The Learning Experience

8VAC20-780-245-J

“Staff members caring for any child for whom emergency medications have been prescribed must have the appropriate Medication Administration Training. Child A has an emergency seizure nasal spray medication on site, but there are no staff certified in Medication Administration Training - Seizure Rescue Nasal Spray.”

Rule 8VAC20-780-245-J.

8VAC20-780-260-A

“The center shall provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction. The last documented fire inspection was conducted 3/11/2025.”

Rule 8VAC20-780-260-A.

8VAC20-780-500-B

“The diapering surface shall be cleaned with soap and at least room temperature water and sanitized after each use. Staff in the twaddler room cleaned and sanitized the diaper changing table but did not allow the bleach water solution to dry for a period of at least 2 minutes, as required.”

Rule 8VAC20-780-500-B.

8VAC20-790-600-D-1

“All staff who work directly with children shall have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Staff 6 did not have CPR training certificate/training that included in-person competency component.”

Rule 8VAC20-790-600-D-1.

8VAC20-780-410-7

“The following actions or threats thereof are forbidden: punishment for toileting accidents. On May 21, 2026, Child 1 (age 4) told his parents that Staff 1 smacked him on his face because he had a toileting accident and made a mess on the toilet.”

Rule 8VAC20-780-410-7.

8VAC20-780-240-E

“Within 30 days of the first day of employment, staff must complete orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care. There was no documentation of orientation training in first aid and CPR on file for Staff 4, Staff 6, and Staff 7.”

Rule 8VAC20-780-240-E.

8VAC20-780-510-P

“When an authorization for medication expires, the facility shall notify parents that that the medication must be picked up within 14 days of the authorization expiring or that a new authorization should be completed. The medication authorization for Child B expired one month ago. The authorization had not been renewed and the medication was not returned or destroyed as required. The medication was on site.”

Rule 8VAC20-780-510-P.

8VAC20-790-600-D-1

“All staff who work directly with children shall have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration. Staff 1, Staff 2 and Staff 3, Staff 4,Staff 8, and Staff 9 did not have CPR training certificate/training that included in-person competency component.”

Rule 8VAC20-790-600-D-1.

8VAC20-790-600-D-2

“All staff who work directly with children shall have current first aid certification. Staff 1, Staff 2 and Staff 3, Staff 4,Staff 8, and Staff 9 did not have documentation of first aid certification from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council.”

Rule 8VAC20-790-600-D-2.

8VAC20-780-350-B-1

“Systemic Deficiency The required ratio for children ages birth up to 16 months is one staff for every four children. Staff 1 was consistently over ratio in the infant room in the mornings during a period from late November to early January. Staff 1 would regularly have 5 to 6 infants between approximately 7:15 a.m. to 8:15 a.m.”

Rule 8VAC20-780-350-B-1. From a complaint.

8VAC20-780-350-C

“When children are in ongoing mixed age groups, the staff-to-children ratio and group size applicable to the youngest child in the group shall apply to the entire group. Staff 2 was consistently over ratio in the mornings during a period from late November to early January. Staff 2 would regularly have up to 12 children with children ages 16 months to 4 years old between approximately 7:15 a.m. to 8:15 a.m.”

Rule 8VAC20-780-350-C. From a complaint.

8VAC20-780-410-8

“In order to promote the child’s physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort, and support. During water play in July 2025, Staff 1 was observed spraying toddler age children in the face with a hose (hard setting) and dumping buckets of water over children’s heads making them cry.”

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

8VAC20-790-600-D-1

“Staff shall have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care within 90 days of employment. Staff 2 and Staff 10, employed over 90 days, did not have cardiopulmonary resuscitation (CPR).”

Rule 8VAC20-790-600-D-1.

8VAC20-790-600-D-2

“Staff shall have first aid certification within 90 days of employment. Staff 2 and Staff 10 employed for over 90 days, did not have documentation of first aid certification.”

Rule 8VAC20-790-600-D-2.

8VAC20-780-240-B

“Staff shall complete orientation training prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities. Staff 2, employed for 10 months, did not have documentation of orientation on file.”

Rule 8VAC20-780-240-B.

8VAC20-780-510-E

“The center shall ensure that procedures for administering medication shall include methods to prevent use of outdated medication. The emergency medication for one child expired 4/22/2025 and the parent had not been notified that a replacement was needed.”

Rule 8VAC20-780-510-E.

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled which contains required information. Child 10, enrolled for over a month, did not have documentation of the child’s proof of identity and age.”

Rule 8VAC20-780-60-A.

8VAC20-780-510-P

“When an authorization for medication expires, the facility shall notify parents that that the medication must be picked up within 14 days of the authorization expiring or that a new authorization should be completed. The medication authorization for Child A expired 3/2024. The authorization had not been renewed and the medication was not returned or destroyed as required. The medication was on site.”

Rule 8VAC20-780-510-P.

8VAC20-780-70

“The facility failed to have required documentation in each staff file. Two references as to character, reputation, and competence should be checked prior to employment. Staff 2(date of employment 6/17/2024) did not have documentation of two references on file.”

Rule 8VAC20-780-70.

22.1-289.035-B-4

Rule 22.1-289.035-B-4.

8VAC20-780-500-B

“Based on observation, the facility failed to dispose of diapers 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. The bathroom in the older twos had diapers in a trashcan. The trash can did not have a foot pedal or another way that neither the staff member’s hand nor the soiled diaper touches an exterior surface of the storage system during disposal.”

Rule 8VAC20-780-500-B.