Dionne Jordan

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

“Child #2, 21 months old, last documented immunization was over 8 months ago.”

Rule 8VAC20-800-90-C.

Current certification is needed in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.

“Caregiver #1, who was supervising children, did not have an up to date CPR certification. CPR certification expired 04/2025.”

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

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

“Caregiver #1, who was supervising children, did not have an up to date first aid certification. The certification expired 04/2025.”

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

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

“An updated TB screening for Caregiver #1 was not completed and was overdue by more than 30 days.”

Rule 8VAC20-800-180-A.

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

“Child #2, 21 months old, last documented immunization was over 11 months ago.”

Rule 8VAC20-800-90-C.

Emergency supplies shall be in the family day home, accessible to outdoor play areas, on field trips, in vehicles used for transportation and wherever children are in care.

“The first aid kit in the home was missing tweezers.”

Rule 8VAC20-800-760-A-1.

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

“Child #4, 17 months old, last documented immunization was over nine months ago.”

Rule 8VAC20-800-90-C.

22.1-289.036-A

“Based on record review, the provider did not have a central registry check or criminal history check that was updated every five years. Evidence: 1. Caregiver #1 had a criminal history background check which was last conducted on 05/13/2019 2. Caregiver #1 had a central registry background check which was last conducted on 04/12/2019 3. Provider acknowledged the background checks have not been renewed.”

Rule 22.1-289.036-A.

8VAC20-800-750-A

“Based on observation and interview, when topical skin products such as diaper ointment and lotion are used, written parent authorization shall be obtained at least annually. Evidence: 1. A diaper cream was observed at the home that was labeled and used for child #1. Upon record review, there was no parent authorization for the diaper cream. 2. The provider acknowledged that they were using a diaper cream for the child without written parent authorization to apply the diaper cream.”

Rule 8VAC20-800-750-A.

Based on observation and interview, the provider did not ensure that cribs were provided for children from birth through 12 months of age as required.

“Evidence: 1. Child #1 was identified to be 10 months old. A crib was not observed in the home. 2. The provider acknowledged a crib was not available in the home.”

Rule 8VAC20-800-520-A.

Based on a review of three (3) caregiver records and interview, the vendor did not ensure that one (1) caregiver who works directly with children annually completed the department’s health and safety update course as required.

“Evidence: 1. The record of caregiver #3 contained an annual health and safety course certificate dated 8/31/2021. 2. The vendor acknowledged that the record did not contain a 2022 course certificate.”

Rule 8VAC20-790-250-F.

Based on a review of three (3) caregiver records and interview, the provider did not ensure to obtain a fingerprint background check for one (1) caregiver prior to the first date of employment:

“Evidence: 1. The record of caregiver #2 (date of employment: 1/2/2023) did not contain a fingerprint background check. 2. The provider acknowledged that it had not been completed.”

Rule 22.1-289.035-B-2.

Based on a review of five (5) caregiver records and interview, the provider did not ensure to obtain a central registry finding for one caregiver by the end of the 30th day of employment as required.

“Evidence: 1. The record of caregiver #2 (date of employment: 1/2/2023) contained a central registry finding dated 3/20/2023. 2. The provider acknowledged the finding was not received within the required time frame.”

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

Based on a review of five (5) child records and interview, the provider did not ensure 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 for three (3) children as required.

“Evidence: 1. The records of child #1, child #2 and child #4 (dates of attendance: 10/1/2022) did not contain physical records. 2. The provider acknowledged that the physical records had not been obtained.”

Rule 8VAC20-800-100-A.

Based on a review of three (3) caregiver records and interview, the provider did not ensure to obtain a tuberculosis screening for one (1) caregiver at the time of hire and prior to coming into contact with children.

“Evidence: 1. The record of caregiver #2 (date of employment: 1/2/2023) contained a tuberculosis screening dated 1/16/2023. 2. The provider acknowledged that the TB screening was received after the start of employment.”

Rule 8VAC20-800-170-A.

Based on a review of three (3) caregiver records and interview, the provider did not ensure to obtain a follow up tuberculosis screening for one (1) caregiver every two years from the date of the first screening or more frequently as recommended by a physician or the local health department.

“Evidence: 1. The record of caregiver #3 contained a TB screening dated 5/11/2021. 2. The provider was unable to locate documentation of a follow up tuberculosis screening for caregiver #3.”

Rule 8VAC20-800-180-A.

Based on observation and measurements, the provider did not ensure that hot water at taps available to children were maintained within a range of 105?F to 120?F.

“Evidence: 1. The hot water was measured at the handwashing sink in the bathroom used by children. The water temp measured at 130 degrees. 2. The provider acknowledged that the water temperature did not fall within the allowable range.”

