Treetop Academy

8VAC20-780-150-B

“Each immunization and physical examination reports for children shall include the date of the physical examination and dates immunizations were received and shall be signed by a physician, his designee, or an official of a local health department. The immunization record for Child #2 did not include the required signature.”

Rule 8VAC20-780-150-B.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Repeat Violation Hazardous substances must be in a locked place that prevents access by children. 1.In the toddler room containers of disinfectant and sanitizers were in an unlocked cabinet. . 2.In the two’s room containers of deodorizer, cleaner, disinfectant and sanitizers were in a unlocked cabinet. 3.In the school age room containers of disinfectant and sanitizers were in a unlocked closet. All items were labeled Keep out of reach of children and at least one other statement hazardous, harmful and flammable.”

Rule 8VAC20-780-280-B.

8VAC20-780-350-M

“One staff member shall not supervise more than one room or area during rest time. Staff #6 was observed supervising 2 rooms(infant and preschool) during rest period.”

Rule 8VAC20-780-350-M.

8VAC20-780-540-E

“The following nonmedical emergency supplies shall be required one working, battery-operated flashlight on each floor of each building that is used by children. There was not a flashlight at the center.”

Rule 8VAC20-780-540-E.

8VAC20-780-570-I

“A one-day’s emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care shall be maintained at the center. Child #6 does not have emergency formula.”

Rule 8VAC20-780-570-I.

8VAC20-780-70

“The following staff records shall be kept for each staff person, documentation that two or more references as to character and reputation as well as competency were checked before employment or volunteering. Staff #1 was missing the second reference.”

Rule 8VAC20-780-70.

8VAC20-780-140-A

“Each child shall have a physical examination by or under the direction of a physician: before the child’s attendance; or within 30 days after the first day of attendance. Child #2 did not have a copy of a physical and was overdue by 4 months.”

Rule 8VAC20-780-140-A.

8VAC20-780-160-C

“Repeat Violation Each staff member shall obtain at least every two years, from the date of the initial screening or testing, the results of a follow- up tuberculosis screening. Staff #1’s record did not include an updated TB screening as the most recent was overdue by 14 months.”

Rule 8VAC20-780-160-C.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Repeat Violation Hazardous substances must be in a locked place that prevents access by children. 1.In Classroom C there was a container of disinfectant wipes in an unlocked cabinet. 2. In Classroom A, there was a container of hand sanitizer on the counter All items were labeled ?Keep out of reach of children? and at least one other statement hazardous, harmful and flammable.”

Rule 8VAC20-780-280-B.

8VAC20-780-350-B-1

“The center did not maintain required staff to child ratios, 1 staff for every 5 children, as an extension of a temporary staff-to-child ratio variance granted by the Office of Child Care Health and Safety on June 25, 2024. In the multipurpose room there were 2 staff with 15 children and the youngest was Child #1 age 5 months. The staff-to-child ratio for children birth to 16 months is 1:4 but the center had an approved variance for 1:5.”

Rule 8VAC20-780-350-B-1.

8VAC20-780-500-A

“Children’s hands shall be washed with soap and running water after toileting and any contact with blood, feces, or urine. In Classroom A diapering was observed for Child #1 and Staff #6 did not wash their hands or the children’s hands after diapering.”

Rule 8VAC20-780-500-A.

8VAC20-780-500-B

“Disposable diapers shall be disposed of 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. Staff #6 was observed throwing away a soiled diaper into a trashcan that did not have a lid and was accessible to children.”

Rule 8VAC20-780-500-B.

8VAC20-780-540-A

“A first aid kit shall be wherever children are in care. The centers vehicle used for transportation does not have a first aid kit.”

Rule 8VAC20-780-540-A.

8VAC20-780-150-B

“Physicals and Immunization records are required to be signed and dated by a physician, his designee, or an official of the local health department. Both records for Child #2 were not signed and they have been attending for over 3 months.”

Rule 8VAC20-780-150-B.

8VAC20-780-260-B

“After the first license, annual approval from the health department shall be provided. The most recent health and sanitation report from the health department was dated 3-15-2024.”

Rule 8VAC20-780-260-B.

8VAC20-780-270-A

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Hazardous substances must be in a locked place that prevents access by children. I 1.In Classroom D, two spray containers of Bug Defense/ Killer and one spray container of cleaning solution were in an unlocked cabinet. 2. In Classroom E, two spray containers of disinfectant were in an unlocked cabinet. 3. In Classroom C there was one container of hand sanitizer on a shelf. All items were labeled ?Keep out of reach of children? and at least one other statement hazardous, harmful and flammable.”

Rule 8VAC20-780-280-B.

