Fabiola Salinas

*REPEAT VIOLATION* The provider shall 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.

“Child #1 who have been in care for five weeks, did not have the results of a physical examination available for review.”

Rule 8VAC20-800-100-A.

*REPEAT VIOLATION* Equipment used by children shall be used in accordance with the manufacturer’s instructions.

“Three toddlers and one infant were observed sitting at feeding chairs during lunch time. The safety strap was not fastened in any of the four feeding chairs as required by manufacturer’s instructions.”

Rule 8VAC20-800-480-D.

*REPEAT VIOLATION* *SYSTEMIC VIOLATION* The family day home shall keep a written record of children in attendance each day.

“At the time of entrance 11 children were in care. There was no record of attendance for the day available. The attendance record for the previous four days was also not available.”

Rule 8VAC20-800-50-A.

The provider shall maintain an up-to-date record at the family day home for each enrolled child.

“There was no record for Child #1 available for review. Child #1 was present during the inspection and, according to Caregiver #1, has been attending for the past five weeks.”

Rule 8VAC20-800-60-A.

*REPEAT VIOLATION* Prescription and nonprescription medications shall be given to a child only with written authorization from the parent.

“Child #1 (3 years-old) has been administered two prescription medications on a daily basis for five weeks, but written authorization from the parent is not on file. The authorization forms on file did not authorize the program to administer the medications, they were not signed by the parent, and indicated that the forms were only valid through the end of the 2025-2026 school year”

Rule 8VAC20-800-700-A.

The caregiver shall administer prescription medication in accordance with the prescriber’s instructions pertaining to dosage, frequency, and manner of administration.

“Physician’s instructions for two prescription medications for Child #1 (3 years-old) were not followed. The prescription label and written instructions indicated that the medication must be administered at 11:00 am daily. According to Caregiver #1, the medication has been administered between 1:30 - 2:00 pm daily, during the past five weeks.”

Rule 8VAC20-800-710.

The provider shall keep a record of prescription and nonprescription medication given to children, that includes required information.

“According to Caregiver #1, two prescription medications have been administered daily to Child #1 for about five weeks, but the provider has not maintained a record with the required information.”

Rule 8VAC20-800-740.

*REPEAT VIOLATION* * SYSTEMIC VIOLATION* Annually, the provider shall review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and obtain the parent’s signed acknowledgment of the review.

“The annual update in the records for Child #2 and Child #3 were overdue for seven months.”

Rule 8VAC20-800-780-B.

*REPEAT VIOLATION* Before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized.

“There was no immunization record available for Child #1. Child #1 was present during the inspection and, according to the provider, has been attending for the past five weeks.”

Rule 8VAC20-800-90-A.

When meals or snacks are provided by the family day home, the menu for the current one-week period shall be posted or placed in an area accessible to parents.

“The menu for the current one-week period was not posted or available for review.”

Rule 8VAC20-800-920.

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

“The current inspection notice for 04/27/2026 was not posted.”

Rule 22.1-289.011-F.

*REPEAT VIOLATION* Potentially poisonous substances shall be stored in areas inaccessible to children.

“The door to the laundry room, which is adjacent to the care area, was unlocked. Potentially poisonous substances were stored in the laundry room as: bleach, laundry detergent, and disinfecting wipes.”

Rule 8VAC20-800-280.

*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day.

“At the time of entrance, the attendance for the day had not been recorded.”

Rule 8VAC20-800-50-A.

*REPEAT VIOLATION* The provider shall maintain an up-to-date record at the family day home for each enrolled child.

“The record for Child #1 did not contain a telephone number for a parent’s place of work, and the policy number for the child’s medical insurance.”

Rule 8VAC20-800-60-B.

When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days.

“There was no authorization for Child #2’s medication. The medication has been in the fdh for more than 14 days.”

Rule 8VAC20-800-700-C.

*REPEAT VIOLATION* When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

“Medication for Child #2 was stored in the refrigerator door, next to some margarine. It was not locked in a container away from food.”

Rule 8VAC20-800-730-C.

8VAC20-800-730-D

“*REPEAT VIOLATION* Medication shall be kept in a locked place using a safe locking method that prevents access by children. Medication for Child #2 was stored in the refrigerator door, which was kept unlocked.”

Rule 8VAC20-800-730-D.

*REPEAT VIOLATION* Temperatures shall be maintained at or below 40?F in refrigerator compartments and at or below 0?F in the freezer compartments.

“Temperature in the refrigerator compartment was 46?F and 10?F in the freezer compartment.”

Rule 8VAC20-800-940-A.

*REPEAT VIOLATION* The provider shall maintain an up-to-date record at the family day home for each enrolled child.

“The Record for Child #1 did not contain an address and telephone number for a second parent’s work place of work.”

Rule 8VAC20-800-60-B.

Nonprescription medications shall be given to a child only with written authorization from the parent.

“Medication for Child #5 did not have written authorization from the parents.”

Rule 8VAC20-800-700-A.

When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

“Medication for Child #5 was stored in the refrigerator door, next to some margarine. It was not locked in a container away from food.”

Rule 8VAC20-800-730-C.

Medication shall be kept in a locked place using a safe locking method that prevents access by children.

“Medication for Child #5 was stored in the refrigerator door, was kept locked.”

Rule 8VAC20-800-730-D.

*REPEAT VIOLATION* Topical skin products such as sunscreen and diaper ointment, did not meet the requirements for their use.

“-There was no authorization form for the use of diaper cream for Child #2 and Child #3 -A second diaper cream product for Child #2 was not labeled with the child’s name and there was no authorization form for it.”

Rule 8VAC20-800-750-A.

*REPEAT VIOLATION* Topical skin products such as sunscreen and diaper ointment, shall not be used beyond the expiration date of the product.

“Diaper cream products for Child #2, Child #3 and Child #4, were being used over the expiration date of the product.”

Rule 8VAC20-800-750-D.

Temperatures shall be maintained at or below 0?F in the freezer compartments.