Rule 8VAC20-800-350-E.

Based on a review of five (5) child records and interview, the provider did not ensure to obtain documentation that one (1) child had been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations.

“Evidence: 1. The record of child #1 (date of attendance: 10/1/2022) contained an immunization record dated 10/31/2022. 2. The provider acknowledged that the immunizations were received after the first date of enrollment.”

Rule 8VAC20-800-90-A.

Based on record review and interview, the vendor did not ensure that each staff complete annually the Virginia Annual Health and Safety Update Course sponsored by the Department as required.

“Evidence: 1. The record of caregiver #1 contained documentation of the Virginia Annual Health and Safety Update dated 7/11/2021. The record of caregiver #2 contained documentation of the Virginia Annual Health and Safety Update dated 8/31/2021. 2. The vendor acknowledged that the training update was not completed annually.”

Rule 8VAC20-790-250-F.

Based on a review of five (5) children’s records and interview, the provider did not ensure that the physical examination received prior to attendance was conducted within the required time frame for one (1) child.

“Evidence: 1. The record of child #1 (date of attendance: 7/14/2022) contained a physical record dated 9/3/2021. The child was 14 months old at the time of enrollment. Physicals must be conducted within three (3) months prior to attendance for children age seven (7) months through 18 months. The physical was 10 months old. 2. The provider acknowledged that the physical was not conducted within the required time frame.”

Rule 8VAC20-800-100-B.

Based on record review and interview, the provider did not ensure that the substitute provider had current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

“Evidence: 1. The record of caregiver #2 contained an expired CPR certification dated 12/16/2019. 2. The provider acknowledged that the substitute provider’s certification had expired.”

Rule 8VAC20-800-140-B-3.

Based on record review and interview, the provider did not ensure that the substitute provider had current certification in First Aid.

“Evidence: 1. The record of caregiver #2 contained an expired first aid certification dated 12/16/2019. 2. The provider acknowledged that the first aid certification was expired.”

Rule 8VAC20-800-140-B-4.

Based on observation and interview, the provider did not ensure that hot water at taps available to children were maintained within a range of 105?F to 120?F.

“Evidence: 1. On 10/28/2022, the hot water at the children’s handwashing sink was measured at 145?F. 2. The provider acknowledged that the water temperature was not maintained within the required limits.”

Rule 8VAC20-800-350-E.

Based on observation and interview, the provider did not ensure that a caregiver did not exceed 16 points by using the point system to determine if an additional caregiver was needed.

“Evidence: 1. On 10/28/2022, at approximately 8:45 am, Nine (9) children were observed with one (1) caregiver. The caregiver had 20 points. The second caregiver did not arrive for over an hour. 2. The provider acknowledged she was over the 16 points.”

Rule 8VAC20-800-570-A.

Based on a review of five (5) children’s records and interview, the provider did not ensure to maintain an up-to-date record at the family day home for each enrolled child as required.

“Evidence: 1. The record of child #2 (date of enrollment 10/3/2022) was missing emergency contact information, signed parental agreements, and written authorization for emergency medical care. 2. The provider acknowledged that the record was incomplete.”

Rule 8VAC20-800-60-A.

Based on observation and interview, the provider did not ensure to have an operable thermometer available to monitor refrigerator and freezer compartment temperatures.

“Evidence: 1. A thermometer was not present in the refrigerator and freezer during the inspection. 2. The provider acknowledged that they were not available.”

Rule 8VAC20-800-940-B.

Based on observation and interview, the provider did not ensure that the home that was built before 2015 and housed a child day program that served preschool aged children was equipped with at least one carbon monoxide detector.

“Evidence: 1. A working carbon monoxide detector was not observed during the inspection. 2. The provider acknowledged that a detector had not been installed.”

Rule 22.1-289.058.

Based on record review and interview, the provider did not ensure that the substitute provider had current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

“Evidence: 1. The record of caregiver #2 contained an expired CPR certification dated 12/16/2019. 2. The provider acknowledged that the substitute provider’s certification had expired.”

Rule 8VAC20-800-140-B-3.

Based on record review and interview, the provider did not ensure that the substitute provider had current certification in First Aid.

“Evidence: 1. The record of caregiver #2 contained an expired first aid certification dated 12/16/2019. 2. The provider acknowledged that the first aid certification was expired.”

Rule 8VAC20-800-140-B-4.

Based on record review and interview, the provider did not ensure to document in writing the annual review and update to the emergency preparedness plan as required.

“Evidence: 1. A written review of the emergency preparedness plan was not documented in 2020. 2. The provider acknowledged that the 2020 review was not documented in writing.”

Rule 22VAC40-111-800-B.