“The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #1, employed for approximately four months, did not have documentation of requesting a central registry check from one state and no documentation of requesting a central registry check or criminal history check from a different state.”

Rule 22.1-289.035-B-4.

8VAC20-780-245-A

“Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. The record for staff #4 who has been working at the center for approximately two years only had 11 hours of documented annual training for 2025.”

Rule 8VAC20-780-245-A.

8VAC20-780-280-B

“Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. The infant room had a bottle of bleach and water mix and a bottle of hand sanitizer in an unlocked cabinet and a bottle of disinfectant spray on a shelf. The preschool classroom had a bottle of disinfectant spray on the sink counter. The items had the warning label, ?Keep out of reach of children? and were unlocked within reach of children.”

Rule 8VAC20-780-280-B.

8VAC20-780-340-D

“In each grouping of children at least one staff member who meets the qualifications of a program leader or program director shall be regularly present. The staff supervising in each classroom were not program leader qualified.”

Rule 8VAC20-780-340-D.

8VAC20-780-350-B-2

“The staff-to-child ratio for children ages 16 months to 24 months whenever children are in care is one staff for every 5 children. On January 6, 2026 the toddler room ratio was 1 staff and 6 children and the youngest child in the room was 18 months.”

Rule 8VAC20-780-350-B-2.

8VAC20-780-350-B-4

“The staff-to-child ratio for children ages 3 years to school age eligible whenever children are in care is 1 staff for every 10 children. On January 6, 2026 the pre-k room ratio was 1 staff and 14 children for approximately five minutes before another staff member arrived.”

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

8VAC20-780-70

“The following staff records shall be kept for each staff person, which shall contain all required information. Staff #1 who have been working at the center for approximately four months, did not have at least two reference verifications on file. The record for staff #3 did not have an employment application documented.”

Rule 8VAC20-780-70.

8VAC20-790-600-B

“REPEAT VIOLATION All staff who work directly with children shall complete Virginia Preservice Training for Child Care Staff with 90 days of employment. Staff #1, who has been working at the center for at least three months, did not complete the 10-hour Virginia Preservice training.”

Rule 8VAC20-790-600-B.

22.1-289.035-B-3

“REPEAT VIOLATION The center must request a search of the central registry prior to the employee’s first day of employment. Staff #2 who has been employed for approximately two months had a central registry request after employment.”

Rule 22.1-289.035-B-3.

8VAC20-770-70-A

“REPEAT VIOLATION Documentation of at least two references to character, reputation, and competency are to be checked prior to employment. Staff #1 and Staff #2, who have been actively working at the center for at least two months, did not have any completed reference verifications on file.”

Rule 8VAC20-770-70-A.

8VAC20-780-140-A

“REPEAT VIOLATION Each child shall 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. The record for child #3 did not have documentation of a completed physical.”

Rule 8VAC20-780-140-A.

8VAC20-780-160-C

“REPEAT VIOLATION At least every two years from the date of the initial screening or testing staff members shall obtain and submit the results of a follow-up tuberculosis screening. The last tuberculosis screening documented for staff #3 was completed in 2022 and the last tuberculosis screening was completed for staff #4 in 2023.”

Rule 8VAC20-780-160-C.

8VAC20-780-210-A

“REPEAT VIOLATION Program leaders shall have fulfilled a high school program completion or the equivalent. The record for staff #1 and staff #2 did not have documentation of a high school completion program or the equivalent.”

Rule 8VAC20-780-210-A.

8VAC20-780-240-B

“Staff shall complete orientation training prior to working alone with children and no later than seven days of the date of assuming job responsibilities. Staff #1 has been actively working in the center alone with children for at least three months and has not completed a staff orientation. The record for staff #5 who has been employed at the center for at least two years did not have documentation of a completed orientation.”

Rule 8VAC20-780-240-B.

8VAC20-780-245-A

“REPEAT VIOLATION Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. The record for staff #3, staff #4 and staff #5 who have all been working at the center for over a year did not have documentation of annual training for 2024.”

Rule 8VAC20-780-245-A.

8VAC20-780-270-A

“REPEAT VIOLATION Areas and equipment of the center, inside and outside, shall be maintained in an operable condition. The following maintenance issues were observed outside: A broken push walker toy, broken plastic playhouse panels and a broken plastic car seat.”