8VAC20-780-320-B

“Repeat Violation Each restroom area provided for children shall be equipped with soap, toilet paper, and disposable towels or an air dryer within reach of children. There are two restrooms in the hallway and one did not have soap for two of the sinks and one restroom did not have toilet paper for three of the toilets.”

Rule 8VAC20-780-320-B.

8VAC20-780-560-G

“When food is brought from home the food container must be clearly labeled to identify the owner and date. Four lunch boxes were observed, and they did not have both names and dates.”

Rule 8VAC20-780-560-G.

8VAC20-780-150-B

“Immunization records shall include the dates immunizations were received and shall be signed by a physician, his designee, or an official of a local health department. The record Child #5 did not include a signature from a physician, his designee, or an official of a local health department”

Rule 8VAC20-780-150-B.

Repeat Violation The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin. The center did not ensure areas and equipment inside and outside, shall be maintained in a clean, safe and operable condition for the following areas on the playground.

Rule 8VAC20-780-270-A.

8VAC20-780-320-B

“Each restroom area provided for children shall be equipped with soap, toilet paper, and disposable towels or an air dryer within reach of children. The boys restroom did not have toilet paper within reach for 3 of the toilets available and the girls restroom did not have toilet paper available for one toilet available.”

Rule 8VAC20-780-320-B.

8VAC20-780-500-B

“The diapering area shall have a nonabsorbent surface for diapering or changing. The diaper pad in 3 classrooms had small tears/ rips and therefore the pad was no longer nonabsorbent.”

Rule 8VAC20-780-500-B.

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. The following was missing from 2 of 5 records reviewed. 1.The record for Child #2, did not include employment location and phone number for one parent listed. 2. The record for Child #4, did not include home phone number for one parent listed, employment location and phone number for one parent listed and a second emergency contact name, address and phone number.”

Rule 8VAC20-780-60-A.

Based on record review and staff interviews, the licensee did not ensure that each staff member had obtained at least every two years from the date of the initial screening or testing, the results of a follow- up tuberculosis screening.

“Evidence: Staff #5’s record did not include updated TB screening;most recent screening dated 7-9-2022.”

Rule 8VAC20-780-160-C.

Based on observation and staff interviews, the licensee did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition.

“Evidence: The following equipment on the outdoor playground poses a safety risk to children on the playground. 1.The tan colored painted metal microphone on the composite piece has areas of peeling paint and rust. 2.There is a screen window frame that is no attached to the screen window frame and has a sharp edge and is accessible to children on the playground.”

Rule 8VAC20-780-270-A.

Based on observation and staff interviews, the licensee did not ensure to follow all handwashing procedures.

“Evidence: 1.The children in the 2?s and 3?s room were observed during snack time and they do not wash their hands or use wipes after eating. 2. In the 2?s and 3?s room were observed during toilet training / restroom time and Staff #2 was observed emptying a toilet chair and did not wash their hands after.”

Rule 8VAC20-780-500-A.

Based on observation and staff interviews, the licensee did not ensure that toilet chairs shall be emptied promptly and cleaned and sanitized after each use

“Evidence: Staff #2 was observed during toileting training time and did not clean or sanitize the toilet chair after it had been emptied.”

Rule 8VAC20-780-500-C.

Based on review of documentation and staff interviews, the licensee did not ensure when an authorization for medication expires, the parent shall be notified the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

“Evidence: Child #3 had a medication (Epi-pen) and the medication authorization signed by the parent expired on 5-30-24. The medication had not been sent home to the parents or disposed of as required.”

Rule 8VAC20-780-510-P.

Based on center documentation review and staff interviews, the licensee did not ensure the center shall maintain a written record of children’s serious and minor injuries in which entries are made the day of occurrence that includes all required information.

“Evidence: Five injury reports reviewed and three were missing some information to include the future action to prevent injury and how the parent was notified of the injury.”

Rule 8VAC20-780-550-P.

Based on observation and staff interviews, the licensee did not ensure the tables used for feeding shall be sanitized after each use for feeding.

“Evidence: The feeding table in the 2’s and 3’s room was not sanitized after snack, as Staff #2 was observed spraying it was disinfectant then immediately wiping it dry. The definition of “Sanitized” means treated in such a way to remove bacteria and viruses from inanimate surfaces through using a disinfectant solution and the surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions.”

Rule 8VAC20-780-560-J.

Based on record review and staff interviews, the licensee did not ensure that all required items were in a staff record.

“Evidence: Center Director verified the record Staff #4 (date of hire 6-27-2024) was missing the second required references and the first reference did not include the signature pf the person conducting the reference check prior to hire.”