“Temperature in the freezer was at 11?F.”

Rule 8VAC20-800-940-A.

8VAC20-800-210-A

“Caregivers shall obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Caregiver #1 completed 11.5 hours out of the required 16 hours.”

Rule 8VAC20-800-210-A.

8VAC20-800-50-A

“*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day. The was no attendance recorded for the current week. The most recent date that attendance was recorded was 02/20/2026.”

Rule 8VAC20-800-50-A.

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

“The record for Child #1 did not contain the policy number for the child’s medical insurance.”

Rule 8VAC20-800-60-B.

*REPEAT VIOLATION* Annually, the provider shall review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and obtain the parent’s signed acknowledgment of the review.

“The annual update in the record for Child #1 was overdue for three weeks.”

Rule 8VAC20-800-780-B.

8VAC20-800-60-B

“*REPEAT VIOLATION* The provider shall maintain an up-to-date record at the family day home for each enrolled child that contains all required information. The records for Child #2 and Child #3, (enrolled for two weeks each), did not contain the parent’s work phone number. The records for Child #1 (enrolled for seven months) and Child #2 (enrolled for two weeks) did not contain policy number for the child’s medical insurance.”

Rule 8VAC20-800-60-B.

*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day.

“At the time of inspection, the attendance record did not have an accurate account of the children in attendance. Twelve children were in care but only nine children were included in the attendance list as present. The other three children were marked as absent.”

Rule 8VAC20-800-50-A.

Providers must obtain a completed national criminal background check prior to the employee’s first day of employment.

“Caregiver #3, who had been employed for two weeks, did not have a completed national criminal background check.”

Rule 22.1-289.035-B-2.

*REPEAT VIOLATION* The provider shall 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.

“The records for Child #3, Child #4 and Child #5, who have been in care for three months each, did not contain the results of a physical examination.”

Rule 8VAC20-800-100-A.

Providers must maintain a complete record for each caregiver.

“The record for Caregiver 2 did not contain the following: date of employment, and documentation that two or more references as to character and reputation as well as competency were checked before employment.”

Rule 8VAC20-800-120-B.

Equipment used by children shall be assembled, maintained, and used in accordance with the manufacturer’s instructions.

“The safety buckle in one of the swings in the backyard playground was missing. In its place, there was a strip of edging ribbon tied around the child.”

Rule 8VAC20-800-480-D.

*REPEAT VIOLATION* The provider shall maintain an up-to-date record at the family day home for each enrolled child.

“Records reviewed did not contain all required information as follows: *For Child #1, the record was missing the phone number for the child’s physician, emergency action plan for the child’s allergies, and first date of attendance. *For Child #2, the record was missing the policy number for the child’s health insurance. *For Child #3, the record was missing the address for the parent’s place of work.”

Rule 8VAC20-800-60-B.

Before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized.

“The records for Child #3, Child #4 and Child #5, who have been in care for three months each, did not contain a copy of their immunization record.”

Rule 8VAC20-800-90-A.

*REPEAT VIOLATION* Potentially poisonous substances shall be stored in an area inaccessible to children

“The door to the laundry room was unlocked. The following substances were observed on the floor of the laundry room: at least three gallons of bleach, fabric softener, and disinfecting (Lysol) wipes.”

Rule 8VAC20-800-280.

The bathroom shall be kept clean and contain a working toilet and sink, toilet tissue, liquid soap, and paper towels.

“There was no paper towels available in the bathroom.”

Rule 8VAC20-800-340-C.

*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day.

“At the time of inspection, ten children were in care but only eight children were included in the attendance list as present.”

Rule 8VAC20-800-50-A.

*REPEAT VIOLATION* The provider shall ensure that a caregiver does not exceed 16 points.

“At the time of entrance, the assistant caregiver was alone with nine children for a total of 20 points.”

Rule 8VAC20-800-570-A.

*REPEAT VIOLATION* The provider shall maintain an up-to-date record at the family day home for each enrolled child.

“On the date of inspection, there was no record for Child #3.”

Rule 8VAC20-800-60-A.

*REPEAT VIOLATION* A child’s record shall contain the required documentation.

“The record for child #1 did not have documentation of addresses for two designated persons to contact in case of an emergency. The record for children #2, #9, and #10 did not have documentation of the signed acknowledgment of the medication policy for the FDH. The record for child #4 did not have documentation that the original proof of the child’s identity had been reviewed. The record did not contain documentation for authorization for emergency care.”

Rule 8VAC20-800-60-B.

*REPEAT VIOLATION* Caregivers shall wash their hands with liquid soap and warm running water after diapering a child or assisting a child with toileting.

“Caregiver #2 was observed changing the diaper of an infant. They did not wash their hands after diapering the child.”

Rule 8VAC20-800-680-A.

*REPEAT VIOLATION* Caregivers shall ensure that children’s hands are washed with liquid soap and warm running water after diapering; and before eating.

“Child #5’s diaper was changed by Caregiver #2 and the child’s hands were not washed with liquid soap and running water. Child #1 arrived to the fdh from home and was offered breakfast. Child #1 began to eat their breakfast without washing their hands first.”

Rule 8VAC20-800-680-B.

The diapering surface shall be cleaned and sanitized after each use.

“The diapering surface was not cleaned and sanitized after Caregiver #2 changed the diaper of Child #5.”

Rule 8VAC20-800-690-D.

*REPEAT VIOLATION* Toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use.

“A toilet chair that was used by a child was emptied and rinsed but not cleaned and sanitized.”

Rule 8VAC20-800-690-L.

When topical skin products are used, the product shall be labeled with child’s name.

“Three out of four diaper cream products in the diapering area were not labeled with the child’s name.”

Rule 8VAC20-800-750-A.

When topical skin products are used, the product shall not be used beyond the expiration date of the product.

“Diaper creams were observed in the diapering area with the following expiration dates: February 2019, October 2023, March 2024, and June 2024.”

Rule 8VAC20-800-750-D.

