The Nest Academy of Cameron

8VAC20-780-60-A-8

“A written care plan is required 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. Child #5, who has been enrolled for five weeks, has a diagnosed food allergy and did not have a written care plan in their file.”

Rule 8VAC20-780-60-A-8.

Based on observation, hazardous substances such as cleaning materials, insecticides, and pesticides were not kept in a locked place using a safe locking method that prevents access by children.

“Evidence: 1. In the combined caterpillars and butterflies classroom, two bleach spray bottles labeled strong and mild, as well as Windex, were kept in an unlocked cabinet. 2. In the combined caterpillars and butterflies classroom, a bottle of cleaning solution was kept in an unlocked cabinet under the bathroom sink.”

Rule 8VAC20-780-280-B.

8VAC20-780-160-B

“Based on records reviewed, the licensee failed to ensure that 1 of 2 staff records included an acceptable form of documentation of a TB screening. Evidence: Staff #3-The TB test submitted does not include a patient name on the document.”

Rule 8VAC20-780-160-B.

Based on records reviewed, the licensee has failed to ensure that individuals working as a program director meet the minimum qualifications.

“Evidence: 1. Staff #2 has been working in the program director role intermittently for a period of years and the documentation submitted does not qualify them for the position of program director. 0 of 4 qualification options were met. 2. Staff #3 has been working in the program director role since 3/31/23-to-date, and the documentation submitted does not qualify them for the position of program director. 0 of 4 qualification options were met.”

Rule 8VAC20-780-190-A.

Based on records reviewed, it was determined that an out-of-state background search did not include required information.

“Evidence: 1. The sex offender search for Staff #2 did not include the staff person’s name and date of search.”

Rule 22.1-289.035-B-4.

Based on records reviewed, it was determined that 1 of 4 staff records did not include a completed central registry search (CRS) within 90-days of employment.

“Evidence: 1. Staff #4 was hired 7/21/22. The CRS was dated as completed 2/23/22.”

Rule 8VAC20-770-40-D-6.

Based on records reviewed, it was determined that 1 of 4 staff records did not include true information on the sworn disclosure statement.

“Evidence: 1. Staff #4 ? The sworn disclosure statement dated 1/6/23 stated ?no? to having lived out of the State of Virginia in the previous 5 years. 2. The job application submitted by Staff #4 indicated otherwise.”

Rule 8VAC20-770-60-B.

Based on records reviewed, it was determined that 1 of 4 staff records did not include true information on the sworn disclosure statement.

“Evidence: 1. Staff #4 ? The sworn disclosure statement dated 1/6/23 stated ?no? to having lived out of the State of Virginia in the previous 5 years. 2. The job application submitted by Staff #4 indicated otherwise.”

Rule 8VAC20-770-60-B.

Based on records reviewed, it was determined that 2 of 4 staff records did not include a TB screening at the time of employment and prior to coming into contact with children that was completed within 30-calendar days prior to the date of employment.

“Evidence: 1. Staff #4 ? Date of employment 7/21/22. Date of TB screening 2/4/22. 2. Staff #5 ? Date of employment 9/20/22. Date of TB screening 8/2/21.”

Rule 8VAC20-780-160-A.

Based on records reviewed and interviews conducted, it was determined that Staff #5 who has been working as the program director does not meet any of the 4 program director qualification options.

Rule 8VAC20-780-190-A.

Based on records reviewed, it was determined that there was no documentation of additional education and training for a program director without management experience.

“Evidence: 1. There was no documentation of previous management experience for Staff #5. 2. There was no documentation that Staff #5 had completed at least one college course in a business-related field, nor was there documentation that the program director had received 10-hours of management training, or that Staff #5 had completed one child care management course that covers planning, budgeting, staffing, and monitoring.”

Rule 8VAC20-780-190-B.

Based on records reviewed, it was determined that there was no documentation of additional education and training for a program director without management experience.

“Evidence: 1. There was no documentation of previous management experience for Staff #5. 2. There was no documentation that Staff #5 had completed at least one college course in a business-related field, nor was there documentation that the program director had received 10-hours of management training, or that Staff #5 had completed one child care management course that covers planning, budgeting, staffing, and monitoring.”

Rule 8VAC20-780-190-B.

Based on records reviewed, it was determined that there was no documentation that 1 of 2 staff working as a program leader (lead teacher) had received required training within 6 months prior to being promoted or beginning work, or one month after being promoted or beginning work.

