Karter School of Cascades

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

“A mop with cleaning solution attached to it was found accessible to children in the Paris A classroom as well as the Milan classroom.”

Rule 8VAC20-780-280-B.

Behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

“A staff member was seen grabbing a 2 year old child by the upper arm, to prevent them from running away from the group.”

Rule 8VAC20-780-400-B.

Areas and equipment of the center shall be maintained in a clean, safe and operable condition.

“A faucet in a preschool classroom had rusted on the top. In addition, there was an area of the wall in a two year old classroom that had paint chipping off.”

Rule 8VAC20-780-270-A.

Physical examinations completed by a physician shall be obtained prior to the first day of attendance or within 30 days after the first day of attendance.

“There was no physical examination in the record of child #5, who had been enrolled for 37 days.”

Rule 8VAC20-780-140-A.

Staff shall wash hands with soap and running water before and after each diaper change.

“A staff member in a two year old room did not wash hands before or after changing the diapers of 3 consecutive children.”

Rule 8VAC20-780-500-A.

Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used 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.

“While changing three children consecutively, a teacher in a two year old classroom, was placing soiled diapers in a pile on the floor.”

Rule 8VAC20-780-500-B.

Over-the-counter skin products shall not be kept or used beyond the expiration date of the product.

“2 diaper ointments were found to be expired in the infant classrooms. One diaper ointment was expired by 5 months, the other diaper ointment was expired by 4 months.”

Rule 8VAC20-780-520-A.

Based on record review, the center had not obtained an updated written authorization for a long-term prescription drug use from the child’s physician and parent, annually.

“Evidence: Child #11 had a written authorization that expired on 06/12/2024.”

Rule 8VAC20-780-510-E.

Based on record review, an updated written care plan was not for each child with a diagnosed food allergy was not obtained annually.

“Evidence: 1. Child #11 had an allergy action plan dated 06/12/2024.”

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

Based on record review and interview, the center did not obtain all the required information for each child’s record.

“Evidence: Child #5 is missing proof of identity and two emergency contacts.”

Rule 8VAC20-780-60-A.

Based on record review and interview, the center did not obtain documentation of the required immunization record.

“Evidence: 1. Child #2 did not have documentation of an immunization record that is required by the State Board of Health before their first day of attendance. 2. Child #2 start date is 11/02/2022.”

Rule 8VAC20-780-130-A.

Based on record review and interview, the center did not obtain documentation of a physical for each child within 30 days of enrollment.

“Evidence: 1. Child #2 did not have documentation of a physical examination. 2. Child #2 start date is 11/02/2022”

Rule 8VAC20-780-140-A.

Based on observation and interview, hazardous substances such as cleaning materials, insecticides, and pesticides were not kept in a locked place using a safe locking method that prevents access by children.

“Evidence: Five spray bottles of sanitizer were found in an unlocked cabinet over a counter in the Florence classroom.”

Rule 8VAC20-780-280-B.

Based on record review and interview, the center did not obtain 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: Child #16’s written care plan did not include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.”

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

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

“Evidence: A bottle of disinfectant spray and all-purpose cleaner was found in the Venice classroom’s bathroom, on a shelf above the diaper changing table, not locked.”

Rule 8VAC20-780-280-B. From a complaint.

Based on observation and interview, the center failed to ensure that medication was labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given.

“Evidence: In the Cairo classroom, an inhaler was not labeled with the child’s name, the name of the medication, the dosage amount, and the time or times to be given.”

Rule 8VAC20-780-510-G. From a complaint.

Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance.

Rule 8VAC20-780-40-E.

Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, constructive in nature and intended to redirect children to appropriate behavior and resolve conflicts.

Rule 8VAC20-780-400-B.

Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment.

Rule 8VAC20-780-410-1.

Based on interviews, the center failed to contact the local department or the department’s toll-free child abuse and neglect hotline to report an allegation of suspected child abuse or neglect.

“Evidence: On October 27, 2022, the center received notification from the local authorities about a recording of Staff #1 rough handling Child #1, which occurred at the center on October 18, 2022. The facility did not contact the local department or the department’s toll-free child abuse and neglect hotline to report the allegation as mandated.”

Rule 63.2-1509-A. From a complaint.