Rule 8VAC20-780-70.

REPEAT Based on record review and staff interview, the licensee did not ensure areas adn equipment ot the center inside and outside, shall be maintained in a clean, safe and operable condition.

“Evidence: Outside there was a bucket with outdoor toys was cracked that could cause snag skin and entangle clothing. There was also a crack on a kids ride on car. Center staff was removing of the equipment while the inspection was conducted.”

Rule 8VAC20-780-270-A.

REPEAT Based on observation, the licensee did not ensure hazordous substances was kept in a locked place iusing a safe locking method that prevents access.

“Evidence: 1-In the infant room, there was aersol spray labeled with keep out of reach of children and warining. It was not in a locked area. 2-In the 4 year old room, there was soap that was labeled with keep out of reach of children and warning. 3- The substances should be kept in locked place.”

Rule 8VAC20-780-280-B.

REPEAT Based on record review, staff interview and observation , the licensee did not ensure at least one staff in each classroom or area where children are present have CPR and First Aid.

“Evidence: Staff #5 was alone with children and did not have CPR and First Aid. Confirmed by center director.”

Rule 8VAC20-780-530-A.

Based on observation, the licensee did not ensure that the current menu was dated.

“Evidence: The menu posted was not dated.”

Rule 8VAC20-780-560-F.

Based on record review, the licensee did not ensure staff have central registry finding within 30 days of employment.

“Evidence: The center was unable to provide documentation of Staff #1 Central registry. Staff #1 hire date in December 2022.”

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

Repeat

“Based on record review and staff interview, the licensee did not ensure children have physical before first date of attendance or with in 30 days from first date of attendance. Evidence:The center was unable to provide a physical for Child #3 start date was 12/2022.”

Rule 8VAC20-780-140-B.

Repeat

“Based on record review and staff interview, the licensee did not ensure the Virginia Department of Education-sponsored orientation course is completed within 90 calendar days of employment. Evidence: Staff #1 date of employment 12/2022 did not have documentation of completing the Virginia Department of Education-sponsored orientation course within 90 calendar.”

Rule 8VAC20-780-240-A.

Based on record review, the licensee did not ensure annual health inspection was completed.

“Evidence: The most recent health inspection was August 22, 2022.”

Rule 8VAC20-780-260-B.

Based on observation and staff interview, the licensee did not ensure cribs, cots, rest mats, and beds shall be identified for use by a specific child.

“Evidence: There were two cribs occupied during the inspection but was not identified for use by a specific child. Staff confirmed .”

Rule 8VAC20-780-440-B.

REPEAT Based on observation, the licensee did not ensure the diapering surface is nonabsorbent surface for diapering or changing .

“Evidence: In the two and three year old room, there was a tear in the diapering surface.”

Rule 8VAC20-780-500-B.

Repeat

“Based on interview with staff and document review, the center did not ensure there were center’s procedure for administering medication including methods to prevent use of outdated medication. Evidence: During inspection Staff # 5 was unable to provide written procedures for methods to prevent use of outdated medication. Staff #5 stated the center was working on the procedures.”

Rule 8VAC20-780-510-E.

Based on staff interview and record review, the licensee did not ensure the center has obtained written authorization from a parent or guardian.

“Evidence: Child #1 written medication authorization form expired on 06/16/2023 . Medication was administered 07/06/2023, 07/12/2023, 07/24/2023, and 07/26/2023.”

Rule 8VAC20-780-510-I.

Based on observation and staff record review, the licensee did not ensure at least one staff in each classroom or area where children are present shall have current certification in cardiopulmonary resuscitation (CPR) as appropriate to the age of the children in care and current certification in first aid.

“Evidence: Staff #2 was in the Pre-K/Preschool classroom during nap time alone.”

Rule 8VAC20-780-530-A.

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

“Evidence: In the infant classroom, there was a child in a high chair not with a protective belt. Confirmed with staff.”

Rule 8VAC20-780-570-A.

Repeat

“Based on record review, the licensee did not ensure all staff records contained al required documents. Evidence: Staff #1 record did not have documentation of orientation training being completed.”

Rule 8VAC20-780-70.

Based on staff interview and documentation, the licensee did not ensure that following actions or threats are forbidden: Punishment by another child.

“Evidence: During interview Staff #1 said child #1 was poking child #2 in eye. Staff #1 said she told child #2 to poke child #1 back. Center documentation on employee action form confirmed on May 12, 2023 Staff #1 told child #2 to poke child #1 back.”

Rule 8VAC20-780-410-3. From a complaint.