*REPEAT VIOLATION* Annually, the provider shall review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and obtain the parent’s signed acknowledgment of the review.

“Records for children #2, #4, #5, #6, #7 and #8 did not have a parent’s signed acknowledgment of the review. Children #2 and #4 have been in care over one year and seven months. Children #5, #6, #7 and #8 have been in care over one year and one month.”

Rule 8VAC20-800-780-B.

Children shall not be allowed to eat or drink while walking, or playing.

“Child #5 was observed drinking milk from a sippy cup while walking around in the infants area.”

Rule 8VAC20-800-900-B.

Certain documents related to the terms of the license are required to be posted on the premises of each facility.

“The Notice of Intent received by the provider on April 8, 2025 was not posted.”

Rule 8VAC20-820-120-E-3.

*REPEAT VIOLATION* The provider is required to obtain a sworn statement or affirmation every five years for all caregivers.

“A sworn statement for Caregiver #3 was overdue for two months.”

Rule 22.1-289.035-B-1.

*REPEAT VIOLATION* The provider shall obtain for each caregiver a current Report of Tuberculosis (Tb) Screening form every two years.

“The Tb screening form in the record for Caregiver #3 was overdue by seven months.”

Rule 8VAC20-800-180-A.

8VAC20-800-200-A

“*REPEAT VIOLATION* 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 Caregiver #3 having received orientation training. Caregiver #3 has been caring for children for two years and a half.”

Rule 8VAC20-800-200-A.

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

“The record for Child #1, who has been in care for six months, did not contain the name address and phone number of a second emergency contact.”

Rule 8VAC20-800-60-B.

*REPEAT VIOLATION* Annually, the provider shall review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and obtain the parent’s signed acknowledgment of the review.

“The annual review of the information was overdue for 13 months in Child #3’s record and by one month in Child #4’s record.”

Rule 8VAC20-800-780-B.

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.

“The attendance record for the days 01/07/25 through 01/14/25 did not document the departure of children.”

Rule 8VAC20-790-180-B.

Within the first 90 days of employment or service all caregivers shall complete Virginia Preservice Training for Child Care Staff sponsored by the Department of Education.

“There is no documentation in the record for Caregiver #3, who has been caring for children for two years and a half, of having completed the Virginia Preservice Training for Child Care Staff.”

Rule 8VAC20-790-250-B.

All caregivers shall have within 90 days of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.

“There is no CPR certification in the record for Caregiver #3 who has been caring for children for two years and a half.”

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

8VAC20-790-250-D-2

“All caregivers shall have within 90 days of employment current certification in first aid appropriate to the ages of children in care. There is no first aid certification in the record for Caregiver #3 who has been caring for children for two years and a half.”

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

Caregivers who work directly with children shall, annually attend the department’s health and safety update course.

“There is no documentation in the record for Caregiver #3, of having completed the 2024 health and safety update course.”

Rule 8VAC20-790-250-F.

*REPEAT VIOLATION* 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 12/04/2024, were not posted in a conspicuous place on the premises.”

Rule 22.1-289.011-F.

*REPEAT VIOLATION* The provider is required to obtain a completed sworn statement every five years for all caregivers.

“A sworn statement for Caregiver #3 was overdue for six days.”

Rule 22.1-289.035-B-1.

*REPEAT VIOLATION* The provider is required to obtain a completed sworn statement every five years for all household members.

“A sworn statement for Household Member #1 was overdue for six days.”

Rule 22.1-289.036-B-1.

The program is required to submit to VDH and implement a plan to test potable water for lead.

“The program did not have evidence of a testing plan submitted to VDH.”

Rule 22.1-289.057-A.

The program is required to submit results of potable water testing to VDH.

“The program did not have evidence of submitting test results to VDH.”

Rule 22.1-289.057-B.

Child day programs shall be equipped with at least one carbon monoxide detector.

“There was no carbon monoxide detector at the fdh.”

Rule 22.1-289.058.

*REPEAT VIOLATION* 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 was no physical exam records available for Child #2, who was in care during the inspection and had been in care for 16 months. The physical exam in the record for Child #3 was dated nine months after the first date of attendance.”

Rule 8VAC20-800-100-A.

*REPEAT VIOLATION* Providers must obtain a current tuberculosis screening from a caregiver at the time of hire and prior to coming into contact with children.

“There was no tuberculosis screening for Caregiver 2, who has been caring for children for 45 days.”

Rule 8VAC20-800-170-A.

*REPEAT VIOLATION* 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 Caregiver #2 and Caregiver #3 having received orientation. Caregiver #2 has been caring for children for 45 days and Caregiver #3 for two years and a half.”

Rule 8VAC20-800-200-A.

Child-resistant protective covers larger than 1-1/4 inches in diameter shall be installed on all unused electrical outlets and surge protectors accessible to children under five years of age.

“One unused electric outlet did not have a protective cover.”

Rule 8VAC20-800-320-B.

*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day.

“At the time of entrance, 9:40 am, the attendance record for the day had not been completed. There were eight children present at that moment. Last time attendance was recorded was two days ago.”

Rule 8VAC20-800-50-A.

*REPEAT VIOLATION* A caregiver shall provide direct care and supervision of each child at all times. Direct care and supervision of each child includes awareness of and responsibility for each child in care, including being near enough to intervene if needed.

“At the time of entrance, Caregiver #2 was by herself caring for eight children. Caregiver #2 was sitting next to the tables area overseeing six children while they were completing worksheets. However, two toddlers, Child #3 and Child #4, were by themselves in an area that is not within sight of were Caregiver #2 was placed.”

Rule 8VAC20-800-560-A.

*REPEAT VIOLATION* The provider shall ensure that a caregiver does not exceed 16 points.

“At the time of entrance, Caregiver #2 was by herself caring for eight children, which totaled 20 points. The Provider has just arrived to the fdh at the same time as the inspector. The Provider stated that she was dropping off two children at school.”

Rule 8VAC20-800-570-A.

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

“There were no records for Child #5, Child #6 and Child #7. The Provider stated that these children attend the fdh for before and after school care.”

