Katrina Nelson

**Repeat Violation** Children’s records are required to contain written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection to provision of medical treatment on religious or other grounds.

“The record for Child 6 did not contain a written authorization for emergency medical care.”

Rule 8VAC20-800-60-B.

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

“Child #6, 20 months old, last documented immunization was over 7 months ago.”

Rule 8VAC20-800-90-C.

Household members are required to undergo a background check every five years.

“The most recent central registry check for household member #1 was overdue by a year and four months.”

Rule 22.1-289.035-A.

Each child shall be provided with an individual crib, cot, rest mat or bed for resting or napping.

“At the time of inspection, there were three children under the age of 12 months in care and only one crib observed in the family day home.”

Rule 8VAC20-800-510-A.

Children’s records are required to contain all of the required information.

“The record for Child #6 and #7 were missing the following required components: Written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection to provision of medical treatment on religious or other grounds.”

Rule 8VAC20-800-60-B.

Bottles shall be refrigerated and labeled with the child’s full name and the date, if more than one infant is in care.

“Four bottles containing milk were observed without a label of the child’s full name and date during the inspection. There were 3 infants in care at the time of the inspection.”

Rule 8VAC20-800-960-E.

Caregivers shall obtain a minimum of 16 clock hours of training annually.

“Caregiver #2 obtained three of the required 16 hours of training in 2024.”

Rule 8VAC20-800-210-A.

Children’s records are required to contain information on allergies and actions to take in an emergency situation.

“The record for child #8, who has been in care for over 2 weeks, has a diagnosed food allergy and did not have actions to take in an emergency situation in their file.”

Rule 8VAC20-800-60-B.

Before attendance, documentation of immunizations is to be obtained for each child.

“The record for child #8 contained immunizations received 7 days after the child entered care.”

Rule 8VAC20-800-90-A.

Based on review of children’s records, the provider did not obtain parent’s signed acknowledgement of annual review of emergency contact information.

“Evidence: 1. The record for child #6 did not contain documentation of an annual review of emergency contact information. 2. The provider acknowledged the parent had not signed the document for reviewing the information.”

Rule 8VAC20-800-780-B.

Based on observation and interview, the provider did not ensure the telephone number for the responsible person for emergency back up care was posted in a visible area close to the telephone.

“Evidence: 1. During the inspection, the telephone number and information for a responsible person for emergency back up care was not listed on the emergency contacts list posted by the provider. 2. The provider acknowledged not having the responsible person for emergency back up care listed.”

Rule 8VAC20-800-790.

Based on review of two caregiver’s records and interview, the assistant caregiver did not obtain a minimum of 16 clock hours of training annually in areas relevant to the job responsibilities.

“Evidence: The assistant had documentation of 3 hours of training in 2023. The provider and the assistant acknowledged that the assistant had not followed through with the annual training requirements.”

Rule 8VAC20-800-210-A.

Based on observation, the provider failed to ensure the license was posted in a conspicuous place.

“Evidence: The provider was not able to locate the license during the inspection.”

Rule 22.1-289.011-F.

Based on observation and interview, the provider failed to ensure areas and equipment of the home, inside and outside, were maintained in a clean, safe and operable condition.

“Evidence: 1.The changing table had visible brown stains and coffee beans were observed underneath the changing pad. 2. During an interview, the provider acknowledged spilled coffee beans were under the changing pad and the changing table was not clean.”

Rule 8VAC20-800-240-A.

Based on observation, the provider did not ensure that the diapering surface was nonabsorbent.

“Evidence: 1.The diaper changing pad on the changing table had tears making it an absorbent surface. 2. Children were observed being diapered on the torn changing pad.”

Rule 8VAC20-800-690-D.

Based on review of documentation and interview, the provider failed to practice monthly evacuation drill.

“Evidence: 1. The practice evacuation drills documented for 2023 did not include an evacuation drill for July 2023. 2. During an interview, the provider acknowledged the last drill was conducted on 6/19/2023.”

Rule 8VAC20-800-830-A.