Based on video observation, the center failed to ensure care, protection, and guidance.

“Evidence: Staff #1 failed to ensure care, protection, and guidance when attempting to place Child #1 on their nap mat. Instead, Staff #1 used rough handling as a method to put the child down for nap.”

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

Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance.

“Evidence: 1. On October 18, 2022, Staff #1 is seen rough handling Child #1 (4-year-old) onto their nap mat after asking the child to lie on their nap mat during nap time. 2. Staff #1 failed to adhere to the center’s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?”

Rule 8VAC20-780-40-E. From a complaint.

Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, constructive in nature and intended to redirect children to appropriate behavior and resolve conflicts.

“Evidence: 1. On October 18, 2022, Staff #1 is seen throwing, grabbing, and flipping Child #1 (4-year-old) on their nap mat after asking the child to lie on their nap mat during nap time. 2. Staff #1?s method of behavior guidance with Child#1 was not age and stage-appropriate, and constructive in nature.”

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

Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment.

Rule 8VAC20-780-410-1. From a complaint.

Based on video observation and a review of the center’s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance.

“Evidence: 1. On October 21, 2022, Staff #1 is seen on video pushing Child #1 (4-year-old), which causes the child to fall and hit the back of their head on a wooden chair after the child is seen pushing into them. 2. Staff #1 failed to adhere to the center’s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?”

Rule 8VAC20-780-40-E.

Based on staff interviews, the center failed to develop written procedures for the prevention of shaken baby syndrome or abusive head trauma.

“Evidence: 1. There was no documentation of written procedures for the prevention of shaken baby syndrome and abusive head trauma. 2. Staff #2 confirmed the center did not have written procedures for the prevention of shaken baby syndrome and abusive head trauma.”

Rule 8VAC20-780-40-K.

Based on video observation, the center failed to use behavioral guidance that was age and stage-appropriate, and constructive in nature.

“Evidence: 1. On October 21, 2022, Child #1 (4-year-old) is seen running towards Staff #1 and pushing into them. Staff #1 pushed Child #1, which resulted in Child #1 falling and hitting their head on a wooden chair. Staff #1 stated “Don’t push me, that’s what you get,? walked away, and did not render aid to Child #1. 2. Staff #1?s method of behavior guidance with Child#1 was not age and stage-appropriate, and constructive in nature.”

Rule 8VAC20-780-400-B.

Based on video observation, the center failed to maintain compliance relating to forbidden actions involving physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercising as punishment.

“Evidence: On October 21, 2022, Staff #1 is seen on video pushing Child #1 (4-year-old), which causes the child to fall and hit the back of their head on a wooden chair. After pushing Child #1, Staff #1 is heard on video saying, ?Don’t push me, that’s what you get.” Staff #1 walked away and rendered no aid to the child.”

Rule 8VAC20-780-410-1.

Based on record review, the center failed to maintain compliance relating to injury reporting.

“Evidence: 1. The injury report stated that Child # 1 hit their head on a wooden chair; however, the report provided no documentation as to how or why Child #1 hit their head. 2. The injury report stated the parent of child #1 was notified at 1:00 pm. However, according to documents provided during the investigation, the parent was called at 1:20 pm.”

Rule 8VAC20-780-550-P.

Based on staff interviews, it was determined the center failed to comply with its own policies and procedures as it relates to reporting incidents.

Rule 8VAC20-780-40-E. From a complaint.

Based on record review and staff interview, the center did not ensure that a tuberculosis screening was completed within the last 30 calendar days of the date of employment .

“Evidence: 1. Date of employment for Staff # 2 was 5/23/22 and the tuberculosis screening on file was dated 06/07/2022. 2. Date of employment for Staff #3 was 8/22/22 and the tuberculosis screening on file was dated 12/2/2021.”

Rule 8VAC20-780-160-A.

Based on observation, the areas and equipment of the center were not maintained in a safe condition.

“Evidence: In the Athens classroom, a small laminator was located on a table, plugged in, and accessible to children.”

Rule 8VAC20-780-270-A.

8VAC20-780-260-A

“Based on the review of the inspection report from the local fire marshal , the center failed to get an annual fire inspection done. Evidence: The last fire inspection was conducted on 2/10 2021.”

Rule 8VAC20-780-260-A.