Rule 8VAC20-800-60-A.

Caregivers shall wash their hands with liquid soap and warm running water after assisting a child with toileting.

“Caregiver #1 was observed assisting Child #2 and Child # 8 with toileting. Caregiver #1 did not wash their hands after assisting each child.”

Rule 8VAC20-800-680-A.

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

“Child #2 and Child #8 hands were not washed after toileting.”

Rule 8VAC20-800-680-B.

Toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use.

“A toilet chair was used by both Child #2 and Child #8 . The chair was emptied but not cleaned and sanitized after each use.”

Rule 8VAC20-800-690-L.

Shelter-in-place procedures shall be practiced a minimum of twice per year.

“A second shelter-in-place emergency drill was not completed for the year 2024.”

Rule 8VAC20-800-830-B.

*REPEAT VIOLATION* Temperatures shall be maintained at or below 0?F in the freezer compartments.

“The thermometer in the freezer compartment showed a temperature of 15?F.”

Rule 8VAC20-800-940-A.

22.1-289.011-F

“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 09/23/2024, were not posted in a conspicuous place on the premises.”

Rule 22.1-289.011-F.

8VAC20-800-100-A

“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 was no physical exam records available for Child #1, who was in care during the inspection and had been in care for eight months.”

Rule 8VAC20-800-100-A.

8VAC20-800-170-A

“*REPEAT VIOLATION* Providers must obtain a current tuberculosis screening from a caregiver at the time of hire and prior to coming into contact with children. There was no tuberculosis screening for Caregiver 2, who has been caring for children for two days.”

Rule 8VAC20-800-170-A.

8VAC20-800-240-A

“Areas and furnishings of the family day home, inside and outside, shall be maintained in a clean, safe, and operable condition. On one wall of the care area there was an area that showed mold. The area was on the higher part of the wall.”

Rule 8VAC20-800-240-A.

8VAC20-800-280

Rule 8VAC20-800-280.

8VAC20-800-50-A

“*REPEAT VIOLATION* *SYSTEMIC DEFICIENCY* The family day home shall keep a written record of children in attendance each day. At approximately 11:30 am, the attendance record for the day has not been completed. There were eight children in attendance at that moment.”

Rule 8VAC20-800-50-A.

8VAC20-800-570-A

“*REPEAT VIOLATION* The provider shall ensure that a caregiver does not exceed 16 points. At the time of entrance, the provider was by herself caring for eight children, which totaled 20 points. A second caregiver arrived 20 minutes after.”

Rule 8VAC20-800-570-A.

8VAC20-800-60-A

“An up to date record for each child enrolled shall be maintained by the provider. There was no record for Child #2, who was in care during the inspection and had been in care for eight months.”

Rule 8VAC20-800-60-A.

8VAC20-800-730-D

“*REPEAT VIOLATION* Medication, including refrigerated medication shall be kept in a locked place using a safe locking method that prevents access by children. Two syringes with medication were stored in ziploc bags on the fridge door. No locking method was being used to prevent access by children.”

Rule 8VAC20-800-730-D.

8VAC20-800-90-A

“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 eight months.”

Rule 8VAC20-800-90-A.

8VAC20-800-920

“*REPEAT VIOLATION* When meals or snacks are provided by the family day home, the menu for the current one-week period shall be dated. The menu posted was dated for October 2024.”

Rule 8VAC20-800-920.

8VAC20-800-940-A

“Temperatures shall be maintained at or below 0?F in the freezer compartments. The thermometer in the freezer compartment showed a temperature of 18?F.”

Rule 8VAC20-800-940-A.

8VAC20-800-460-E

“Based on interview, the Provider did not ensure that children are safe when exposed to animals. Evidence: 1) An incident that occurred on 08/26/2023 was reported by the parent of Child #2 (3 yrs) in which the child received a scar on their face resulting from the Provider’s dog jumping on the child. 2) The Provider stated that the dog had followed one caregiver and Child #2 got close to him and the dog scratched her.”

Rule 8VAC20-800-460-E. From a complaint.

8VAC20-800-560-B

Rule 8VAC20-800-560-B. From a complaint.

8VAC20-800-570-A

“Based on interview, the Provider did not ensure that a caregiver does not exceed points maximus while supervising children. Evidence: 1) Parent states that on the date of the incident, 10/26/2023, only one caregiver was present with a large group of children. 2) The Provider states that only one caregiver was present while the Provider and a second caregiver were out picking up children from school.”

Rule 8VAC20-800-570-A. From a complaint.

8VAC20-800-840-A

Rule 8VAC20-800-840-A. From a complaint.

*REPEAT VIOLATION* The provider shall obtain from each adult household member a current Report of Tuberculosis (Tb) Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.

“The records for Household Member #2 and Household Member #3 did not contain a Tb screening.”

Rule 8VAC20-800-170-A.

*REPEAT VIOLATION* The provider shall obtain for each adult household member a current Report of Tuberculosis Screening form, every two years from the date of the first screening.

“The Tb screening form in the record for Household Member #1 (dated 11/30/2021) was overdue by one year and nine months.”

Rule 8VAC20-800-180-A.

Potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, and disinfectants, shall be stored away in areas inaccessible to children.

“The following substances were observed in areas that were accessible to children: * One spray bottle labeled as “bleach” was observed on a table on the outside area were the children play and sometimes have lunch. * Various containers with laundry detergent and bleach were observed inside of the laundry room which door was unlocked.”

Rule 8VAC20-800-280.

*REPEAT VIOLATION* The family day home shall keep a written record of children in attendance each day.

“The attendance record for the day was not completed. The last completed attendance available for review was completed two weeks ago on 09/10/2024.”

Rule 8VAC20-800-50-A.

A caregiver shall be physically present on site and provide direct care and supervision of each child at all times. Direct care and supervision of each child includes awareness of and responsibility for each child in care, including being near enough to intervene if needed.