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“REPEAT VIOLATION Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A bottle of hand sanitizer in the preschool room had the warning label, ?Keep out of reach of children? and was unlocked within reach of children.”

Rule 8VAC20-780-280-B.

8VAC20-780-60-A

“REPEAT VIOLATION Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required information. The record for child #1 did not contain the employment phone number for one parent. The record for child #2 did not list two emergency contacts. The record for child #3 did not contain the address of both emergency contacts. The record for child #2 and #4 did not contain documentation of the first day of attendance.”

Rule 8VAC20-780-60-A.

8VAC20-790-530-C

“For each group of children, the vendor shall maintain a written hard copy record of daily attendance that documents the arrival and departure of each child in care as it occurs. There were 25 children present at the center and only 7 children were checked in on the attendance system. There was no observed written hard copy of daily attendance of the children in care.”

Rule 8VAC20-790-530-C.

8VAC20-790-600-B

“REPEAT VIOLATION Within the first 90 days of employment or subsidy vendor approval all staff who work directly with children shall complete Virginia Preservice Training for Child Care Staff. Of the 8 staff files reviewed, 4 staff member did not have documentation of completion of this training.”

Rule 8VAC20-790-600-B.

22.1-289.035-B-1

“The center is required to obtain a completed sworn statement prior to the employee’s first day of employment. The record for staff #4 and #7 did not have documentation of a sworn statement.”

Rule 22.1-289.035-B-1.

22.1-289.035-B-2

“Providers must obtain a completed national criminal background check prior to the employee’s first day of employment. Staff #7, who had been employed for approximately a month, did not have a completed national criminal background check. Staff #7 was working with children alone.”

Rule 22.1-289.035-B-2.

22.1-289.035-B-3

“The center must request a search of the central registry prior to the employee’s first day of employment. Staff #4 who had been employed for approximately a year and staff #7, who had been employed for approximately a month, did not have a central registry search requested. Staff #7 was working alone with children.”

Rule 22.1-289.035-B-3.

8VAC20-780-140-A

“Each child shall 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. The record for child #5 did not have documentation of a completed physical. The child has been in care for approximately four months.”

Rule 8VAC20-780-140-A.

8VAC20-780-160-A

“Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. The record for staff #3, staff #5, and staff #7 did not have documentation of a completed tuberculosis screening.”

Rule 8VAC20-780-160-A.

8VAC20-780-160-C

“At least every two years from the date of the initial screening or testing staff members shall obtain and submit the results of a follow-up tuberculosis screening. The last tuberculosis screening documented for staff #1 was completed in 2023 and the last tuberculosis screening was completed for staff #6 in 2022.”

Rule 8VAC20-780-160-C.

8VAC20-780-210-A

“Program leaders shall have fulfilled a high school program completion or the equivalent. The record for staff #3 and staff #7 did not have documentation of a high school completion program or the equivalent.”

Rule 8VAC20-780-210-A.

8VAC20-780-245-A

“Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. The record for staff #, staff #4, staff #5 and staff #6, who have all been working at the center for over a year did not have documentation of annual training.”

Rule 8VAC20-780-245-A.

8VAC20-780-245-J

“Any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements in Medication Administration Training (MAT). The medication box had the medications listed above and there is only one staff member who is MAT certified and they were not present at the time of the inspection.”

Rule 8VAC20-780-245-J.

8VAC20-780-270-A

“REPEAT VIOLATION Areas and equipment of the center, inside and outside, shall be maintained in a safe condition. There was an extension cord on a shelf in the school age room and a power cord with multiple plugs on a changing table in the infant room. Both areas were accessible to children.”

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“REPEAT VIOLATION Hazardous substances shall be kept in a locked place using a safe locking method that prevents access by children. There was an unlocked cabinet in the toddler room with a can of disinfectant spray with the label ?keep out if reach of children? accessible to children.”

Rule 8VAC20-780-280-B.

8VAC20-780-350-B-1

“The staff-to-children ratio for children ages birth to 16 months is one staff for every four children and are required whenever children are in care. The ratio for the infant room was one staff and twelve children for approximately two hours.”

