The Garden of Children, LTD.

8VAC20-780-570-E

“Prepared infant formula shall be refrigerated, dated and labeled with the child’s name. Child #6 & #7 bottles were not dated.”

Rule 8VAC20-780-570-E.

8VAC20-780-60-A

“Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. The record for Child #4, enrolled for two months, was missing the name and phone number of the child’s physician, a 2nd emergency contact, and a physical.”

Rule 8VAC20-780-60-A.

8VAC20-780-130-A

“The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. Child #3, who had been attending for four months, did not have documentation of an immunization record on file.”

Rule 8VAC20-780-130-A.

8VAC20-780-140-A

“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. Child #3, who had been attending for four months, did not have documentation of a physical examination on file.”

Rule 8VAC20-780-140-A.

8VAC20-780-240-A

“The Virginia Department of Education-sponsored orientation course shall be completed within 90 calendar days of employment. Staff #1, employed for seven months, has not completed this training.”

Rule 8VAC20-780-240-A.

8VAC20-780-270-A

“Areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. In one of the children’s bathrooms there was a section of tile that was chipped up creating an uneven surface that was a tripping/slipping hazard. There were also several rugs in the classroom that were curled up on the corners also causing tripping hazards.”

Rule 8VAC20-780-270-A.

Based on documentation review and staff interviews, the licensee did not ensure to obtain an annual approval from the health department.

“Evidence: Center Director confirmed the most recent copy of the health inspection available for review was dated 1-6-2023.”

Rule 8VAC20-780-260-B.

Based on observation and staff interviews, the licensee did not ensure. Areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin.

Rule 8VAC20-780-270-A.

Based on record review, observation and staff interviews, the licensee did not ensure there shall be in each grouping of children at least one staff member who meets the qualifications of a program leader or program director.

“Evidence: Staff #1 was the only staff on the infant playground supervising 3 infant children and there was not documentation indicting they meet the qualifications for program leader.”

Rule 8VAC20-780-340-D.

Based on documentation review and provider interview the licensee did not ensure that for each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.

“Evidence: The following groups of children did not have adequate attendance sheets; 1.Staff #1 did not have an attendance sheet for the 3 children they were supervising on the playground 2.Staff #3 did not have an attendance sheet for the 5 children they were supervising in the Blue Room 3. The attendance sheet in the Orange Room had 16 children listed and only 8 were in the classroom. 4. The attendance sheet in the Infant Room had 6 children listed and only 3 were in the classroom.”

Rule 8VAC20-780-80-A.

Based on observation and staff interviews, the licensee did not ensure that inside areas occupied by children, the temperature shall be maintained no lower than 68?F.

“Evidence: During the inspection the thermostat in the infant room and the digital thermometer both displayed a temperature reading of 63.”

Rule 8VAC20-780-270-C. From a complaint.

Repeat Violation Based on record review and licensee interviews, the licensee did not ensure to obtain the results of a out of state criminal records check and the out of state search of the central registry check ( CPS ) as required. The out of state background checks are required for any person who has lived out side of Virginia within the last five years.

“Evidence: Center Director confirmed, there was not a criminal record result available for review for Staff #6 who lives in the District of Columbia.”

Rule 22.1-289.035-B-4.

Based on observation and staff interviews, the licensee did not ensure that diapers shall be disposed 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.

“Evidence: In the pre-toddler room diapers were not disposed of as required 1.The plastic trashcan used for disposable soiled diapers was not operable as the foot operated step did not open the lid of the trashcan 2.There was not a separate plastic storage system as required for soiled cloth diapers belonging to child #1.”

Rule 8VAC20-780-500-B.

Based on observation and staff interviews, the licensee did not ensure the center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children’s allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present.

“Evidence: Child #1 has a food sensitivity (milk) and that was not listed on the center’s the allergy / sensitivity food list. The list had not been updated, as the most recent list for staff to review was dated 9-25-2023. Child #1`s first date of attendance was 10-10-2023.”

Rule 8VAC20-780-40-M. From a complaint.

Based on a record review and staff interviews, the licensee did not ensure each staff member had obtained by the end of the 30th day of hire the results of the Central Registry ( CPS ) finding for the state of Virginia.

“Evidence: Staff # 1?s date of hire 5-27-2022 did not have results of a CPS check by the end of the 30th day of hire. The CPS check was dated 7-14-2022 and Center Director confirmed there was not documentation available for review related to obtaining the CPS check for staff #1 within the required timeframe.”

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

Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician’s designee, or an official of the local health department.

“Evidence: Staff #1 date of hire was 5-27-2022 and the TB screening was dated 1-20-2022. Center Director confirmed there was not documentation of a TB screening conducted within the required timeframe.”

Rule 8VAC20-780-160-A.

Based on review of center documentation and staff interviews, the licensee did not ensure the center shall 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: Center Director confirmed the center does not have written procedures for abusive head trauma, safe sleep and coping with crying babies.”

Rule 8VAC20-780-40-K.

Based on observation and staff interviews, The diapering surface shall be used only for diapering or cleaning children, and it shall be cleaned with soap and at least room temperature water and sanitized after each use.

“Evidence: On the diaper changing table in the infant room a single infant toy and a bucket of toys were observed on the diaper changing table.”

Rule 8VAC20-780-500-B.

Based on observation and staff interviews, when centers choose to provide meals or snacks, centers shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) and children shall be allowed second helpings of food listed in the USDA’s child and adult care meal patterns.

Rule 8VAC20-780-560-F-4.

