Zuhra Hashemi

All staff shall have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall have an in-person competency demonstration.

“Staff #4’s CPR certification has been expired for four months.”

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

Caregivers who work directly with children shall complete the department’s annual health and safety update course.

“Staff #1 and Staff #2 did not have documentation of completing the annual health and safety update course.”

Rule 8VAC20-790-250-F.

Repeat Violation

“The provider shall obtain documentation signed by a licensed physician, the physician’s designee, or an official of a local health department that includes dates immunizations were received for all children by date of enrollment. Child #1 did not have immunization records on file that were signed by a physician, physician’s designee, or an official of a local health department.”

Rule 8VAC20-800-110-B.

Children under two years of age shall not have access to stairs.

“Children, age two and younger, were able to access the stairs leading upstairs on numerous occasions during the inspection when the gate was left open by a caregiver and later the children were able to open it by themselves and went to play on the stairs.”

Rule 8VAC20-800-430-A.

Infant walkers shall not be used.

“A child was observed moving around the space in an infant walker during the inspection.”

Rule 8VAC20-800-540-B.

The provider shall ensure that a caregiver does not exceed 16 points by using the point system outlined in the standards to determine if an additional caregiver is needed.

“There were 12 enrolled children and one resident child present at the time of inspection ranging in age from seven months to three years old with a total of 36 points. There were two caregivers present, with each caregiver having 18 points.”

Rule 8VAC20-800-570-A.

Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours confined in a crib, play pen, high chair or other confining piece of equipment.

“Child #1 was confined in a rocker and Child #2, Child #4 and Child #5 were confined in a play pen for the duration of the inspection, approximately one hour and 30 minutes.”

Rule 8VAC20-800-600-B.

Caregivers shall use positive methods of discipline. Discipline shall be constructive in nature and include techniques such as using limits that are consistently applied, providing children with reasons for limits, and modeling/redirecting children to acceptable behavior.

“Staff #1 was observed offering a cell phone to watch a video to Child #6 and offering snacks on multiple occasions when they were engaging in inappropriate behavior. In addition, multiple children were observed climbing on tables and cribs repeatedly without redirection. Other times, Staff #1 would lift the child up and move them to another area with no words.”

Rule 8VAC20-800-630-A.

Infants who cannot hold their own bottles shall be picked up and held for bottle feeding. Bottles shall not be propped.

“Staff #2 propped a bottle up for Child #1, age seven months, who was seated in a rocker.”

Rule 8VAC20-800-960-B.

The provider shall obtain documentation signed by a licensed physician, the physician’s designee, or an official of a local health department that includes dates immunizations were received for all children by date of enrollment.

“Child #4 has attended the program for two weeks and did not have immunization records on file that were signed by a physician, physician’s designee, or an official of a local health department.”

Rule 8VAC20-800-110-B.

The provider is required to obtain a completed sworn statement prior to the employee’s first day of employment.

“Staff #3 and Staff #4 who were caring for children at the time of inspection did not have a signed sworn statement or affirmation on file.”

Rule 22.1-289.035-B-1. From a complaint.

Providers must obtain a completed national criminal background check prior to the employee’s first day of employment.

“Staff #3 and Staff #4, who were caring for children at the time of inspection, did not have a completed national criminal background check on file.”

Rule 22.1-289.035-B-2. From a complaint.

The provider shall ensure assistants are at least 16 years of age or older.

“Staff #3 was caring for children at the time of inspection and was under 16 years of age.”

Rule 8VAC20-800-150-A. From a complaint.

Repeat Violation

“The provider shall obtain from each caregiver at the time of hire documentation of a negative Tuberculosis (TB) test or screening. Staff #3, who was caring for children at the time of inspection, did not have TB test or screening on file.”

Rule 8VAC20-800-170-A. From a complaint.

Repeat Violation

Rule 8VAC20-800-40-A. From a complaint.

Children under two years of age and children over two years of age who are developmentally ready to climb or descend stairs without supervision shall not have access to stairs.