“At the time of entrance, six children were playing on the care area and were observed to be by themselves with no caregiver present to supervise. When asked, the children stated that the provider was upstairs. About approximately a minute later, the provider came downstairs to the care area.”

Rule 8VAC20-800-560-A.

When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

“Two over-the-counter medication were observed in a plastic Ziploc bag in the refrigerator’s door among food.”

Rule 8VAC20-800-730-C.

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.

“Two over-the-counter medication bottles were observed in the refrigerator, stored in a Ziploc bag, with no locking method to prevent access by children.”

Rule 8VAC20-800-730-D.

When topical skin products such as sunscreen, diaper ointment and lotion, oral teething medicine, and insect repellent are used, the product does not need to be kept locked, but shall be inaccessible to children.

“One bottle of sunscreen was observed inside a box in a low shelf of the diaper changing table, making it accessible to children.”

Rule 8VAC20-800-750-B.

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

“The menu available for review was not dated for the current one-week period. It was dated 02/19-23/2024.”

Rule 8VAC20-800-920.

8VAC20-800-170-A

“*REPEAT VIOLATION* Based on record review, the provider did not obtain from each adult household member prior to coming into contact with children a current Report of Tuberculosis (Tb) Screening. Evidence: 1) The records for Household Member #2 and Household Member #3 did not contain a Tb screening.”

Rule 8VAC20-800-170-A.

8VAC20-800-180-A

“*REPEAT VIOLATION* Based on record review, the provider did not ensure to obtain from each adult household member the results of a follow-up tuberculosis (Tb) screening at least every two years. Evidence: 1) The Tb screening form in the record for Household Member #1 was dated 11/30/2021.”

Rule 8VAC20-800-180-A.

8VAC20-800-780-B

Rule 8VAC20-800-780-B.

8VAC20-800-920

“*REPEAT VIOLATION* Based on documentation review, the menu for the current one-week period did not meet all requirements. Evidence: 1) The menu available for review was not dated for the current one-week period. It was dated 02/19-23/2024.”

Rule 8VAC20-800-920.

8VAC20-790-250-B

“Based on record review, one out of four caregivers did not complete the Virginia Preservice Training for Child Care Staff sponsored by the Department of Education within 90 calendar days of employment. Evidence: 1) The records for Caregiver #3 (start date 06/01/2023) did not contain documentation of having completed the Virginia Preservice Training.”

Rule 8VAC20-790-250-B.

8VAC20-790-250-D-1

“Based on record review, one out of four caregivers did not have a current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Evidence: 1) The record for Caregiver #3 (start date 06/01/2023) did not contain documentation of having a current certification in CPR.”

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

8VAC20-790-250-D-2

“Based on record review, one out of four caregivers did not have a current certification in first aid appropriate to the ages of children in care. Evidence: 1) The record for Caregiver #3 (start date 06/01/2023) did not contain documentation of having a current certification in first aid.”

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

22.1-289.035-B-1

“Based on record review and interview, the provider did not ensure to obtain a completed Sworn Statement prior to first day of employment for caregivers. Evidence: 1) On the date of inspection, there was no Sworn statement available for review for Caregiver #4 (start date 07/01/2024).”

Rule 22.1-289.035-B-1.

22.1-289.035-B-2

“Based on record review and interview, the provider did not ensure to obtain a fingerprint-based criminal history check determination letter prior to first day of employment for caregivers and every five years subsequently. Evidence: 1) On the date of inspection, there was no criminal history check determination letter available for review for Caregiver #4 (start date 07/01/2024). 2) The criminal history check determination letter in the record for Caregiver #2 was dated 06/10/2019.”

Rule 22.1-289.035-B-2.

22.1-289.035-B-3

“Based on record review and interview, the provider did not ensure to obtain that Central Registry search results every five years. Evidence: 1) The Central Registry search results in the record for Caregiver #3 was dated 02/12/2018.”

Rule 22.1-289.035-B-3.

22.1-289.035-B-3

“Based on record review and interview, the provider did not ensure to obtain that Central Registry search results every five years. Evidence: 1) The Central Registry search results in the record for Caregiver #3 was dated 02/12/2018.”

Rule 22.1-289.035-B-3.

22.1-289.036-B-1

“Based on record review and interview, the provider did not ensure to obtain a completed Sworn Statement by the end of the 30th day for new household members. Evidence: 1) The records for Household member #4 and Household Member #5 did not contain a completed Sworn Statement. The provider had stated that they had been living in the home since September 2023.”

Rule 22.1-289.036-B-1.

22.1-289.036-B-3

“Based on record review and interview, the provider did not ensure to obtain that Central Registry search results by the end of the 30th day for new household members. Evidence: 1) The records for Household member #4 and Household Member #5 did not contain Central Registry search results. The provider had stated that they had been living in the home since September 2023.”

Rule 22.1-289.036-B-3.

8VAC20-800-120-A

“Based on record review and interview, the provider did not maintain a record for each caregiver. Evidence: 1) On the date of inspection, a record for Caregiver #4 (start date 07/01/2024) was not available for review. The provider stated that she had not prepared a record for Caregiver #4 with all required documentation.”

Rule 8VAC20-800-120-A.

8VAC20-800-170-A

“Based on record review, the provider did not obtain from each caregiver at the time of hire and and each adult household member prior to coming into contact with children a current Report of Tuberculosis (Tb) Screening. Evidence: 1) There was no Tb screening available for review for Caregiver #4 (start date 07/01/2024). 2) The records for Household member #4 and Household Member #5 did not contain a Tb screening. The provider had stated that they had been living in the home since September 2023.”

Rule 8VAC20-800-170-A.

8VAC20-800-180-A

“Based on record review, the provider did not ensure to obtain from each adult household member the results of a follow-up tuberculosis (Tb) screening at least every two years. Evidence: 1) The Tb screening form in the record for Household Member #1 was dated 11/30/2021.”

Rule 8VAC20-800-180-A.