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

8VAC20-780-350-B-4

“The staff-to-children ratio for children ages three years old to school age eligible is one staff for every ten children and are required whenever children are in care. The ratio for the pre-k room was one staff and thirteen children for approximately two hours.”

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

8VAC20-780-500-A

“Children’s hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks. Four infant’s hands were not washed before eating.”

Rule 8VAC20-780-500-A.

8VAC20-780-510-G

“Medication shall be labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given. Prescriptive medications were observed loosely in the medication box that were not in the original container.”

Rule 8VAC20-780-510-G.

8VAC20-780-520-C

“Diaper ointment or cream shall be labeled with the child’s name. In the infant room, 7 tubes of diaper cream were unlabeled with no child’s name.”

Rule 8VAC20-780-520-C.

8VAC20-780-560-G

“When food is brought from home, the food container shall be clearly dated and labeled in a way that identifies the owner. In the infant room refrigerator, there were 2 baby bottles with milk that had no names or dates to identify the owner.”

Rule 8VAC20-780-560-G.

8VAC20-780-570-A

“When a child is placed in an infant seat or high chair, the protective belt shall be fastened securely. In the infant room, 2 of 4 children at the infant feeding table did not have the protective belt fastened securely.”

Rule 8VAC20-780-570-A.

REPEAT VIOLATION Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain all required information.

“The record for child #1, child #4 and child # 6 did not have documentation of work information for both parents and child #2 did not have the work information for one parent. The record for child #1 and child #5 did not have documentation of the contact information of two emergency contacts. The record for child #3 did not have the first day of attendance documented.”

Rule 8VAC20-780-60-A.

8VAC20-780-70

“Documentation of at least two references to character, reputation, and competency are to be checked prior to employment. Staff #3, staff #4, and staff #7 did not have completed reference verifications on file. The record for staff #5 only had one reference in their file.”

Rule 8VAC20-780-70.

8VAC20-780-340-A

“When staff are supervising children, they shall always ensure their care and guidance. On April 2, 2025 at approximately 9:00am, staff #1 was in the pre-k classroom sitting and looking at their cell phone for approximately five minutes and in that time, child #1, child #3, child #4 and child #5 (between the ages of 4-5) engaged in inappropriate actions with each other. Staff #1 did not notice the incident occurring. When Staff #2 entered the classroom, they immediately intervened with the group of children to end the inappropriate activity.”

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

8VAC20-780-340-F

“Children under 10 years of age always shall be within actual sight and sound supervision of staff. The infant room and the pre-k room each had one staff supervising the classrooms and on multiple occasions, the staff walked out of the classroom leaving the children unsupervised. Child #6 (age 5 years) was sitting in a chair unsupervised outside of the pre-k classroom for approximately two hours.”

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

8VAC20-780-410-2

“Enclosure in a small, confined space or any space that the child cannot freely exit himself is a forbidden action. Staff #3 placed child #2 (age 2 ? years old) in an infant crib in a separate area away from other children because they were trying to run out of the building.”

Rule 8VAC20-780-410-2. From a complaint.

8VAC20-790-600-B

“All staff who work directly with children shall complete Virginia Preservice Training for Child Care Staff with 90 days of employment. The record Staff #2, who has been working at the center for eight months, did not contain documentation of a completed 10-hour Virginia Preservice training.”

Rule 8VAC20-790-600-B.

8VAC20-780-270-A

“Areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. The following maintenance issues were observed: The 2 and 3 year old and pre-k room had various areas with peeling paint within reach of children.”

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. A bottle of hand sanitizer in the waddler room had the warning label, ?Keep out of reach of children? and was unlocked within reach of children”

Rule 8VAC20-780-280-B.

8VAC20-780-510-P

“When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center. The medication and authorization form for Child #4 expired in July of 2024 and the staff had administered the medication in December of 2024.”

Rule 8VAC20-780-510-P.

8VAC20-780-560-G

“When food is brought from home, the food container shall be sealed and clearly dated and labeled in a way that identifies the owner. The refrigerator in the toddler room contained a bottle that did not have a name or date on it to identify the owner.”

Rule 8VAC20-780-560-G.