Based on record review and staff interview, the center did not ensure each child shall have a physical examination by or under the direction of a physician before the child’s attendance; or within 30 days after the first day of attendance.

“Evidence: On May 10, 2023, child #3 (enrollment date 1/11/2022) record was missing physical.”

Rule 8VAC20-780-140-A.

Based on record review and staff interview, the licensee did not ensure each staff member and individual from an independent contractorshall submit documentation of a negative tuberculosis screening. Documentation of the screening should be submitted at the time of employment and prior to coming into contact with children. The documentation have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician’s designee, or anofficial of the local health department.

“Evidence: Staff #1 hire date 04/20/2023 the TB test results recieved 04/21/2023. Staff #4 hire date 02/01/2023 the TB test results recieved 02/01/2023. The documentation was not completed within the last 30 calendar days of the date of employment.”

Rule 8VAC20-780-160-A.

Based on record review and staff interview, the licensee did not ensure the Virginia Department of Education-sponsored orientation course is completed within 90 calendar days of employment.

“Evidence: Staff #2 date of employment 01/31/2023 did not have documentation of completing the Virginia Department of Education-sponsored orientation course within 90 calendar.”

Rule 8VAC20-780-240-A.

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

“Evidence: 1- On May 10, 2023, the license inspector and staff#5 observed outside on the playground, there was sticks with sharp points on the playground. There was a black material on both playground that causes a tripping hazard. 2- On May 10, 2023 in the inside of the center, there was urine on the bathroom floor. Confirmed by staff #5, The center had staff to clean the bathroom.”

Rule 8VAC20-780-270-A.

Based on observation and staff interview, the licensee did not ensure where playground equipment is provided resilent surfacing comply with minimum standards.

“Evidence: On May 10, 2023, there was fall zones by the slides and climbing apparatus that did not have adequate shredded rubber (resilent surfacing). In some fallzone areas there was approximatley 1-2 inches of rubber resilent surfacing.”

Rule 8VAC20-780-330-B.

Based on interview with staff and document review, the center did not ensure there were center’s procedure for administering medication including methods to prevent use of outdated medication.

“Evidence: On May 10, 2023, staff #5 was unable to provide written procedures for methods to prevent use of outdated medication.”

Rule 8VAC20-780-510-E.

Based on staff interview and record review, the center did not ensure when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

“Evidence: On May 10 , 2023, Child #4 medication authorization form expired 12/2022 and the emergency medication was still being stored at the center. Staff #5 confirmed the authorization expired.”

Rule 8VAC20-780-510-P.

Based on staff interview, the center did not ensure there was one working battery operated flashlight on each floor of each used by children;and one working, battery -operated radio in each building, used by children.

“Evidence: During the inspection May 10, 2023, Staff #5 confirmed the center did not have battery operated radio and flashlight.”

Rule 8VAC20-780-540-E.

Based on records review and staff interview, the center did not ensure two references were completed before employment.

“Evidence: Staff #1 and Staff #2 records were missing two references. Confirmed by staff #5.”

Rule 8VAC20-780-70.

Based on record review, the licensee did not enure areas of equipment of the center , inside and outside were maintained in a clean, safe and operable condition.

“Evidence: 1-Outside on the playground, against the building there was a broken chair had visible cracks and could entangle clothes and/or snag skins. 2- Inside the building in the restroom, there was a toilet lid that was not fitted and possible tipping hazard and caps are missing to cover the anchors of the toilets need to be covered could cause possible entanglement.”

Rule 8VAC20-780-270-A.

Based on observation, the licensee did not ensure hazordous substances such as cleaning materiasl are kept in a locked place using a safe locking method.

“Evidence: In preschool classroom, the cabinet was not locked that stored bleach and water. In the kitchen, the door was unlocked and there was sanitizers on the counter.”

Rule 8VAC20-780-280-B.

Based on observation and staff interview, the licensee did not enure the disposable diapers are 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.

“Evidence: The diapering storage system was not working . The lid would not close completley and the staff would need to pushed it the lid down with there hand.”

Rule 8VAC20-780-500-B.

Based on record reveiw and staff interview, the licensee did not ensure monthly evauction drills were documented.

“Evidence : There was not documentaiton of monthly drills for the month of August during the inspection.”

Rule 8VAC20-780-550-G.

8VAC20-780-580-B

“Based on observation and staff interview, the licensee did not ensure that a vehicle used for the transportation of children met the safety standards set by the Department of Motor Vehicles. Evidence: The licensing inspector observed that one bus used for the transportation of children had an expired inspection sticker. The inspection sticker showed an expiration date of 08/2022. Staff confirmed vehicle is being used to transport children.”

Rule 8VAC20-780-580-B.