“Staff #2 forgot to close the gate at the bottom of the stairs when going upstairs. Two children under age 2 began to ascend the stairs before the other staff noticed and went to intervene.”

Rule 8VAC20-800-430-A. From a complaint.

When being used for sleeping or napping children, cots shall have linens consisting of a top cover and a bottom cover or a one-piece covering that is open on three edges.

“Nine children were observed resting on cots and did not have top covers.”

Rule 8VAC20-800-530-A. From a complaint.

Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours confined in a crib.

“Child #7 (Age 15 months) was awake from nap and standing up hanging over the side of the crib for approximately 45 minutes before the provider removed the child from the crib at the Inspector’s request.”

Rule 8VAC20-800-600-B. From a complaint.

The following acts or threats thereof are forbidden: Enclosure in a small, confined space or any space that the child cannot freely exit themself.

“Child #6 (Age 2) kept leaving their cot during rest time and Staff #1 placed Child #6 in a crib so they could not freely exit. Staff #1 said Child #6 needed to be confined so they won’t scratch other children.”

Rule 8VAC20-800-640-2. From a complaint.

The following acts or threats thereof are forbidden: withholding or forcing of food, water, or rest.

“At the time of inspection, Staff #1 stated to a child “If you not sleep, no more snacks” and later stated to another child “If you want snacks then go to sleep.””

Rule 8VAC20-800-640-4. From a complaint.

Family Day Home Providers shall have current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

“The provider’s CPR certification has been expired for over one month.”

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

The provider shall obtain for each caregiver documentation of a negative Tuberculosis (TB) screening or test at least every two years or more frequently as recommended by a physician or the local health department.

“Staff #2’s updated TB screening was overdue by two weeks and has not yet been completed.”

Rule 8VAC20-800-180-A.

The provider shall ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home.

“The provider’s licensed capacity is 12 children. There were 13 enrolled children present throughout the inspection.”

Rule 8VAC20-800-40-A.

Repeat Violation

“Children’s records shall contain all required information. Child #4 and Child #5’s documentation of the required parental annual review of the child’s emergency contact information was overdue by four months.”

Rule 8VAC20-800-60-B.

Before the child’s first day of attendance, parents shall be provided required written information regarding the family day home’s policies and procedures.

“Child #3 has been enrolled for four months and did not have documentation on file that the parent’s were provided the provider’s policy regarding the administration of medication.”

Rule 8VAC20-800-70-A.

The provider shall obtain documentation that the child has been adequately immunized according to the requirements of the Code of Virginia and applicable State Board of Health regulations.

“Child #7 has attended the program for two days and did not have immunizations on file.”

Rule 8VAC20-800-90-A.

The provider must obtain the results of a central registry search within 30 days of employment for all staff.

“Staff #2 has been employed at the family day home for over 18 months and did not have central registry results on file.”

Rule 22.1-289.035-B-3.

The provider must obtain a completed sworn disclosure statement by the end of the 30th day of residing in the home for all adult household members.

“Adult Household Member #2 has resided in the home for approximately five months and did not have a completed sworn disclosure statement on file.”

Rule 22.1-289.036-B-1.

The provider must obtain the results of a central registry search within 30 days of residing in the home for all adult household members.

“Adult Household Member #2 has resided in the home for approximately five months and did not have central registry search results on file.”

Rule 22.1-289.036-B-3.

The provider shall obtain documentation a physical examination for all children prior to a child’s attendance or within 30 days after the first day of attendance.

“Child #4, attending the program for over five months, did not have a physical examination on file. Child #5, attending the program for over two months, did not have a physical examination on file. Child #6, attending the program for over three months, did not have a physical examination on file. Child #7, attending the program for over four months, did not have a physical examination on file.”

Rule 8VAC20-800-100-A.

The provider must obtain a tuberculosis screening documenting the absence of communicable tuberculosis for all adult household members.

“Adult Household Member #2 has resided in the home for approximately five months and does not have a tuberculosis screening on file.”