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain when applicable, work phone number and place of employment of each parent who has custody. The record for Child #1, Child #2 and Child #3 were missing the employment phone number for both parents and the record for Child #3 was missing the employment information for one parent. All three children were present during the inspection and had been in care for at least three months.”

Rule 8VAC20-780-60-A.

8VAC20-780-70

“Documentation of at least two references to character, reputation, and competency are to be checked prior to employment. Staff #1 and Staff #2, who have been actively working at the center for at least two months, did not have any completed reference verifications on file. Staff #3, who has been actively working at the center for a month only one reference verification on file.”

Rule 8VAC20-780-70.

8VAC20-780-270-A

“Areas and equipment of the center, inside and outside, shall be maintained in a safe and operable condition. The children in the waddler classroom were eating lunch in a dark classroom and there were four out of six seats on the feeding table that had broken straps.”

Rule 8VAC20-780-270-A. From a complaint.

8VAC20-780-290-A-2

“Fans, when used, shall be out of reach of children and cords shall be secured so as not to create a tripping hazard. The waddler room had a fan cord that was plugged in and not secured on the side of the wall within reach of children.”

Rule 8VAC20-780-290-A-2. From a complaint.

8VAC20-780-340-F

“Children under 10 years of age always shall be within actual sight and sound supervision of staff, except that staff need only be able to hear a child who is using the restroom provided that staff may need to provide intermittent sight supervision to provide assistance to children as needed. A child (age 3 years) was using the urinal, and two other children (ages 3 years) began to use the same urinal at the same time and a staff intervened about a minute later.”

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

8VAC20-780-350-B-4

“The staff-to-children ratios for children 3 years old to school age eligible is 1:10 and is required whenever children are in care. Staff #1 was alone in the classroom supervising 15 children aged three and four for approximately 3 minutes before another staff member arrived.”

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

8VAC20-780-500-A

“Children’s hands shall be washed with soap and running water after toileting. Two children in the three- and four-year-old classroom did not wash their hands after using the restroom.”

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

8VAC20-780-500-B

“Disposable diapers shall be disposed in such a way that neither the staff member’s hand nor the soiled diaper touches an exterior surface of the storage system during disposal. A staff member in the waddler classroom was observed touching the trash can with their hands to dispose of a diaper.”

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

8VAC20-780-560-J

“Tables shall be sanitized before and after each use for feeding. Staff in the two- and three-year-old classroom did not sanitize the tables before the children sat down for lunch.”

Rule 8VAC20-780-560-J. From a complaint.

8VAC20-780-130-A

“Based on record review and interviews, it was determined the center did not obtain documentation that each child in care had received immunizations as required by the State Board of Health before the child attends the center. Evidence: 1.There was no documentation of immunizations in the record for child #1. The child began care on 5/29/24 and was in care on 6/3/2024. 2.The Director confirmed the immunization record was not in the record.”

Rule 8VAC20-780-130-A.

8VAC20-780-130-E

“Based on record review and interviews, it was determined the center did not obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1.The most current documentation of immunizations for child # 2, who was under two years of age, was dated 7/6/2023, 11 months prior. 2.The Director confirmed additional immunization documentation was not in the record.”

Rule 8VAC20-780-130-E.

8VAC20-780-140-A

“Based on record review and interview, it was determined the center did not ensure that the required physical was in the child’s record before the child’s attendance or within 30 days after the first day of attendance. Evidence: 1.There was no physical in the record for child #5 who was in care from 1/2/24 to 3/1/2024. 2.The Director confirmed the physical was not in the record.”

Rule 8VAC20-780-140-A.

8VAC20-780-150-B

“Based on record review, it was determined the center did not ensure that the documentation accepted as proof of immunizations included all of the required information. Evidence: 1.Documentation of immunizations in the record for child #5 was not signed by a physician, his designee, or an official of a local health department. It did not contain an official stamp from the physician’s office. The child’s name was not included in the documentation, but was handprinted at the top of the documentation.”

Rule 8VAC20-780-150-B.

8VAC20-780-260-B

“Based on a review of documentation and interview, it was determined that the facility did not ensure that an annual health inspection was provided. Evidence: 1. The health inspection report available for viewing during the inspection was dated 5/3/2023. The report was more than a year old and was no longer current. 2. The Director confirmed the health inspection was not current.”

