Tick...Tock...Around the Clock, LLC

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 #3, who has been employed for over two months did not have a central registry search requested.”

Rule 22.1-289.035-B-3.

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 prior to the employee’s first day. Staff #1, employed for more than two months, did not have documentation of requesting a central registry, criminal history and sex offender checks from one state.”

Rule 22.1-289.035-B-4.

Areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. The following conditions were observed:

“1. One swing seat on Playground #3 was torn in half. 2. Approximately three exposed tarps on Playground #3 posed a tripping hazard. 3. There were multiple areas of peeling paint on the surface of the composite playground pieces on Playground #1, #2 and #3. 4. Two tricycles at the outdoor play area entrance were each missing a pedal.”

Rule 8VAC20-780-270-A.

8VAC20-780-290-3

“Electrical outlets shall have protective covers that are of a size that cannot be swallowed by children. There were approximately five outlets that were uncovered in Classroom #1, Classroom #2 and Classroom #3.”

Rule 8VAC20-780-290-3.

8VAC20-780-330-B

“Where playground equipment is provided, resilient surfacing shall comply with minimum safety standards. The areas surrounding the composite playground pieces of equipment on Playground #1 and Playground #2 did not have enough to comply with minimum standards. When measured, there was less than one inch of surfacing in more than one area.”

Rule 8VAC20-780-330-B.

The center’s procedures for administering medication shall include duration of the parent’s authorization for medication, provided that it shall expire or be renewed after 10 work days. Long-term prescription drug use and over-the- counter medication may be allowed with written authorization from the child’s physician and parent.

“1. A medication reviewed for Child #8 authorized by the parent on 1/23/26, did not include the physician’s written authorization. 2. A medication reviewed for Child #9 did not include duration of the parent’s authorization nor the physician’s authorization.”

Rule 8VAC20-780-510-E.

8VAC20-780-540-E

“The following nonmedical emergency supplies are required: a working battery-operated radio. The battery-operated radio was inoperable during the inspection.”

Rule 8VAC20-780-540-E.

8VAC20-780-570-E

“Prepared infant formula shall be refrigerated, dated and labeled with the child’s name. There were approximately two bottles in Classroom #6 that were not dated.”

Rule 8VAC20-780-570-E.

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. 1. The records for Child #4 and Child #5 did not list the name of any additional programs or schools that the child is concurrently attending. 2. The record for Child #6 did not contain the full address for the second emergency contact. 3. The record for Child #5 did not contain a work number for one parent.”

Rule 8VAC20-780-60-A.

8VAC20-790-600-D-1

“Current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Staff#1, who has been employed for 8 months did not have documentation of a current certification in cardiopulmonary resuscitation.”

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

Current certification in first aid appropriate to the ages of children in care.

“Staff #1 who has been employed for 8 months, did not have documentation of a current certification in first aid.”

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

A tuberculosis (TB) screening is required every two years from the last screening.

“Staff#2 record did not have documentation for a follow-up tuberculosis screening.”

Rule 8VAC20-780-160-C.

22.1-289.035-A

“(Repeat Violation) The center is required to have employees undergo a background check every five years. The most recent central registry check for staff #2 was overdue by a year and 7 months.”

Rule 22.1-289.035-A.

8VAC20-780-280-B

Rule 8VAC20-780-280-B.

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

“The most recent central registry for Staff#1 was overdue by a year and 4 months.”

Rule 22.1-289.035-A.

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 and/or the program did not have evidence of the implementation of the required testing plan.”

Rule 22.1-289.057-A.

A tuberculosis screening is required every two years from the date of the last screening.

“Staff#5 updated screening was due a year ago. The updated screening have not been completed yet.”

Rule 8VAC20-780-160-C.

8VAC20-780-245-A

“Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care. Staff#1, Staff#2, Staff#3 did not have annual training documents of a minimum 16 hours of training.”

Rule 8VAC20-780-245-A.

8VAC20-780-270-A

“The center areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. In the Rubber room, there was a detached door accessible to children with a sharp point. In the Infant room, there were multiple areas on the blue cabinet cracked and exposing the wood interior. In School Age bathroom, large area of peeling paint inside the stall behind the toilet.”

Rule 8VAC20-780-270-A.

Hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.

“A bottle of sanitizer on the desk in Young Achiever classroom with the warning labels,” keep out of reach of children”. Disinfectant cleaners were unlocked in the storage closet adjacent to the school age classroom and accessible to the children in care.”

Rule 8VAC20-780-280-B.

8VAC20-780-320-B

“Each restroom area provider for children shall: be equipped with soap, toilet paper, and disposable towels and supplied with running warm water that does not exceed 120 F. There was no disposable towels in the School Age area bathroom when used by a child in care. In Young Achiever, and Tiny Tots, classrooms, the warm water temperatures were 133 and 141.”

Rule 8VAC20-780-320-B.

