Country Day Care

Annual approval from the health department shall be provided, or approvals of a plan of correction, for meeting requirements for: 1. Water supply; 2. Sewage disposal system; and 3. Food service, if applicable.

“The center’s annual report of environmental sanitation inspection was five months overdue.”

Rule 8VAC20-780-260-B.

Repeat violation

“Over-the-counter skin products shall not be kept or used beyond the expiration date of the product. Child #5 had a diaper ointment that had expired over one month ago.”

Rule 8VAC20-780-520-A.

The center shall notify the parent by the end of the day of any known minor injuries.

“Child #6 and Child #7 had written injury reports which indicated that the parents were notified in person one day after the date the minor injuries occurred.”

Rule 8VAC20-780-550-O.

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, enrolled for over 16 months, has diagnosed food allergies and did not have a written care plan in their file.”

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

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

“The updated training for Staff #2 was over one month late, and had not been completed.”

Rule 8VAC20-790-600-F.

Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment.

“Staff #1, employed for four months, had a TB screening that was dated over 6 months prior to the date of employment.”

Rule 8VAC20-780-160-A.

The center is required to keep a current list of all known allergies, sensitivities, and dietary restrictions in each room or area where children are present. The list must be dated and kept confidential.

“An undated list in the toddler room was posted by the refrigerator in plain sight.”

Rule 8VAC20-780-40-M.

Medication shall be kept in a locked place using a safe locking method that prevents access by children.

“In the infant classroom, a prescription diaper cream was kept in an unlocked bin on a shelf that was inaccessible to the children in care.”

Rule 8VAC20-780-510-L.

Nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product.

“In the infant room, child #1 had a diaper cream that had expired in 2023. In the toddler room, child #2 had a diaper cream that had expired in 2017.”

Rule 8VAC20-780-520-A.

Repeat violation

“Physical examinations completed by a physician shall be obtained prior to the first day of attendance or within 30 days after the first day of attendance. There was no physical examination in the record of child #2 and child #4, who had both been enrolled for over 5 months.”

Rule 8VAC20-780-140-A.

If diaper ointment or cream is used, written parent authorization noting any known adverse reactions shall be obtained.

“Child #5 did not have written parent authorization for their diaper ointment.”

Rule 8VAC20-780-520-C.

The center shall maintain a written record of children’s serious and minor injuries in which entries are made the day of occurrence. The record shall include the following: 1. Date and time of injury; 2. Name of injured child; 3. Type and circumstance of the injury; 4. Staff present and treatment; 5. Date and time when parents were notified; 6. Any future action to prevent recurrence of the injury; 7. Staff and parent signatures or two staff signatures; and 8. Documentation on how parent was notified.

“An injury report for child #9 was missing one required signature, the date the parent was notified, and how the parent was notified.”

Rule 8VAC20-780-550-P.

Based on a review of five child records and interview, the center did not ensure that one child had a physical examination by or under the direction of a physician: 1. Before the child’s attendance; or 2. Within 30 days after the first day of attendance.

“Evidence: 1. The record of child #2 (date of enrollment: 5/28/2024) did not contain a physical. 2. Administration acknowledged that a physical record was not obtained.”

Rule 8VAC20-780-140-A.

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

“Evidence: 1. Six swings were observed on the preschool playground that had rust on the chain supports that the children hold. 2. Administration acknowledged that the rusted swings required maintenance.”

Rule 8VAC20-780-270-A.

Based on interview, the center did not ensure that diapering surfaces were cleaned and sanitized after each use.

Rule 8VAC20-780-500-B.

Based on interview, the center did not ensure that tables were sanitized before and after each use for feeding as required.

“Evidence: 1. In interview, staff #3 (three and four year old room) stated that she had been recently using sanitizing wipes to clean the tables and the sanitizing spray bottle had not been filled. Staff #5 (school age room) stated that she had been wiping the tables but had not been utilizing the sanitizing spray. 2. Administration acknowledged that the tables had not been sanitized properly.”

Rule 8VAC20-780-560-J.