Rule 8VAC20-780-260-B.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-330-B

Rule 8VAC20-780-330-B.

8VAC20-780-500-A

“Based on observation it was determined the center did not ensure that children’s hands were washed with soap and running water after toileting. Evidence: 1.In the four-year-old classroom the inspector observed two children use the bathroom and return to the carpeted area without washing their hands.”

Rule 8VAC20-780-500-A.

8VAC20-780-510-E

“Based on record review and interviews, it was determined that the center did not ensure that long term over the counter medication was allowed with written authorization from the child’s physician and parent. Evidence: 1.The parent of child #6 signed an authorization for Infant Tylenol on 3/18/24. The authorization did not have a physician’s signature therefore, it had expired 10 working days later on 4/1/2024. 2. Child #6 was given the medication on 4/23/24 and 4/24/24, after the authorization had expired.”

Rule 8VAC20-780-510-E.

8VAC20-780-540-E

“Based on observation and interviews, it was determined the facility did not ensure the required nonmedical emergency supplies were available on each floor of the building. Evidence: 1.The battery-operated radio did not work. 2.There was no working flashlight. 3.The Director confirmed the radio and flashlight were not working.”

Rule 8VAC20-780-540-E.

8VAC20-780-550-E

“Based on record review and interviews, it was determined the center did not ensure that shelter in place procedures were practiced a minimum of twice per year. Evidence: 1.There was only one shelter in place drill conducted in 2023. 2.The Director confirmed only one drill was documented.”

Rule 8VAC20-780-550-E.

8VAC20-780-550-P

“Self-reported Based on record review and interviews, it was determined the center did not ensure that a written record of children’s serious and minor injuries was documented on the day of occurrence and includes all the required information. Evidence: 1.The written record of an injury that occurred on 3/1/2024 was not completed with all required information on the day the injury occurred. The center’s Injury/Incident form (written record) was completed on 3/4/2024.”

Rule 8VAC20-780-550-P.

8VAC20-780-60-A

“Based on review of children’s records and interviews, it was determined that the center did not ensure that each child’s record contains all required information. Evidence: 1.The record for child #1 did not contain the work phone number for the father, the physicians name and phone number and documentation of viewing the proof of identity and age of the child. 2.The Director confirmed the documentation was not in the record.”

Rule 8VAC20-780-60-A.

Based on record review and interview, the center did not ensure that each child shall 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. The record for child 1 (date of enrollment: 7/6/23) does not contain documentation of a physical examination. 2. The center owner confirmed that the record for child 1 is lacking documentation of a physical examination.”

Rule 8VAC20-780-140-A.

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

“Evidence: 1. There was a wooden shelving unit located on the younger children’s playground with two rusted nails protruding from the top of the shelf. The shelving unit was accessible to the children in care. 2. The center owner confirmed that the wooden shelving unit was not maintained in a safe and operable condition.”

Rule 8VAC20-780-270-A.

Based on record review and interview, the center did not ensure that staff records contain all the required information.

“Evidence: 1. The record for staff 1 (date of hire: 7/25/23) does not contain documentation that two or more references as to character and reputation as well as competency were checked before employment. 2. The center owner confirmed that the record for staff 1 is lacking documentation of the two required reference checks.”

Rule 8VAC20-780-70.

8VAC20-780-440-N

Rule 8VAC20-780-440-N.

Based on observation and interview, the center did not ensure that prepared infant formula shall be dated.

“Evidence: 1. In the infant room, there were 3 bottles of formula that were not dated. 2. The infant teacher confirmed that the bottled formula in the infant room were not dated.”

Rule 8VAC20-780-570-E.

Based on record review and interview, the vendor did not ensure that all staff have current certification in cardiopulmonary resuscitation (CPR) appropriate to the age of children in care within 90 days of the date of employment.

“Evidence: 1. The records for staff 1 (date of hire: 8/29/22) does not contain documentation of current certification in CPR. 2. The vendor confirmed that the record staff 1 lacks documentation of current certification in CPR.”

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

Based on record review and interview, the vendor did not ensure that all staff have current certification in first aid within 90 days of the date of employment.

“Evidence: 1. The records for staff 1 (date of hire: 8/29/22) does not contain documentation of current certification in first aid. 2. The vendor confirmed that the record for staff 1 lacks documentation of current certification in first aid.”