8VAC20-780-270-A

“The center shall ensure that areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. There was a cracked log on the walkway on the playground where children were actively playing.”

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Hazardous substance such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. Four containers of disinfecting wipes with the warning labels, “keeping out of reach of children” were unlocked on the diapering station in the toddler classroom.”

Rule 8VAC20-780-280-B.

Based on review of staff records and interview, the center did not ensure to obtain all background checks every five years thereafter.

“Evidence: 1. In Staff#1’s record (date of hire: 10/08/18), the criminal check was dated 09/13/18. 2.In Staff#2’s record (date of hire: 05/30/19), the criminal check was dated 03/29/19. 3. In Staff#4’s record (date of hire: 10/02/18), the criminal check was dated 09/21/18. 4. Interview with staff confirmed available documentation for review during the inspection.”

Rule 22.1-289.035-A.

Based on records and interview, the center did not ensure all physical examination documentation is signed by a physician, his designee, or an official of local health department.

“Evidence: In Child#6’s record (start date: 08/28/23), there was no documentation of a physical signature found. Interview with staff confirmed the documentation available for review during the inspection.”

Rule 8VAC20-780-150-B.

Based on review of staff records and interview, the center did not ensure to obtain documentation of a negative tuberculosis screening.

“Evidence: In Staff#6’s record (date of hire: 12/04/23) there was no documentation of a tuberculosis screening found. Interview with staff confirmed there was no documentation available for review during the inspection.”

Rule 8VAC20-780-160-A.

Based on review of staff records and interview, the center did not ensure to obtain documentation of a tuberculosis screening at least every two years from the date of the first initial screening.

“Evidence: In Staff#4’s record (date of hire:10/02/18) the last dated TB results was 06/26/13. Interview with staff confirmed the documentation available during the inspection.”

Rule 8VAC20-780-160-C.

Based on review of documentation and interview, the center did not ensure to obtain an annual fire inspection report.

“Evidence: 1. The fire inspection report reviewed was dated 02/15/2023. 2. Interview with center’s staff confirmed the annual fire inspection was not complete for this year at this time.”

Rule 8VAC20-780-260-A.

Based on review of documentation and interview, the center did not ensure to obtain an annual approval from the health department.

“Evidence: 1. The annual health report was dated 02/16/2023. 2. Interview with center’s staff confirmed the annual health report had not been completed for this year at this time.”

Rule 8VAC20-780-260-B.

Based on observation, the center did not ensure all hazardous substance are kept in a locked place using a safe locking method that prevents access by children.

“Evidence: In the Tiny Tots room, there was disinfectant wipes with the labels “keep out of reach of children” and “caution” on the countertop unlocked.”

Rule 8VAC20-780-280-B.

Based on review of children’s record and interview, the center did not ensure to maintain all information in each enrolled child’s record.

“Evidence: In Child# 3’s record (start date: 08/28/23), there was no documentation of viewing proof of the child’s identity and age found. Interview with staff confirmed information not being available for review during the inspection.”

Rule 8VAC20-780-60-A.

Based on review of records and interview, the center did not ensure to obtain all background checks for all applicants for employment. employees, applicants to serve as volunteers and volunteers every five year thereafter.

“Evidence: In Staff#2’s record (date of hire: 10/02/18) the last criminal was dated 09/14/18 and central registry was dated 10/26/18. In Staff#3’s record (date of hire: 10/02/18) the last criminal was dated 09/21/18 and central registry was dated 10/02/18. In Staff#4’s record (date of hire: 10/08/18) the last criminal was dated on 09/18/18 and central registry was dated on 10/03/18.”

Rule 22.1-289.035-A.

Based on review of records and interview, the center did not ensure to obtain documentation of a negative tuberculosis screening for each staff member.

“Evidence: In Staff#5’s record (date of hire: 08/23/2023), there was no documentation of a TB screening found. Interview with staff confirmed no documentation was available for review during the inspection.”

Rule 8VAC20-780-160-A.

Based on review of records and interview, the center did ensure to obtain documentation of a negative tuberculosis screening at least every two years.

“Evidence: 1. In Staff#1’s record, the last TB screening was 08/23/21. 2. In Staff#3’s record, the last TB screening was 08/19/21. 3. Interview with staff confirmed the documentation available for review during the inspection.”

Rule 8VAC20-780-160-C.

Based on observations and photographs, the center did not ensure all hazardous substances were kept in a locked place using a safe locking method that prevents access by children.

“Evidence: In classroom 103, Early Learner group, the cabinet was observed unlocked containing multiple cleaners, sprays, and disinfectants with the labels, “keep out of reach of children” and “warning” and “caution”. Photographs of observations of the unlocked cabinet taken during the inspection.”

Rule 8VAC20-780-280-B.

Based on observation and interview, the center did not ensure handwashing procedures for staff and children were followed after toileting.