Rule 8VAC20-800-170-A.

The provider must ensure that equipment used by children is used in accordance with the manufacturer’s instructions.

“Two children were observed seated in high chairs with the shoulder and lap buckle not fastened. In addition, two children were observed in swings with only their lap buckles fastened and their shoulders were not strapped in.”

Rule 8VAC20-800-480-D.

The provider shall not use cribs with mesh sides.

“Two infants, at different times during the inspection, were placed into a pack and play crib with mesh sides to nap.”

Rule 8VAC20-800-520-C.

The provider shall ensure cribs have a tight-fitting bottom cover when being used by infants.

“An infant was observed resting in a crib with no sheet covering the crib mattress. This infant was moved to another area during the inspection and then a second infant was placed into the same crib with no sheet.”

Rule 8VAC20-800-530-B.

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

“At the time of inspection, the point total was 36 with 13 children ages 8 months to 3 years in care. There were two caregivers present, each with 18 points.”

Rule 8VAC20-800-570-A.

Repeat violation

“The provider ensure children’s records contain names, addresses, and phone numbers for two emergency contacts. Child #6 has attended the program for over three months and was missing two addresses for their emergency contacts. Child #7 has attended the program for over four months and was missing a second emergency contact name, address, and phone number.”

Rule 8VAC20-800-60-B.

Based on observation, children under two years of age had access to stairs.

“Evidence: Three children under the age of two years were present at the time of inspection and there was no gate at the bottom of the stairs leading into the programming space where the children were playing.”

Rule 8VAC20-800-430-A.

Repeat violation

“Based on record review, the provider did not ensure that children’s records contained all required information. Evidence: Child #1’s record was missing two emergency contact names, addresses, and phone numbers, the medical insurance policy number, and the parent’s signed acknowledgement of the receipt of the information on the information for parents form.”

Rule 8VAC20-800-60-B.

Based on observation, the provider did not ensure that children’s hands are washed with liquid soap and warm running water before eating.

“Evidence: 6 children transitioned from free play activities to eating lunch without first washing their hands before beginning to eat.”

Rule 8VAC20-800-680-B.

Based on record review, the provider did not obtain the results of a Virginia Child Abuse and Neglect Central Registry search for all staff within 30 days of employment.

“Evidence: Staff #2 (Date of Hire: 5/1/2023) did not have Virginia Child Abuse and Neglect Central Registry search results on file at the time of inspection.”

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

Based on record review, the provider did not obtain documentation that two or more references as to character and reputation as well as competency were checked before employment for all staff.

“Evidence: Staff #2 (Date of Hire: 5/1/2023) had only one reference check on file at the time of inspection.”

Rule 8VAC20-800-120-B.

Based on observation and documentation review, the provider did not ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home.

“Evidence: There were 10 enrolled children and 1 resident child present at the time of inspection. The current licensed capacity for the family day home is 8 children.”

Rule 8VAC20-800-40-A.

Repeat violation

“Based on observation and record review, the provider did not ensure that a caregiver does not exceed 16 points by using the supervision point system to determine if an additional caregiver is needed. Evidence: 10 enrolled children and 1 resident children ranging in age from 5 months to 4 years old (34 points) were present with 2 caregivers at the time of inspection.”

Rule 8VAC20-800-570-A.

Based on a review of two household member records, the provider did not obtain documentation of a completed sworn disclosure statement for each household member over the age of 18 years old.

“Evidence: The record for household member #1 did not contain documentation of a completed sworn disclosure statement.”

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

Based on a review of two household member records, the provider did not obtain documentation of the results of a central registry search for household members 14 years and older.

“Evidence: The record for household member #2 did not contain documentation of the results of a search of central registry at the time of inspection.”

Rule 8VAC20-770-40-D-5-a.

8VAC20-800-170-A

“Based on a review of two household member records the provider did not obtain an Initial tuberculosis screening for household members. Evidence: The record for household member #1 did not have documentation of tuberculosis testing or screening at the time of inspection.”