8VAC20-800-200-A

“Based on record review, the provider did not orient the substitute provider and assistant by the end of their first week of assuming job responsibilities. Evidence: 1) On the date of inspection, there was no documentation available to review to demonstrate that Caregiver #3 (start date 06/01/2023) and Caregiver #4 (start date 07/01/2024) had completed orientation training as required.”

Rule 8VAC20-800-200-A.

8VAC20-800-40-A

“* REPEAT VIOLATION * SYSTEMIC DEFICIENCY* Based on observation, the provider exceeded the maximum licensed capacity of the home. Evidence: The provider is licensed for 12 children. During the visit on 07/31/2024, there were 19 children in care.”

Rule 8VAC20-800-40-A.

8VAC20-800-50-A

Rule 8VAC20-800-50-A.

8VAC20-800-570-A

Rule 8VAC20-800-570-A.

8VAC20-800-760-A

“Based on review of the emergency supplies, the emergency kit did not contain all required components. Evidence: 1) On the date of inspection, the first aid kit did not contain antiseptic cleaning solution or pads.”

Rule 8VAC20-800-760-A.

8VAC20-800-780-B

“Based on record review, the provider did not ensure to annually review with the parent the emergency contact information required in 8VAC20-800-60 B 2 to ensure the information is correct, and to obtain the parent’s signed acknowledgment of the review. Evidence: 1) The most recent record review of the emergency information in the record for Child #1 was dated 01/01/2023 and for Child #4 was dated 2023.”

Rule 8VAC20-800-780-B.

8VAC20-800-920

“*REPEAT VIOLATION* Based on documentation review, the menu for the current one-week period did not meet all requirements. Evidence: 1) The menu available for review was not dated for the current one-week period. It was dated 02/19-23/2024.”

Rule 8VAC20-800-920.

8VAC20-800-570-A

“*REPEAT VIOLATION* Based on interview, the Provider did not ensure that a caregiver does not exceed points maximus while supervising children. Evidence: 1) Complainant observed when the Assistant went upstairs and left the Provider caring for 13 children totaling 26 points. 2) The Provider stated that the Assistant went upstairs to prepare lunch.”

Rule 8VAC20-800-570-A. From a complaint.

22.1-289.011-F

“Based on review of required posted documents, the provider did not ensure that all required documents related to the terms of the license were posted on the premises of the program. Evidence: 1) On the date of inspection, the most recently issued license (08/04/23 - 08/04/24) was not posted. The license that was posted was dated 02/04/2023 - 08/03/2023. 2) The findings of the most recent inspection of the facility (07/11/2023) were not posted. The inspection Summary posted was dated 03/28/2023.”

Rule 22.1-289.011-F.

8VAC20-800-40-A

“Based on observation, the provider did not ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home. evidence: 1) The approved capacity of the current license is 12 children. On the date of inspection, there were 13 children under care.”

Rule 8VAC20-800-40-A.

8VAC20-800-50-A

“Based on documentation review, the family day home did not keep a written record of children in attendance each day. Evidence: 1) On the date of inspection, there was no attendance record for the day available for review.”

Rule 8VAC20-800-50-A.

8VAC20-800-60-B

“Based on record review, children’s records did not contain all required information. Evidence: 1) The record for Child #2 did not contain the following: Name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached; Name and policy number of the child’s medical insurance; Written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately; Proof of the child’s age and identity; First date of attendance.”

Rule 8VAC20-800-60-B.

8VAC20-800-920

“Based on documentation review, the menu for meals and snacks provided by the family day home did not meet all requirements. Evidence: 1) The menu available for review was not dated for the current one-week period. 2) The menu did not list substituted food - The menu posted listed the afternoon snack as: tortilla chips, apples and water. The afternoon snack provided consisted of animal crackers and water. This substitution was not listed on the menu.”

Rule 8VAC20-800-920.

8VAC20-770-40-D-4-a

“Based on record review, it was determined that the provider did not ensure that Central Registry search results are obtained every five years for household members. Evidence: 1) The most recent Central Registry search request results available in the record for Household member #1 were dated 02/12/2018.”

Rule 8VAC20-770-40-D-4-a.

8VAC20-800-800-B

“Based upon review of the emergency preparedness plan, the provider did not ensure that the emergency preparedness plan is reviewed at least annually and the review is documented in writing. Evidence: 1. The most recent review of the Emergency Preparedness Plan documented by the provider was dated 03/07/2022.”

Rule 8VAC20-800-800-B.

8VAC20-800-830-A

“Based on documentation review, emergency evacuation procedures were not practiced monthly. Evidence: 1) On the date of inspection, the 2023 emergency drills log provided for review, did not have evacuation (fire) drills documented for the months of May and June 2023.”

Rule 8VAC20-800-830-A.

22.1-289.035-B-2

“Based on record review and interview, the provider did not ensure to obtain fingerprint-based criminal history check determination letter prior to first day of employment for one Caregiver. Evidence: 1) On the date of inspection, the results of a criminal history check was not available for review for Caregiver #3 (start date 03/27/2023). The provider stated that a fingerprint-based criminal history check for Caregiver #3 had not been requested.”

Rule 22.1-289.035-B-2.

8VAC20-770-60-B

“Based on record review and interview, the provider did not ensure to obtain a completed Sworn Statement prior to first day of employment. Evidence: 1) On the date of inspection, a completed Sworn Statement was not available for review for Caregiver #3 (start date 03/27/2023) . The provider stated that Caregiver #3 had not completed a Sworn Statement.”

Rule 8VAC20-770-60-B.

8VAC20-800-120-A

“Based on record review, the provider did not maintain a record for each caregiver. Evidence: 1) On the date of inspection, a record for Caregiver #3 was not available for review.”

Rule 8VAC20-800-120-A.

8VAC20-800-170-A

“Based on record review and interview with the provider, the provider did not obtain from each caregiver at the time of hire a current Report of Tuberculosis (Tb)Screening. Evidence: 1) On the date of inspection, a Tb screening report for Caregiver #3 (start date 03/27/2023) was not available for review. The provider stated that they don’t have a Tb screening report for Caregiver #3.”