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

Based on record review and interview, the center did not ensure that all employees shall undergo a background check every five years after the initial check is completed.

“Evidence: 1. The most recent central registry search result for staff 1 is dated 8/2/17. Staff 1 was due for an updated central registry search in August 2022. 2. The center director confirmed that the central registry search results for staff 1 is expired.”

Rule 22.1-289.035-A.

Based on record review and interview, the center did not ensure that the results of a national fingerprint search are received for each staff member before employment.

“Evidence: 1. The record for staff 4 (date of hire: 12/12/22) contains results of a national fingerprint search dated 12/14/22, which is after her first day of employment. 2. The center director confirmed that staff 4 began employment at the center prior to receiving the results of her national fingerprint search.”

Rule 22.1-289.035-B-2.

Based on record review and interview, it was determined that the center did not ensure that a copy of the results of a search of the child abuse and neglect registry is obtained from any state in which the individual has resided in the preceding five years.

“Evidence: 1. Staff 3 has a hire date of 8/29/22. Staff 3 indicated on her sworn statement or affirmation that she has resided in the state of New Jersey within the past five years. The results of a search of the child abuse and neglect registry were not available for staff 3 from the state of New Jersey. 2. The center director confirmed that the required out-of-state background check was not completed for staff 3.”

Rule 22.1-289.035-B-4.

Based on record review and interview, the center did not ensure that an employee of a licensed or registered child day program must be denied continued employment or volunteer service if the licensed child day program does not have a central registry finding within 30 days of employment.

“Evidence: 1. The records for staff 2 (date of hire: 10/25/22) and staff 3 (date of hire: 8/29/22) do not contain documentation of a central registry finding. 2. The center director confirmed that the records for staff 2 and staff 3 are lacking documentation of a central registry finding.”

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

Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and before coming into contact with children.

“Evidence: 1. The record for staff 3 (date of hire: 8/29/22) does not contain documentation of a negative tuberculosis screening. 2. The record for staff 6 (date of hire: 11/18/22) contains documentation of a negative tuberculosis screening dated 11/20/22, which is after her date of hire. 3. The center director confirmed that the tuberculosis screenings for staff 3 and staff 6 were not completed within the required timeframes.”

Rule 8VAC20-780-160-A.

Based on record review and interview, the center did not ensure that all staff shall complete the Virginia Department of Education-sponsored orientation training within 90 calendar days of employment.

“Evidence: 1. The record for staff 3 (date of hire: 8/29/22) does not contain documentation of completing the Virginia Department of Education-sponsored orientation training. 2. The center director confirmed that staff 3 has not completed the required orientation training.”

Rule 8VAC20-780-240-A.

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

“Evidence: 1. The wooden shelving unit in the school-age classroom has multiple areas of chipped and peeling paint. 2. The center director confirmed that the shelving unit in the school-age classroom has chipped and peeling paint.”

Rule 8VAC20-780-270-A.

Based on observation and interview, the center did not ensure that hazardous substances, such as cleaning materials, shall be kept in a locked place using a safe locking method that prevents access by children.

Rule 8VAC20-780-280-B.

Based on interview and a review of medication, the center did not ensure that nonprescription medication shall be given to a child only with written authorization from the parent.

“Evidence: 1. Child 1 was administered Benadryl by center staff on 11/1/22 without written authorization from the parent. 2. The center director confirmed that there is no written parental authorization to administer Benadryl to child 1.”

Rule 8VAC20-780-510-B.

Based on interview and a review of medication, the center did not ensure that the center’s procedures for administering medication shall include written authorization from the child’s physician and parent for long-term prescription drug use.

Rule 8VAC20-780-510-E.

Based on observation and interview, the center did not ensure that prepared infant formula shall be dated.

“Evidence: 1. In the infant room, there were 6 bottles of formula in the refrigerator that were not dated. 2. The center director confirmed that the refrigerated bottled formula in the infant room were not dated.”

Rule 8VAC20-780-570-E.