“Evidence: In classroom 102, Tiny Tots, Staff#1 was observed diapering Child#1 and did not complete handwashing procedures of the child and the staff prior to retrieving another child in the group for diapering. Interview with staff confirmed handwashing procedures were not followed.”

Rule 8VAC20-780-500-A.

Based on observation, the most recent violation notice was not posted.

“Evidence: The violation noticed posted was from 06/2021 and the most recent inspection conducted 02/2023.”

Rule 22.1-289.011-F.

Based on record review and staff interview, the licensee did not ensure there was one staff on duty who obtained with in the last three years instruction in performing daily health observation of children.

“Evidence: The center was unable to provide docuemtnation of one staff during the operating hours with daily health observation training certificate.”

Rule 8VAC20-780-245-L.

Based on observation , the licensee did not ensure areas of the center inside and outside is maintained in a clean safe and operable condition.

“Evidence: In a gym , the facility was using had a bucket of dirty water and their was baseboard peeling off the wall. The staff confirmed observing the area that was not maintained.”

Rule 8VAC20-780-270-A.

Based on observation, the licensee did not ensure that hazordous substances were kept in a lcked place using a safe locking method.

“On June 7, 2023, the facility was using a space that had a closet unlocked with multiple chemicals. Confirmed by staff during the inspection tour.”

Rule 8VAC20-780-280-B.

Based on record review, the licensee did not ensure child has recieved physical exmination 30 days from the child’s start date.

“Evidence: Child #1 started July 2022 the physical document was not provided during the inspection.”

Rule 8VAC20-780-140-B.

Based on record review, the licensee did not ensure there was at least every two years from the date of the first initial screening or testing, or more frequently as if recommended by a licensed physician or the local health department, staff members and individuals from independent contractors shall obtain and submit the results of a follow-up tuberculosis screening .

“Evidence: Staff #1 documentation in the record provided most recent TB test was 07/08/2020 which is more than 2 years old.”

Rule 8VAC20-780-160-C.

Based on observation , the licensee did not ensure when a child is placed in an infant seat or high chair, the protective belt was fastened securely.

“Evidence: During the inspection, in the infant classroom, a child’s straps were not buckeld while sitting in the buckest seat activity table. Confirmed by staff.”

Rule 8VAC20-780-570-A.

Based on observation the licensee, did not ensure a fingerprint reults before employment.

“Evidence: new Staff #1 rehired 06/1/2022 did not have a new fingerprint results before employment. Staff #1 last date of employment was 12/20/2020 more that a year old.”

Rule 22.1-289.035-B-2.

Based on staff interview and observation, the licensee did not ensure there was a carbon monoxide detectors in the building that serves preschool - age children .

“Evidence : During the inspection conducted staff confirmed there was not a carbonmonoxide detector in the building.”

Rule 22.1-289.058.

Based on record review the licensee did not ensure a completed sworn statement or affirmation was completed befrore employement.

“Evidence: Staff #1 was rehired June 1, 2022 and did not have updated sworn statement form before employment.”

Rule 8VAC20-770-60-B.

Based on record review, the licensee did not enure there was a physical examiniation provided before the child’s attendance; or within 30 days after the first day of attendance.

“Evidence: Child # 2 first date of attendance 7/12/2021 did not have a physical in the record during the inspection.”

Rule 8VAC20-780-140-A.

Based on record review and staff interview, the license did not ensure staff had a negative tuburculosis test completed within the last 30 calendar days of the date of employment.

“Evidence: Staff #1 date of employment 6/1/2022 most recent TB test reults were 03/11/2019.”

Rule 8VAC20-780-160-A.

Based on record review and staff interview, the licensee did not enusre there was a annual fire inspection conducted annually.

“Evidence: The most recent fire inspection was conducted 03/09/2021, which is more than a year old.”

Rule 8VAC20-780-260-A.

Based on record review and staff interview, the licenee did not ensure there was a health inspection completed annually.

“Evidence: The most recent health inspection provided during inspeciton was conducted 03/17/2021 , which is more than a year old.”

Rule 8VAC20-780-260-B.

Based on observation, the licensee did not ensure hazpprdous substances are kept in a locked place using a safe locking method that prevents access by children.

“Evidence: In infant room, there was sanitizer that were next to the diapering area. The sanitizer had two labels with Keep out of reach of children and Warning.”

Rule 8VAC20-780-280-B.

Based on observation, the licensee did not ensure there was 6 inches of resilent surfacing in all fall zone areas.

“Evidence: On all the playground areas, there was approximatley 2-3 inches of resilent surfacing on both School Age playground, Preschool playground and swings. There needs to be at least 6 inches of resilent surfacing.”

Rule 8VAC20-780-330-B.

Based on observation, the licensee did not enure there was crib identified for use by specific child.

“Evidence: In the infant there was 2 cribs not identified use for specific children. Staff confirmed the crib did not have anything that identify specific child’s crib.”

Rule 8VAC20-780-440-B.