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

“Evidence: 1. Chipped and peeling paint was observed on a half door in the infant room. 2. Administration acknowledged that the area required maintenance.”

Rule 8VAC20-780-270-A.

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

“Evidence: 1. In the two year old classroom, 2 cans of Lysol disinfectant, one spray bottle of Odoban, and one container of Lysol wipes were observed unlocked on top of the refrigerator. 2. Administration acknowledged that the cleaners/sanitizers were not locked.”

Rule 8VAC20-780-280-B.

Based on a review of five staff records and interview, the center not ensure that two staff had a repeat fingerprint background check every five years as required.

“Evidence: 1. The record of staff #1 (date of employment: 2/24/2014) contained a fingerprint background check dated 7/19/2018. The record of staff #4 (date of employment: 7/27/2018) contained a fingerprint background check dated 7/26/2018. 2. Administration acknowledged that the repeat background checks were missing from the records.”

Rule 22.1-289.035-A.

REPEAT VIOLATION Based on a review of five child records and interview, the center did not ensure that one child had a physical examination by or under the direction of a physician: 1. Before the child’s attendance; or 2. Within 30 days after the first day of attendance.

“Evidence: 1. The record of child #2 (date of attendance: 1/22/2023) contained a physical dated 8/25/2023. 2. Administration acknowledged that the physical record was not received within the required time frame.”

Rule 8VAC20-780-140-A.

REPEAT VIOLATION Based on a review of five child records and interview, the center did not ensure that a record was kept for one child that contained the required information.

“Evidence: 1. The record of child #1 (date of attendance: 5/11/2023) did not contain documentation of viewing proof of the child’s identity and age. 2. Administration acknowledged that the documentation was missing from the record.”

Rule 8VAC20-780-60-A.

Based on a review of documentation and interview, the center did not ensure that when staff are supervising children; they always ensured their care and protection.

Rule 8VAC20-780-340-A.

Based on a review of documentation and interview, the center did not ensure that children under 10 years of age were always within actual sight and sound supervision of staff.

“Evidence: 1. On 9/1/2023, child #1, age 4, was determined to be out of the sight and sound of staff for approximately 25 minutes. During that time, child #1 left the premises of the center and was located on a busy street by several witnesses. Local law enforcement was called to assess the situation and approve the transfer of care from witness #1 to the center. 2. Administration acknowledged that child #1 was not within actual sight and sound supervision of staff.”

Rule 8VAC20-780-340-F.

Based on interviews, the center did not ensure that when children are in ongoing mixed age groups, the staff-to-children ratio and group size applicable to the youngest child in the group applied to the entire group.

“Evidence: 1. In interviews, two staff stated that the two-year old class often combined with preschool aged children on the playground in the afternoon. Staff acknowledged that when combined on numerous occasions, including the afternoon of the incident 9/1/2023, they exceeded the required two-year old ratio of one staff to eight children (1:8). Staff stated that there were occasions where they had two staff and over 20 children, ranging in age from two years to five years.”

Rule 8VAC20-780-350-C.

Based on review of documentation and interview, the center did not ensure that their activities and services were maintained in compliance with the center’s own policies and procedures that are required by these standards.

Rule 8VAC20-780-40-E.

REPEAT VIOLATION Based on records review and interview, the center did not ensure that one child’s record contained the required information.

“Evidence: 1. The record of child #1 (date of enrollment: 3/6/2023) did not contain a second complete emergency contact. Children’s records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged the emergency contact information was incomplete.”

Rule 8VAC20-780-60-A.

Based on a review of records and interview, the center did not ensure to maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurred.

“Evidence: 1. Upon review of attendance records from 9/1/2023, staff stated that several children were signed out over an hour after departure. 2. Administration acknowledged that there were times when children were not signed out immediately as they departed for the day.”

Rule 8VAC20-780-80-A.

Based on a review of five (5) staff records and interview, the center did not ensure to obtain the required out of state background checks for one (1) staff.

Rule 22.1-289.035-B-4.

Based on a review of five (5) staff records and interview, the center did not ensure to obtain documentation of a negative tuberculosis screening for on (1) staff at the time of employment and prior to coming into contact with children.