Rule 8VAC20-800-170-A.

Based on a review of staff records the provider did not obtain subsequent tuberculosis (TB) screening every two years from the date of the initial screening.

“Evidence: The last documented TB test for Staff #1 is dated 8/5/20”

Rule 8VAC20-800-180-A.

Based on observation the provider did not ensure the family day home was in a clean safe and operable condition.

“Evidence: At the time of the inspection the Licensing Inspector observed an area rug covering wood flooring in disrepair. One board was missing and several unsecured boards remained in the cavity covered by the area rug, causing a loss of balance when walked across.”

Rule 8VAC20-800-240-A.

Based on observation the provider did not ensure small electrical appliances were unplugged when not in use.

“Evidence: During the inspection the bottle warmer was plugged in with the power button on for approximately 45 minutes when not in use.”

Rule 8VAC20-800-320-A.

Based on observation the provider did not ensure that pressure mounted gates were not used as protective barriers at stair openings.

“Evidence: A pressure mounted gate was installed at the bottom of the stairway to prevent access to stairs.”

Rule 8VAC20-800-430-B.

Based on review of the written attendance record and interview with the provider, the provider did not ensure all children were included on the written attendance record.

“Evidence: At approximately 9:00 a.m. on 6/6/23 the attendance record did not contain documentation of five children in care. The attendance record dated 6/5/23 did not contain documentation of children in care, the provider confirmed there were children in care on this date.”

Rule 8VAC20-800-50-A.

Based on observation the provider did not ensure infant swings were used according to the manufacturer’s instructions. Evidence: 1. Child #4, 2 years old, was observed seat belted in an infant swing. The child was crying and leaning forward.

“2. The manufacturer’s warning label on the base of the swing stated ?Stop using this product when the baby can climb?”

Rule 8VAC20-800-540-A.

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

“Evidence: At the time of inspection there were six children present, ranging in age from 4 months to 2 years that totaled twenty points with one caregiver.”

Rule 8VAC20-800-570-A.

Based on observation of children, infants who cannot hold their own bottles shall be picked up and held for bottle feeding. Bottles shall not be propped.

“Evidence: During the inspection, Child #3, an infant, was observed in an infant swing with a bottle propped using blankets. Child #3 is 3 months and can’t hold their own bottle”

Rule 8VAC20-800-960-B.

Based on record review and provider interview, the provider did not maintain a written hard copy record of daily attendance that documents the arrival and departure of each child in care as it occurs.

“Evidence: There were 5 children present at the time of inspection and attendance had not been done yet for the day. After an interview with the provider, the attendance record was updated at approximately 12:04pm documenting the arrival of the 5 children between 7:30am and 8:00am today.”

Rule 8VAC20-790-180-B.

Based on interview, the provider has not ensured that there is at east one carbon monoxide detector installed at the family day home.

“Evidence: There was no carbon monoxide detector present at the time of inspection.”

Rule 22.1-289.058.

Based on record review, the provider did not obtain a physical examination prior to a child’s attendance or within 30 days after the first day of attendance for all children.

“Evidence: Child #3 (Start Date: 1/24/22) did not have a physical examination on file.”

Rule 8VAC20-800-100-A.

Based on record review, the provider did not ensure that children’s records contained all required information.

“Evidence: Child #1 and Child #4 were both missing an address for 1 of 2 required emergency contacts.”

Rule 8VAC20-800-60-B.

Based on record review, the provider did not maintain documentation of an annual review of the emergency preparedness and response plan.

“Evidence: The emergency preparedness and response plan was last reviewed on 7/19/2020 as documented on the plan.”

Rule 8VAC20-800-800-B.

Based on record review and provider interview, the provider did not ensure that emergency evacuation drills are practiced monthly with all caregivers and children in care.

“Evidence: Emergency evacuation drills were not done in September 2021 or October 2021.”

Rule 8VAC20-800-830-A.