Rule 8VAC20-800-170-A.

8VAC20-800-70-A

“Based on record review, the provider did not ensure to provide parents in writing the following all required information before the child’s first day of attendance. Evidence: 1) The record for Child #1 did not contain the Policies for the administration of medication and the Provisions of the family day home’s emergency preparedness and response plan.”

Rule 8VAC20-800-70-A.

8VAC20-800-90-A

“Based on record review, the provider did not obtain documentation that the child has been adequately immunized before the child may attend the family day home. Evidence: 1) The record for Child #1 (start date 03/03/2023) did not contain an immunization report.”

Rule 8VAC20-800-90-A.

8VAC20-800-920

“Based on documentation review, the menu for meals and snacks provided by the family day home for the current one-week period did not meet all requirements: Evidence: 1) The menu posted did not have listed the substitutions for the day. The menu listed as lunch for the day: ground beef, mixed veggies, noodles, fruit and milk. On the date of inspection, the inspector observed that the children were eating chicken nuggets, potato tots, broccolli and mandarin oranges.”

Rule 8VAC20-800-920.

8VAC20-790-270-C

“Based on observation and interview with the provider, hazardous substances kept in substitute containers, were not clearly labeled. Evidence: 1) When hazardous substances are not kept in original containers, the substitute container shall clearly indicate their contents. - On the date of inspection, the inspector observed two spray bottles with no labeling to identify their contents. 2) The provider indicated that one bottle spray contained Lysol cleaner and the second bottle contained a vinegar/soap/water mixture.”

Rule 8VAC20-790-270-C.

8VAC20-790-390-A

“Based on observation, children’s hands were not washed with soap and running water or disposable wipes after eating meals. Evidence: 1) The inspector observed the children while eating lunch. Once lunch was finished, the provider took the children out to play without washing their hands first.”

Rule 8VAC20-790-390-A.

8VAC20-800-210-A

“Based on record review, caregivers did not obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1) On the date of inspection, certificates in the record for Staff #2 documented having completed only 5 of the required 16 hours of annual training.”

Rule 8VAC20-800-210-A.

8VAC20-800-280

Rule 8VAC20-800-280.

8VAC20-800-40-A

“Based on observation, the provider did not ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home. evidence: 1) The approved capacity of the current license is 12 children. On the date of inspection, there were 14 children under care. At one point, there were 15 children under care.”

Rule 8VAC20-800-40-A.

8VAC20-800-50-A

“Based on documentation review, the family day home did not keep a written record of children in attendance each day. Evidence: 1) On the date of inspection, there was no attendance record for the day and the week available for review.”

Rule 8VAC20-800-50-A.

8VAC20-800-500-B

Rule 8VAC20-800-500-B.

8VAC20-800-500-D

“Based on observation, outdoor play equipment did not meet all requirements: Ropes, loops, or any hanging apparatus that might entrap, close, or tighten upon a child shall not be used. Evidence: 1) The play structure in the backyard of the family day home has a net and a loose rope intended for the children to climb to the lower platform. Children in care were observed using this net/rope to climb.”

Rule 8VAC20-800-500-D.

8VAC20-800-520-A

“Based on observation, cribs were provided for children older than 12 months of age. Evidence: 1) On the date of inspection, two of four children sleeping in cribs were older than 12 months of age and did not present any developmental issue/reason to not be ready to sleep on a cot or rest mat. (Child #11- 17 months and Child #6 - 2 years)”

Rule 8VAC20-800-520-A.

8VAC20-800-530-F

“Based on observation, soft bedding was used around infants. Evidence: 1) On the date of inspection, four children sleeping in cribs were observed using blankets. Two of these children were infants. (Child # 5 - 10 mos and Child #13 - 11 mos)”

Rule 8VAC20-800-530-F.

8VAC20-800-570-A

“Based on observation, the provider did not ensure that a caregiver does not exceed 16 points. Evidence: 1) On the date of inspection, there were two caregivers supervising the children (7 months to 4 years). The total points was 37. The fdh was 5 points over.”

Rule 8VAC20-800-570-A.

8VAC20-800-60-A

“Based on record review, the provider did not maintain an up-to-date record at the family day home for each enrolled child. Evidence: 1) On the date of inspection, there were no records for Child #3, Child #8 and Child #14.”

Rule 8VAC20-800-60-A.

8VAC20-800-920

“Based on documentation review, the menu for meals and snacks provided by the family day home for the current one-week period did not meet all requirements. Evidence: 1) The menu posted was not dated for the current one-week period. 2) The menu did not have listed the substitutions for the day.”

Rule 8VAC20-800-920.

8VAC20-820-120-E-2

“Based on review of required posted documents, the provider did not ensure that all required documents related to the terms of the license were posted on the premises of the program. Evidence: 1) On the date of inspection, the findings of the most recent inspection of the facility (08/29/2022) were not posted as required.”

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

8VAC20-790-180-B

“Based on documentation review, the vendor did not maintain a written hard copy record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: 1) At the time of entrance, an attendance record for the day was not available for review. Attendance records for the prior weeks were also not available. 2) The attendance records available for review for the following dates, did not document the departure of each child: week of 07/04 to 07/08, week of 06/27 to 07/01.”

Rule 8VAC20-790-180-B.

8VAC20-800-100-A

“Based on record review, 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 physical examination in the record for Child #4 (start date 11/29/2021) was dated 07/21/2022.”

Rule 8VAC20-800-100-A.

8VAC20-800-240-A

Rule 8VAC20-800-240-A.

8VAC20-800-30-A

“Based on observation, the provider did not ensure to comply with the terms of the current license issued by the department. Evidence: 1) On the date of inspection, 13 children were in care in the family day home. The current license limits the maximum number of children who may be in care at any time to 12 children.”

Rule 8VAC20-800-30-A.

8VAC20-800-320-B

“Based on observation, child-resistant protective covers were not installed on all unused electrical outlets and surge protectors accessible to children under five years of age. Evidence: 1) One electrical outlet located next to the mirror in the central rug area did not have a protective cover.”