“Evidence: 1. The record of staff #1 (date of employment: 12/01/2022) contained a TB screening dated 12/02/2022. 2. Administration acknowledged that the negative screening results were received after the start of employment.”

Rule 8VAC20-780-160-A.

Based on a review of five (5) staff records and interview, the center did not ensure to obtain the results a follow up tuberculosis screening for one (1) staff at least every two years from the date of the first initial screening or testing as required.

“Evidence: 1. The record of staff #5 contained a TB screening dated 12/25/20. 2. Administration acknowledged that they had not obtained a follow up screening from staff #5.”

Rule 8VAC20-780-160-C.

Based on observation and interview, the center did not ensure to maintain the required staff to child ratio of one (1) staff to 10 children for children three years of age to school age eligible.

“Evidence: 1. On 5/3/2023, 24 children were observed in the care of two (2) staff for approximately 10 minutes. The children ranged in age from 3 to 10 years. 2. Administration acknowledged that the classroom was four (4) children over ratio for the 10 minutes due to a staff member calling out sick.”

Rule 8VAC20-780-350-B-4.

Based on a review of five (5) staff records and interview, the center did not ensure that two (2) staff had a central registry finding within 30 days of employment as required.

“Evidence: 1. The record of staff #1 (date of employment: 5/12/2022) contained a central registry finding dated 6/14/2022. The record of staff #3 (date of employment: 10/31/2022) did not contain a central registry finding. 2. Administration acknowledged that the findings had not been received within 30 days of employment.”

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

Based on a review of five (5) child records and interview, the center did not ensure one (1) child had a physical examination by or under the direction of a physician: 1. Before the child’s attendance; or 2. Within 30 days after the first day of attendance.

“Evidence: 1. The record of child #2 (date of attendance:10/3/2022) did not contain documentation of a physical examination. 2. Administration acknowledged that the physical was not obtained.”

Rule 8VAC20-780-140-A.

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

“Evidence: 1. Rusting was observed on both sides of a bathroom stall located in the children’s hallway bathroom. The rust was located in an area accessible to children. 2. Administration acknowledged that the areas required maintenance.”

Rule 8VAC20-780-270-A.

Based on observation and interview, the center did not ensure that where playground equipment is provided, resilient surfacing complied with minimum safety standards.

“Evidence: 1. A climber with a slide was observed on the toddler playground. The slide required resilient surfacing. No surfacing was observed under the equipment. 2. Administration acknowledged that the equipment required resilient surfacing.”

Rule 8VAC20-780-330-B.

Based on a review of five (5) child records and interview, the center did not ensure that two (2) records contained the required information.

“Evidence: 1. The record of child #1 (date of enrollment: 10/3/2022) did not contain the required emergency contact information. The record of child #4 (date of enrollment: 9/6/2022) was missing the addresses for the two (2) emergency contacts. The records are required to contain the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 2. Administration acknowledged that the records were incomplete.”

Rule 8VAC20-780-60-A.

Based on record review and interview, the center did not ensure to obtain the results of a central registry background check for one staff within 30 days of employment as required.

“Evidence: 1. The record of staff #3 (DOH: 11/18/2021) contained central registry results dated 1/8/2022. 2. Administration acknowledged that the finding was not received within the required time frame.”

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

Based on record review and interview, the center did not ensure to obtain documentation that each child had received the immunizations required by the State Board of Health before the child attended the center as required.

“Evidence: 1. The record of child #1 (DOE: 1/31/2022) contained an immunization record dated 2/1/2022. 2. Administration acknowledged that the immunizations were received late.”

Rule 8VAC20-780-130-A.

Based on record review and interview, the center did not ensure to obtain documentation of a tuberculosis (TB) screening at the time of employment and prior to coming into contact with children for each staff as required.

“Evidence: 1. The record of staff #3 (DOH: 11/18/2022) contained documentation of a TB screening dated 12/2/2021. 2. Administration acknowledged that the TB screening was obtained after the first date of employment.”

Rule 8VAC20-780-160-A-1.