Ms. Sabrina Wilson

Caregivers who work directly with children shall annually attend at least 16 hours of training, to include the department’s health and safety update course.

“Staff 2 did not have documentation of completion of 16 hours of training to include the health and safety update course.”

Rule 8VAC20-790-250-F.

REPEAT VIOLATION Potentially poisonous, substances, materials and supplies shall be stored in areas inaccessible to children.

“Lysol Disinfectant spray was stored on the back of the toilet in the restroom used by the children.”

Rule 8VAC20-800-280.

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

“Caregiver used hand sanitizer and disposable wipes for Child 1 after diaper change.”

Rule 8VAC20-800-680-B.

An up-to-date record for each child enrolled shall be maintained by the provider.

“There was no record for children 3 and 4, who were in care during the inspection and had been in care for 3 days.”

Rule 8VAC20-800-60-A.

Children’s records are required to contain parental home and employment addresses and phone numbers.

“The record for Child #1 was missing the Name, address and telephone number of two designated people to contact in case of an emergency if the parent cannot be reached, and Chronic physical problems, pertinent development information, and special accommodations needed. The record for Child # 2 was missing the address for one of the two emergency contacts and Chronic physical problems, pertinent development information, and special accommodations needed.”

Rule 8VAC20-800-60-B.

Enclosure in a small, confined space or any space that the child cannot freely exit himself; however, this does not apply to the use of equipment such as cribs, play pens, high chairs, and safety gates when used for their intended purpose with children preschool age or younger.

“Child # 5 was sitting in a floor highchair and was not able to freely exit himself and was not used for its intended purpose. The child was in the floor highchair for 15 minutes.”

Rule 8VAC20-800-640-2.

Documentation shall be maintained for emergency evacuation and shelter-in place drills.

“During the inspection the provider completed the emergency drill log for January to present.”

Rule 8VAC20-800-830-C.

Repeat violation

“Poisonous materials shall be stored in an area inaccessible to children. Poisonous cleaning chemicals were on the floor in the kitchen and the children had access to the chemicals.”

Rule 8VAC20-800-280.

Stationary outdoor playground equipment shall: Be placed at least six feet from the perimeter of other play structures or obstacles.

“There are four pieces of equipment, and all of the pieces did not have the required six foot of perimeter.”

Rule 8VAC20-800-500-C.

Repeat violation

Rule 8VAC20-800-60-A.

Medication, except for those prescriptions designated otherwise by a written Physician’s order, including refrigerated medication and medications for caregivers and household members, shall be kept in a locked place using a safe locking method that prevents access by children.

“There were several containers of prescription medication sitting by the couch. One of the containers had pills that was not locked and accessible to the children in care.”

Rule 8VAC20-800-730-D.

The provider shall obtain documentation of a physical examination prior to a child’s attendance or within 30 days after the first day of attendance.

“There were no physical exam records available for Child #1, who had been in care for over 6 months.”

Rule 8VAC20-800-100-A.

Repeat violation

“Poisonous materials shall be stored in an area inaccessible to children. Poisonous cleaning chemicals were on the floor in the kitchen and the children had access to the chemicals.”

Rule 8VAC20-800-280.

Cribs, cots, rest mats, and beds when being used for sleeping or napping by children other than infants shall have linens consisting of a top cover and a bottom cover or a one-piece covering that is open on three edges.

“No linens were available for one child during naptime.”

Rule 8VAC20-800-530-A.

Each provider shall maintain a separate record for each child enrolled that contains all of the required information.

“The record for Child #1, enrolled for six months, was missing the following required components: name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached. The record for Child #2, enrolled for 14 months, was missing the following required components: One of the two required designated persons to contact in case of an emergency if the parent cannot be reached did not have a complete address, authorized persons to pick up, previous school attended,”

Rule 8VAC20-800-60-A.

Tables and high chairs trays shall be cleaned and sanitized daily and before and after each use for feeding.

“Staff #1 did not clean and sanitize the table and two highchair trays before feeding.”

Rule 8VAC20-790-440-E.

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

“The most recent central registry check for staff #1 staff # 2 was overdue by a 11 months.”

Rule 22.1-289.035-A.

Repeat violation

“A tuberculosis (TB) screening is required every two years from the last screening. An updated TB screening for Caregiver #2 was not completed and was overdue by eleven months.”

Rule 8VAC20-800-180-A.

Poisonous materials shall be stored in an area inaccessible to children.

“Poisonous cleaning chemicals were on the floor in the kitchen and the children had access to the chemicals.”

Rule 8VAC20-800-280.

Cribs when being used by infants shall have a tight-fitting bottom.

“Two cribs were in use and the bottom cover was loose.”

Rule 8VAC20-800-530-B.

Children’s hands shall be washed with soap and running water after toileting, or any contact with blood, feces or urine.

“Staff # 2 changed a child’s diaper in the infant room and did not wash the child’s hands with soap and water. Three children were served lunch/bottle, and the hands were not washed before eating.”

Rule 8VAC20-800-680-B.

Documentation of additional immunizations is required once every six months for children under the age of two years.

“Child #2, 2 years old, last documented immunization was over 18 months ago.”

Rule 8VAC20-800-90-C.

Based on record review and interview, the center failed to ensure staff obtained a current certification in CPR appropriate to the ages of children in care.

“Evidence: Staff 2’s CPR certification expired 11/23.”

Rule 8VAC20-790-250-D-1.

Based on record review and interview, the center failed to ensure staff obtained a current certification in first aid appropriate to the ages of children in care.

“Evidence: Staff 2’s first aid certification expired 11/23.”

Rule 8VAC20-790-250-D-2.