“Evidence: 1. 1. Staff #6 began working as a lead teacher on 11/28/22. 2. There was no documentation that Staff #6 had received 24 hours of training related to the care of children. 3. On 4/4/23, the inspector received an email from the owners that included documentation that Staff #6 received 16 hours of training related to the care of children.”

Rule 8VAC20-780-210-A-4-a.

Based on observations made it was determined that there was not at least 12? of space between occupied cots.

“Evidence: 1. In 1 of 2 classrooms where children were napping on cots, there were 3 occupied cots pushed together. 2. There was no space for staff to walk between the cots.”

Rule 8VAC20-780-440-E.

Based on records reviewed and interviews conducted, it was determined that 3 of 4 staff records did not include required documentation.

Rule 8VAC20-780-70.

Based on records reviewed and interviews conducted, it was determined that 3 of 4 staff records did not include required documentation.

Rule 8VAC20-780-70.

Based on observations made and interview conducted it was determined that the findings of the most recent inspection report were not posted in the facility.

“Evidence: 1. The violation notice from the 9/8/22 inspection was not posted on the premises. 2. The program director did not know where the violation notice might be.”

Rule 8VAC20-820-120-E-2.

8VAC20-790-600-F

“Based on records reviewed, it was determined that 1 of 3 staff records reviewed did not include documentation of the Virginia Health + Safety Training dated as completed within the previous 12 months. Evidence: The training certificate for Staff #1 was dated as completed in 2019.”

Rule 8VAC20-790-600-F.

Based on records reviewed, it was determined that a prescription medication was given to a child by staff that are not currently trained in medication administration.

Rule 8VAC20-780-245-J.

Based on observations made, it was determined that occupied cribs in the infant room did not have a minimum of 30? clearance on the service side.

Rule 8VAC20-780-440-J.

8VAC20-780-550-P

“Based on records reviewed, it was determined that 1 of 6 written injury reports did not document required information. Evidence: An injury report written for Child #3 did not include the time the parent was notified of the injury. The space was left blank.”

Rule 8VAC20-780-550-P.

Based on record review, the provider did not obtain criminal history record results from a state in which the applicant has resided in the preceding five years before a final determination was made of the individual’s eligibility to have responsibility for the safety and well-being of children.

“Evidence: Staff #1 was hired on 9/10/2021. Results of criminal history results from a state where the employee has resided within the previous five years were not obtained prior to employment. Staff#1 was present during the inspection.”

Rule 22.1-289.035-B-4.

Based on record review, a staff’s tuberculosis (TB) test/screening results were not completed within the last 30 calendar days of the date of employment.

“Evidence: Staff #2’s (DOH: 2/28/2022) record contains a TB test/screening that was completed on 6/3/2021.”

Rule 8VAC20-780-160-A-2.

Based on observation, staff-to-children ratios were not maintained in the Infant 1’s classroom.

“Evidence: The Infant 1’s classroom had 5 children with one staff member during the inspection. Upon checking ages of children in the classroom, it was determined that the youngest child is 3 months and the oldest child is 9 months, which requires the group to follow a ratio of 4 children to 1 staff member. An additional staff member was assigned to the classroom shortly after the inspector entered the classroom.”

Rule 8VAC20-780-350-B.

Based on observation, the protective belt was not securely fastened while an infant was sitting in an infant seat.

“Evidence: An infant was observed sitting in a Bumbo seat while eating a cracker, the Bumbo seat had a protective belt, but the child was not buckled into their seat by the caregiver.”

Rule 8VAC20-780-570-A.

Based on record review, the center did not obtain out of state criminal history results and out of state child abuse and neglect registry results for a staff member that has resided outside the state of Virginia in the preceding five years.

“Evidence: Staff #2’s (DOH: 10/01/2021) record did not include criminal history results and abuse and neglect results from a state the employee had resided in within the past five years.”

Rule 22.1-289.035-B-4.

Based on documentation review and interview, the center did not develop and implement a written policy and procedure that describes how the center will ensure that each group of children receives care by consistent staff or team of staff members.

“Evidence: There was no documentation at the center to verify that they have a written policy and procedures that describe how the center will ensure that each group of children receives care by consistent staff or team of staff members.”

Rule 8VAC20-780-350-F.

Based on review of documentation and interview, the center did not develop written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices, and sudden infant death syndrome awareness.

“Evidence: There was no documentation at center to verify that the center has a written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices, and sudden infant death syndrome awareness.”

Rule 8VAC20-780-40-K.