Based on record review and interview, the center did not ensure that children’s records contain a written care plan for each child with a diagnosed food allergy, 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: 1. Child 2 is identified on the center’s written allergies, sensitivities and dietary restrictions list as having a diagnosed food allergy and has an emergency medication being stored at the center. The center does not have a written allergy care plan for child 2. 2. The center director confirmed that the center does not have a written allergy care plan for child 2’s diagnosed food allergy.”

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

Based on record review and interview, the center did not ensure that staff records contain all the required information.

Rule 8VAC20-780-70.

Based on observation and interview, the center did not ensure that children under 10 years of age shall always be within actual sight and sound supervision of staff.

Rule 8VAC20-780-340-F.

Based on observation and interview, the center did not ensure that the staff-to-children ratio of 1:4 for birth up to 16 months is maintained.

“Evidence: 1. During an on-site inspection on 9/28/22, the licensing inspector observed 1 staff person caring for 5 infants, ages 4 months to 9 months, in the infant room. The number and ages of the children required 2 staff to be present. 2. Staff 1 (center director) confirmed that there was only 1 staff person with 5 children in the infant room, where 2 staff are required.”

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

Based on record review and interview, the center did not ensure that children’s records contain all the required information.

“Evidence: 1. The record for child 1 (date of enrollment: 9/6/22) does not contain the name, address and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Staff 1 (center director) confirmed that the record for child 1 is lacking the required emergency contact information.”

Rule 8VAC20-780-60-A.

Based on record review and interview, it was determined that the center did not ensure that 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 is obtained from any state in which the individual has resided in the preceding five years.

Rule 22.1-289.035-B-4.

Based on record review and interview, the center did not ensure that an employee of a licensed or registered child day program must be denied continued employment or volunteer service if the licensed child day program does not have a central registry finding within 30 days of employment.

“Evidence: 1. The records for staff 1 (date of hire: 10/18/21) and staff 2 (date of hire: 2/28/22) do not contain documentation of a central registry finding. 2. The center director confirmed that the records for staff 1 and staff 2 are lacking documentation of a central registry finding.”

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

Based on record review and interview, the center did not ensure that each child shall have a physical examination by or under the direction of a physician before the child’s attendance or within one month after attendance.

“Evidence: 1. The record for child 1 (date of enrollment: 1/18/22) contains documentation of a physical examination dated 3/2/22, which is more than one month after attendance. 2. The center director confirmed that documentation of child 1’s physical examination was obtained more than one month after the child’s enrollment.”

Rule 8VAC20-780-140-A.

Based on record review and interview, the center did not ensure that each staff member shall submit documentation of a negative tuberculosis screening.

“Evidence: 1. The records for staff 2 (date of hire: 2/28/22) and staff 4 (date of hire: 9/9/21) do not contain documentation of a negative tuberculosis screening. 2. The center director confirmed that the records for staff 2 and staff 4 are lacking documentation of a negative tuberculosis screening.”

Rule 8VAC20-780-160-A.

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

“Evidence: 1. On the toddler playground, there was a plastic play structure with broken and cracked steps, which is a pinching and tripping hazard. Children were observed playing on the structure and going up the steps of the play structure during the inspection. 2. The center owner confirmed that the plastic play structure on the toddler playground was broken and cracked.”

Rule 8VAC20-780-270-A.

Based on observation and interview, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader shall be regularly present.

“Evidence: 1. During the inspection, staff 2 was observed working alone in the school-age classroom with 8 children from 9:30am until 11:30am. Staff 2 is not program leader qualified. 2. The center director confirmed that staff 2 is not program leader qualified and was working alone with the school-aged children for a period of two hours.”

Rule 8VAC20-780-340-D.

Based upon review of emergency drill records and interview, the center did not ensured that a minimum of two shelter-in-place drills are conducted per year.

“Evidence: 1. The emergency drill record provided had only one shelter-in-place drill documented for 2021. 2. The center director confirmed that only one shelter-in-place drill was conducted in 2021.”

Rule 8VAC20-780-550-E.

Based on record review and interview, the center did not ensure that staff records contain all the required information.

“Evidence: 1. The record for staff 4 (date of hire: 9/9/21) does not contain documentation that two or more references as to character and reputation as well as competency were checked before employment. 2. The center director confirmed that the record for staff 4 is lacking documentation of the required reference checks.”

Rule 8VAC20-780-70.