Based on record review and interview, the provider failed to ensure a sworn disclosure statement and criminal history record check was completed for one household member within 30 days of the person turning 18 years old.

“Evidence: 1. Household member #1 became 18 years of age on 4/6/2023 and did not have documentation of a sworn disclosure statement or criminal history record check. 2. During an interview with the provider, household member #1’s birthdate was confirmed as correct and the provider acknowledged the sworn disclosure statement and criminal history record check has not been completed.”

Rule 8VAC20-770-40-D-4-a.

Based on record review and interview, the provider did not ensure to obtain a current Report of Tuberculosis Screening published by the Virginia Department of Health or a form consistent with it documenting the absence of a communicable form for adult household member prior to coming into contact with children.

“Evidence: 1. The record for adult household member #1 did not contain documentation of a tuberculosis screening. 2. During an interview with the provider, it was acknowledged that a tuberculosis screening has not been conducted.”

Rule 8VAC20-800-170-A.

Based on documentation reviewed and interview, the Provider failed to ensure all household pets (dogs or cats) are vaccinated for rabies and treated for fleas, ticks or worms as needed.

“EVIDENCE: 1. The provider’s 3 dogs were observed in the backyard. 2. Vaccinations for the 3 dogs expired on 2/15/2023. 3. During an interview, the provider confirmed the vaccinations were expired.”

Rule 8VAC20-800-460-C.

Based on record review and interview, the provider failed to annually review contact information for 3 children to ensure the information was correct.

“Evidence: 1 Child #1(start date 8/30/21), Child #4 (start date 6/22/20) and child #5 (start date 7/2/19) did not document annual reviews for 2022 to ensure emergency contact information was correct. 2. During an interview with the provider, it was acknowledged that the annual reviews were not completed.”

Rule 8VAC20-800-780-B.

Based on review of caregiver records, the provider did not obtain for each caregiver a current tuberculosis screening every two years from the date of the first screening.

“Evidence: The record of caregiver #2 contained documentation of a tuberculosis screening dated 10/20/2019, exceeding two years.”

Rule 8VAC20-800-180-A.

Based on review of caregiver records and interview, the provider did not ensure in addition to first aid and CPR training, caregivers obtained a minimum of 16 hours of training annually.

“Evidence: 1. The provider had documentation of three hours of training completed during the training period. The provider stated she could not locate her own record containing her remaining training hours for the year of September 17, 2021 through September 16, 2022. A total of 13 hours was missing. 2. The record of caregiver #2 contained documentation of 3 hours of annual training for the period 03/03/2021- 03/02/2022. A total of 13 hours was missing.”

Rule 8VAC20-800-210-A.

Based on observation, the provider did not ensure potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, disinfectants and deodorizers were stored in area inaccessible to children.

“Evidence: Two canisters of cleaning agents were observed under the bathroom sink in the unlocked cabinet. The bathroom is used by children in care.”

Rule 8VAC20-800-280.

Based on observation, the provider did not ensure child-resistant protective covers were installed on all unused electrical outlets and surge protectors accessible to children under five years of age.

“Evidence: Two electrical outlets located in the living room where children were in care did not have protective covers installed.”

Rule 8VAC20-800-320-B.

Based on interview, the provider did not have a landline telephone available, operable, and accessible during the family day home’s hours of operation.

“Evidence: The provider stated she did not have a telephone in the home but did have service for one.”

Rule 8VAC20-800-330-A.

Based on review of four children’s records, the provider did not obtain documentation that a child had been adequately immunized before a child attended the family day home.

“Evidence: 1. The record of child #1, enrolled 05/23/2022, contained documentation of immunizations dated 05/25/2022, exceeding the first day of enrollment. 2. The record of child #2, enrolled 08/15/2022, contained documentation of immunizations dated 08/23/2022, exceeding the first day of enrollment 3. The record of child #3, enrolled 09/06/2022, contained documentation of immunizations dated 09/12/2022, exceeding the first day of enrollment”

Rule 8VAC20-800-90-A.