(REPEAT VIOLATION) Based on observation, the provider failed to post the most recent license in a conspicuous place.

“Evidence: An inspection of the family day home was conducted. The license could not be found on the premises.”

Rule 22.1-289.011-F.

Based on record review, the provider failed to 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 for child 1, first day 1/22/22, and child 3, first day 1/1/23, does not have documentation of a physical examination.”

Rule 8VAC20-800-100-A.

(REPEAT VIOLATIONS) Based on record review and interview, the provider failed to obtain updated TB screenings every two years from each caregiver.

“Evidence: Staff 2’s most recent TB screening is dated 10/17/21.”

Rule 8VAC20-800-180-A.

Based on observation, the provider failed to ensure that a caregiver does not exceed 16 points by using the required point system to determine if an additional caregiver is needed.

“Evidence: The licensing inspector arrived at 10:40 AM finding the provider alone with nine children totaling 23 points. The provider stated the assistant went to the grocery store. The assistant arrived at 11:03 AM.”

Rule 8VAC20-800-570-A.

Based on record review, the provider failed to obtain emergency contact information that included the name, address and telephone number of at least two designated persons to contact in case of an emergency if the parents cannot be reached.

“Evidence: The record for child 5 only contained one emergency contact.”

Rule 8VAC20-800-60-B.

Based on observation and interview, the provider failed to post the license and most recent inspection in a conspicuous place.

“Evidence: 1. An inspection of the family day home was conducted. The license and most recent inspection could not be found posted on the licensed premises. 2. The provider stated she was unaware they were not posted.”

Rule 22.1-289.011-F.

Based on record review and interview, the provider failed to obtain repeat fingerprint background checks every 5 years.

“Evidence: 1. The most current fingerprint result for staff 1 on file is dated 5/21/18. 2. The most current fingerprint results for staff 2 on file is dated 6/27/18. 3. The provider stated she completed staff 1’s fingerprints but cannot find the results and she forgot to do staff 2’s.”

Rule 22.1-289.035-A.

Based on observation, the provider failed to ensure cleaning agent was inaccessible to children.

“Evidence: A spray bottle of cleaner was on the floor beside the changing table in the room with toddlers. Toddlers were observed freely moving around the room. Staff 2 was observed using the spray bottle of cleaner to clean the changing table surface after diapering.”

Rule 8VAC20-800-280.

Based on observation, the provider failed to ensure children’s hands were washed with liquid soap and warm running water before eating.

“Evidence: Children were observed eating snack after sitting on the floor playing a game. The children did not wash hands before eating snack.”

Rule 8VAC20-800-680-B.

Based on observation and interview, the provider failed to document emergency evacuation drills.

“Evidence: 1. The documentation of emergency evacuation drills did not contain documentation for the months of June through September of 2023. 2. The provider stated they completed the drills but she forgot to document them.”

Rule 8VAC20-800-830-C.

Based on observation, the caregiver failed to wash their hands with liquid soap and warm running water after diapering each child.

“Evidence: Staff 2 was observed diapering three children. Staff 2 did not wash hands after diapering three children.”

Rule 8VAC20-800-680-A.

Based on observation, the caregiver failed to ensure that children’s hands were washed with liquid soap and warm running water after diapering.

“Evidence: Staff 2 was observed diapering three children. None of the three children washed hands after diapering.”

Rule 8VAC20-800-680-B.

Based on record review and interview, the provider failed to obtain documentation before a child may attend the family day home that the child has been adequately immunized.

“Evidence: 1. The record for child 1 was reviewed on 02/23/2023. The first date of attendance was documented as 12/15/2022. The immunization record was dated 01/19/2023. 2. The record for child 2 was reviewed on 02/23/2023. The first date of attendance was documented as 03/14/2022. The immunization record was dated 04/01/2022.”

Rule 8VAC20-800-90-A.

Based on observation and interview, the provider failed to ensure the findings of the most recent inspection of the family day home was posted.

“Evidence: 1. An inspection of the family day home was conducted on 02/23/2023. The findings of the most recent inspection was not found posted. 2. The provider verified the findings of the most recent inspection was not posted.”

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

Based on record review and interview, the center failed to obtain from each caregiver every two years an updated report of TB screening.

“Evidence: 1. The record for staff 1 had documentation of a TB screening dated 10/8/20. 2. The provider verified she had not updated the TB screening since 2020.”

Rule 8VAC20-800-180-A.

Based on observation, the provider failed to assure caregivers washed hands with liquid soap and warm running water after diapering a child.

“Evidence: The assistant was observed diapering three children. The assistant did not wash hands after diapering any of the three children. The assistant did have gloves on and changed the gloved between each diapering.”

Rule 8VAC20-800-680-A.

Based on record review and interview, the provider failed to ensure all staff’s cardiopulmonary resuscitation (CPR) certification was current.

“Evidence: 1. The CPR certificate for staff 2 expired on 8/2021. 2. The provider stated she has been unable to find classes for staff 2 to take.”

Rule 22VAC40-665-230-E-1.

Based on record review and interview, the provider failed to ensure all staff’s first aid certification was current.

“Evidence: 1. The first aid certificate for staff 2 expired on 8/2021. 2. The provider stated she has been unable to find classes for staff 2 to take.”

Rule 22VAC40-665-230-E-2.

Based on record review and interview, the provider failed to obtain a current report of Tuberculosis Screening form every two years from the date of the previous screening.

“Evidence: 1. The record for the assistant shows the most current TB was completed on 6/25/18. Leniency was granted by the department during the state of emergency, but the state of emergency ended on 6/30/2021. 2. The provider stated she is still experiencing difficulty finding medical providers that will administer TB screenings.”

Rule 22VAC40-111-180-A.