Ms. Denise Green

Children under two years of age shall not use pillows or filled comforters

“Child A was sleeping in a crib with a pillow, child A is under 2 years of age.”

Rule 8VAC20-800-530-G.

Children shall not be allowed to eat or drink while walking, running, playing, lying down, or riding in vehicles.

“Child A was in a crib which had a bottle of milk next to them.”

Rule 8VAC20-800-900-B.

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

“There were 8 children present for a total of 17 points. The provider was the sole caregiver.”

Rule 8VAC20-800-570-A.

Out of state background checks must be requested before hire.

“The out of state child abuse and neglect and sex offender searches has not been requested for Caregiver A who has been employed for two weeks,”

Rule 22.1-289.035-B-4.

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.

“There was no physical on file for child A, the physical was over due by 7 weeks.”

Rule 8VAC20-800-100-A.

The provider shall obtain from each caregiver at the time of hire and each adult household member prior to coming into contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.

“There was no Tuberculosis test./screening on file for Caregiver A, this tuberculosis test was overdue by 15 days.”

Rule 8VAC20-800-170-A.

The provider shall obtain for each caregiver and adult household member a current Report of Tuberculosis Screening form, in accordance with the requirements in 8VAC20-800-170, every two years from the date of the first screening or more frequently as recommended by a physician or the local health department.

“Caregiver B’s tuberculosis test was overdue by one month.”

Rule 8VAC20-800-180-A.

The provider shall orient the substitute provider and assistant by the end of their first week of assuming job responsibilities.

“Caregiver A was not provided orientation training, the training was overdue by 1 week.”

Rule 8VAC20-800-200-A.

Repeat Violation Systemic Deficiency Prescription and non prescription medications shall be given to a child only with authorization from the parent.

“There was no parental authorization for emergency medications for child B and C. The authorization for child B was overdue by 3 weeks and by 5 months for child C.”

Rule 8VAC20-800-700-A.

Before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations.

“There were no immunization record on file for child A who has been enrolled for 11 weeks.”

Rule 8VAC20-800-90-A.

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

“There was no allergy care plan on file for child A, who has diagnosed food allergies.”

Rule 8VAC20-790-190-B-12.

8VAC20-790-430-A-3

“Repeat violation: Lockdown procedures shall be practiced at least annually. There was no documentation to show that lockdown procedures have been practiced at least annually.”

Rule 8VAC20-790-430-A-3.

22.1-289.011-F

“The license and any other documents required by the Superintendent shall be posted in a conspicuous place on the licensed premises. The findings from the most recent inspection in October 2024 was not posted in a conspicuous place.”

Rule 22.1-289.011-F.

8VAC20-800-210-A

“Repeat violation: In addition to satisfactory completion of first aid training and CPR training, caregivers shall obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Caregiver #! provided documentation of 6 of the 16 hours of annual training for 2024.”

Rule 8VAC20-800-210-A.

8VAC20-800-60-A

“The provider shall maintain an up-to-date record at the family day home for each enrolled child. There was no insurance policy number on file for child A and child B, this information was overdue by 3 months for both children. There was no insurance information on file for child D, this information was overdue by 5 months.”

Rule 8VAC20-800-60-A.

8VAC20-800-700-A

“Repeat violation: Prescription and nonprescription medications shall be given to a child only with authorization from the parent. There was no parental authorization for an emergency medication for child C.”

Rule 8VAC20-800-700-A.

Repeat violation: The family day home may administer prescription medication that would normally be administered by a parent or guardian to a child provided that the caregiver administer medication dispensed from a pharmacy and maintained in the original labeled container.

“An emergency medication for child C was not in the original pharmacy container nor did it have a prescription label attached.”

Rule 8VAC20-800-710.

Within seven business days of the child’s first day of attendance at the family day home, the provider shall obtain from the parent proof of identify for the child.

“There was no proof of identity obtained for child A and B, which was overdue by 3 months.”

Rule 8VAC20-800-80-A.

The vendor shall maintain in a way that is accessible to all caregivers, a current written list of all children’s allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential.

“1. Child #1 has an allergy to medication that was not listed on a written list. 2. Child #2 has 4 allergies to food, these allergies were not listed on a written list. 3. Child # 3 has an allergy to food, this allergy was not listed on a written list.”

Rule 8VAC20-790-170-G.

Lockdown procedures shall be practiced at least annually.

“There were no lockdown drills for 2023.”

Rule 8VAC20-790-430-A-3.

Repeat violation: Caregivers shall obtain a minimum of sixteen clock hours of training annually.

“Caregiver #1 had 14 of the 16 training hours for 2023.”

Rule 8VAC20-800-210-A.

8VAC20-800-700-A

“Prescription medications shall be given to a child only with written authorization from the parent. There was no parental authorization for an emergency medication for child #1.”

Rule 8VAC20-800-700-A.

8VAC20-800-710

“The family day home may administered prescription medication to a child provided that the caregiver adminster only medication dispensed from a pharmacy and maintained in the original, labeled container. 1. A prescribed medication for child #1 was not in the original pharmacy container nor did it have a prescription label attached.”

Rule 8VAC20-800-710.

8VAC20-790-170-G

“The vendor shall maintain in a way that is accessible to all caregivers, a current written list of all children’s allergies, sensitivities, and dietary restrictions, The list shall be dated and kept confidential. There was no written list of child #1’s allergy to shellfish and there was no written list of child #2’s allergy to peanuts, tree nuts, diary and eggs.”

Rule 8VAC20-790-170-G.

8VAC20-790-190-B-12

Rule 8VAC20-790-190-B-12.