Rule 8VAC20-800-320-B.

8VAC20-800-480-D

“Based on observation, equipment used by children was not used in accordance with the manufacturer’s instructions. Evidence: 1) The safety straps in a Bumbo floor seat were not buckled in while being used by Child #5.”

Rule 8VAC20-800-480-D.

8VAC20-800-50-A

“Based on documentation review, the family day home did not keep an accurate written record of children in attendance each day. Evidence: 1) At the time of entrance, an attendance record for the day was not available for review. Attendance records for the prior weeks were also not available.”

Rule 8VAC20-800-50-A.

8VAC20-800-60-A

“Based on record review and interview with the provider, the provider did not maintain a record for each child at the family day home. Evidence: 1) On the date of inspection, there were no records for Child #6 and Child #7 who were in care in the family day home. 2) The provider stated that she had no records for Child #6 and Child #7.”

Rule 8VAC20-800-60-A.

8VAC20-800-60-B

Rule 8VAC20-800-60-B.

8VAC20-800-680-A

Rule 8VAC20-800-680-A.

8VAC20-800-680-B

“Based on observation, caregivers did not wash children’s hands with liquid soap and warm running water when required. Evidence: 1) Staff #1 was observed changing the diaper of Child #2. After Staff #1 finished, put Child #2 on the floor and let her go play without washing the child’s hands first. 2) Staff #2 was observed feeding a bottle of milk to Child #5. Staff #2 did not wash the child’s hands before feeding her the milk.”

Rule 8VAC20-800-680-B.

8VAC20-800-690-D

“Based on observation, the diapering surface was not cleaned and sanitized after each use. Evidence: 1) Although Staff #1 was observed using Lysol disinfecting wipes on the diapering surface after changing the diaper of a child, this does not comply with the requirement of cleaning and sanitizing as per the definitions of “cleaned” and “sanitized” covered in 8VAC20-800-10.”

Rule 8VAC20-800-690-D.

8VAC20-800-770

“Based on review of emergency supplies, a working battery-operated flashlight was not available to caregivers. Evidence: 1) On the date of inspection, the flashlight available for review was not working.”

Rule 8VAC20-800-770.

8VAC20-800-830-A

“Based on documentation review, emergency evacuation procedures were not practiced monthly. Evidence: 1) On the date of inspection, the 2022 emergency drills log provided for review, did not have an evacuation (fire) drill documented for the month of July 2022.”

Rule 8VAC20-800-830-A.

8VAC20-800-940-A

“Based on observation, temperature was not maintained at or below 0?F in the freezer compartment. Evidence: 1) On the date of inspection, the thermometer in the freezer compartment read approximately 5 degrees.”

Rule 8VAC20-800-940-A.

8VAC20-820-120-E-2

“Based on review of required posted documents, the provider did not ensure that all required documents related to the terms of the license were posted on the premises of the program. Evidence: 1) On the date of inspection, the findings of the most recent inspection of the facility (01/06/2022) were not posted.”

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

8VAC20-770-40-D-4-a

“Based on record review, the provider did not ensure that Central Registry search results are obtained every five years for household members 18 years or older. Evidence: 1) The most recent Central Registry search request results available in the record for HM #1 were dated 07/25/2016.”

Rule 8VAC20-770-40-D-4-a.

8VAC20-770-60-C-2

“Based on record review, the provider did not ensure that Central Registry search results are obtained every five years for staff. Evidence: 1) The most recent Central Registry search request results available in the record for Staff #1 were dated 07/15/2016.”

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

8VAC20-800-100-A

“Based on record review, 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 #3 (start date 11/04/2021) did not contain the results of a physical examination.”

Rule 8VAC20-800-100-A.

8VAC20-800-180-A

“Based on record review, the provider did not obtain for each caregiver and adult household member a current Report of Tuberculosis (Tb) Screening form, every two years from the date of the first screening. Evidence: 1) The most recent Tb screening report for Staff #2 was dated 10/29/2019.”

Rule 8VAC20-800-180-A.

8VAC20-800-60-B

Rule 8VAC20-800-60-B.

8VAC20-800-780-B

“Based on record review, the provider did not review, annually, with the parent the emergency contact information required in 22 VAC 40-111-60 B 2 to ensure the information is correct, and obtain the parent’s signed acknowledgment of the review. Evidence: 1) The most recent review of the emergency contact information in the record for Child #1 was dated 02/27/2020.”

Rule 8VAC20-800-780-B.

8VAC20-800-80-A

“Based on record review, the provider did not obtain from the parent, within seven business days of the child’s first day of attendance at the family day home, verification of the identity and age of the child. Evidence: 1) The record for Child #2 (start date 11/04/2021) and Child #3 (start date 11/04/2021) did not contain information that the provider obtained documentation to verify the identity and age of the children.”

Rule 8VAC20-800-80-A.

8VAC20-800-800-B

“Based on documentation review, the provider did not review the emergency preparedness plan (EPP) at least annually, update the plan as needed and document in writing each review and update to the emergency plan. evidence: 1) The most recent review documented in the EPP provided was dated 08/04/2016.”

Rule 8VAC20-800-800-B.

8VAC20-800-90-A

“Based on record review, the provider did not obtain documentation that the child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia. Evidence: 1) The record for Child #2 (start date 11/04/2021) did not contain an immunization report as required.”

Rule 8VAC20-800-90-A.

8VAC20-800-90-C

“Based on record review, the provider did not obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1) The most recent immunization report in the record for Child #1 (dob 11/29/2019) was dated 05/29/2020.”

Rule 8VAC20-800-90-C.

8VAC20-820-120-E-2

“Based on document review and interview with the provider, certain documents related to the terms of the license were not posted on the premises of the facility, as required. Evidence: 1) The findings of the most recent inspection of the facility on 08/10/2021 were not posted. The provider could not locate a copy of the inspection report for 08/10/2021.”

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