22.1-289.036-A

“Background checks are required every five years after the initial background checks. Caregiver #1’s Sworn Disclosure Statement had not been obtained for 2 months beyond the five years, their Central Registry Child Abuse and Neglect background check had not been obtained for 7 days beyond the five years and their Fingerprint background check had not been obtained in almost a month beyond the five years.”

Rule 22.1-289.036-A.

8VAC20-800-120-B

“Caregivers records shall contain two or more references as to character and reputation as well as competency are checked before employment. There were no references checked for Caregiver # 2 for 23 months after employment.”

Rule 8VAC20-800-120-B.

8VAC20-800-200-A

“The provider shall orient caregivers by the end of their first week of assuming job responsibilities. Caregiver #2 was not provided orientation training approximately 1 year and 11 months after assuming job responsibilities.”

Rule 8VAC20-800-200-A.

8VAC20-800-210-A

“Caregivers shall obtain a minimum of 16 clock hours of training annually in areas relevant to their job responsibilities. Caregiver #2 has obtained none of the required 16 hours of training from June 2022 to June 2023.”

Rule 8VAC20-800-210-A.

8VAC20-800-90-A

“Before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized. There were no immunization record on file for child A for 5 months after attending the family day home.”

Rule 8VAC20-800-90-A.

8VAC20-800-210-A

“Based on review, the provider did not ensure that they obtained 16 clock hours of annual training. Evidence: reviewed the provider’s log of annual trainings and found that they only had documentation of 2 clock hours of annual training since December 2022.”

Rule 8VAC20-800-210-A.

8VAC20-800-60-B

“Based on review, the facility did not ensure that children’s records were maintained with the parents’ annual review and update of emergency contact information. Evidence: reviewed 4 children’s records and found that Child 1’s last annual update was on 10/3/2022.”

Rule 8VAC20-800-60-B.

8VAC20-800-730-D

“Based on observation, the provider did not ensure that medications are kept in a locked place, using a safe locking method that prevents access by children. Evidence: observed the first aid kit that was not locked had small packets of aspirin and non-aspirin containing medications.”

Rule 8VAC20-800-730-D.

8VAC20-800-830-C

“Based on review, the provider did not ensure that documentation of emergency evacuation drills was maintained. Evidence: reviewed the provider’s emergency drill log and found that there was no documentation of an emergency evacuation drill in October 2023.”

Rule 8VAC20-800-830-C.

8VAC20-800-120-A

“Based on review of documentation and an interview with the provider, not all caregivers had a record as required. Evidence: there was no record for caregiver #2 who was observed outside supervising seven children alone.”

Rule 8VAC20-800-120-A.

8VAC20-800-150-A

“Based on observation, review of documentation and interview, not all caregivers were 16 years of age or older. Evidence: caregiver #2 (date of birth: 3/12/2009) was observed outside supervising seven children alone.”

Rule 8VAC20-800-150-A.

8VAC20-800-150-B

“Based on observation, review of documentation and interview, an assistant under 18 years of age was not always working under direct supervision of the provider. Evidence: when the LI arrived, caregiver #2 (date of birth: 3/12/2009) was observed alone outside supervising seven children ranging in age from 20 months to eight years of age. The provider was inside the house therefore not able to see or hear the assistant and children at all times as the sliding door was closed.”

Rule 8VAC20-800-150-B.

8VAC20-800-830-B

“Based on review of documentation, and an interview with the provider, not all shelter-in-place procedures were practiced a minimum of twice per year. Evidence: the last documented shelter-in-place drill was 4/7/2022.”

Rule 8VAC20-800-830-B.

8VAC20-800-320-A

“Based on observation, the provider failed to ensure that small electrical appliances were unplugged while not in use. Evidence: there was an air fryer and a Keurig coffee maker sitting on the kitchen counter plugged in, and the appliances were not in use.”

Rule 8VAC20-800-320-A.

22.1-289.035-B-2

“Based on review of two caregiver records, it was determined that not all caregivers had an Office of Background Investigations (OBI) fingerprinting-based criminal history record check prior to their first day of employment. Evidence: the record for caregiver #2 (date of hire: 1/4/2022) did not have an OBI determination letter.”

Rule 22.1-289.035-B-2.

22.1-289.058

“Based on observation, and an interview with the provider, it was determined that the home did not have a carbon monoxide detector as required. Evidence: the provider stated that the home does not have a carbon monoxide detector.”

Rule 22.1-289.058.

8VAC20-800-120-B

“Based on review of documentation and an interview with the provider, not all records contained all required information. Evidence: the record for caregiver #2 (date of hire: 1/4/2022) did not contain the job title, date of hire, name, address and phone number of a person to be notified in an emergency, or documentation that two references as to character and reputation as well as competency were checked before employment.”

Rule 8VAC20-800-120-B.

8VAC20-800-170-A

“Based on review of two caregiver records, the provider did not have documentation of a tuberculosis (TB) test/screening for a caregiver at the time of hire and prior to coming into contact with children. Evidence: the record for caregiver #2 (date of hire: 1/4/2022) had a TB test/screening dated: 2/19/22.”

Rule 8VAC20-800-170-A.

8VAC20-800-200-A

“Based on review of documentation, and an interview with the provider, not all caregivers received orientation by the end of their first week of assuming job responsibilities. Evidence: the record for caregiver #2 (date of hire: 1/4/2022) did not contain documentation of orientation training.”

Rule 8VAC20-800-200-A.

8VAC20-800-730-D

“Based on observation, and an interview with the provider, it was determined that not all medication was kept in a locked place, using a safe locking method that prevents access by children. Evidence: three medications were observed inside an open grocery-type bag sitting on the floor.”

Rule 8VAC20-800-730-D.