Based on a record review and staff interviews, the licensee did not ensure that staff have documentation to demonstrate the individuals have the education, training and certification, required by the job position.

“Evidence: The records for Staff #3, designated as a program lead, does not have documentation in their record to demonstrate they have the training/education required for program lead. Center Director confirmed the missing information.”

Rule 8VAC20-780-70.

Based on record review and staff interviews, the licensee did not ensure, all staff had obtained an out of state criminal history name check ( CRC ) prior to the first day of employment and an out of state child abuse and neglect search ( CPS ) was request by the 30th day of employment

“Evidence: Staff #5?s record did not include an out of state CPS check and a CRC for Washington where they had lived within the last five years from date of hire (DOH 2-15-23). Staff #8 DOH was 1-3-2022.”

Rule 22.1-289.035-B-4.

Based on record review and staff interview the licensee did not ensure documentation of the Tuberculosis screening shall be submitted at the time of employment and prior to coming into contact with children.

“Evidence: Center Director confirmed that Staff #4 did not have documentation of a TB screening and the first date of employment was 11-14-22”

Rule 8VAC20-780-160-A.

Based on record review and staff interviews, the licensee did not ensure each staff member had completed orientation training in all required facility specific topics prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities.

“Evidence: The record for Staff #1 (hire date 10-6-22), Staff #3 (hire date 3-7-2023), Staff #4 (hire date 11-14-22) and Staff #5 (hire date 2-15-22) did not include information the staff had obtained training in prevention of abusive head trauma and safe sleeping practices.”

Rule 8VAC20-780-240-C.

Based on observation and staff interviews, the licensee did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin.

“Evidence: In the Preschool room bathroom there was foam placed around the edges of the bathroom sinks and the foam had been painted. The paint was peeling on 1 of 3 sinks and was easily accessible children.”

Rule 8VAC20-780-270-A.

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

“Evidence: Hazardous substances, (1 container of cleaner and 2 containers of disinfectant wipes) were observed on a shelf and 1 container of staff medication, (pain reliever) was observed on a desk in the unlocked staff office. The office is on the hallway that leads to a children’s restroom. These items observed were accessible to children and were labeled “keep out of reach of children” and at least one other statement “caution”, “flammable” and “warning”.”

Rule 8VAC20-780-280-B.

Based on measurements, observation and staff interviews, the licensee did not ensure where playground equipment is provided, there shall be under equipment with moving parts or climbing apparatus enough resilient surfacing to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child’s trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing.

Rule 8VAC20-780-330-A.

Based on review of center documentation and staff interviews, the licensee did not ensure the center shall 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: Center Director confirmed the center does not have written procedures for abusive head trauma, safe sleep and coping with crying babies.”

Rule 8VAC20-780-40-K.

8VAC20-780-70

“Based on a record review and staff interviews, the licensee did not ensure that staff have documentation to demonstrate the individuals have the education, training and certification, required by the job position. Evidence: The records for Staff #4, designated as a program lead, does not have documentation in their record to demonstrate they have the training/education required for program lead.”

Rule 8VAC20-780-70.

Based on observation and staff interviews, the licensee did not ensure child day programs and certain other programs; carbon monoxide detectors. Each building that was built before 2015 and that houses a child day program that is licensed and that serves preschool-age children shall be equipped with at least one carbon monoxide detector.

“Evidence: The Center Director confirmed they did not have a carbon monoxide detector.”

Rule 22.1-289.058.

Based on record review and staff interviews, the licensee did not ensure all staff had obtained orientation training that is appropriate to the age of the children in care and include all of the required facility specific topics.

“Evidence The Center Director confirmed the following staff staff #1 (date of hire 4-18-2022), #2 (date of hire 4-11-2022) and #4 (date of hire 2-22-2022) had not obtained the required orientation training prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children.”

Rule 8VAC20-780-240-C.

Based on observation and staff interviews, the licensee did not ensure the electrical outlets for preschool age children and younger shall have protective covers that are of a size that cannot be swallowed by children.

“Evidence: In the Pink Room (ages 2- 3) there were 4 electrical outlets on the wall that were approximately 4 feet from the ground and were uncovered.”

Rule 8VAC20-780-290-A-3.

Based on observation and staff interviews, the licensee did not ensure children three years of age or younger may not be offered foods that are considered to be potential choking hazards.

“Evidence: The children in the Pink room (ages 2-3), the Orange room (ages 3-4) and the Yellow room (ages 16 months to age 2) were observed during their lunch and they were served and observed eating large portions of bananas. The portions of the bananas were cut into 4 chunks or cut in half, these portions in length were between approximately 2 to 4 inches and the banana remained circular.”

Rule 8VAC20-780-560-F-4.

Based on record review and licensee interviews, the licensee did not ensure to a obtain the out of state criminal records check and a sex offender check prior to employment The licensee also did not ensure to obtain the out of state search of the central registry check ( CPS ) as required. The out of state background checks are required for any person who has lived out side of Virginia within the last five years.

“Evidence: Center Director confirmed, there was not a criminal record result or sex offender result available for review for the applicant #2 who lives in the District of Columbia.”

Rule 22.1-289.035-B-4.

Based on record review and license interviews, the licensee did not ensure that staff have completed a tuberculosis screening (TB) signed by a physician, physician’s designee, or an official of the local health department.

“Evidence: The records for Staff #1 (date of hire 9-7-21) did not include documentation of a TB screening completed within the last 30 calendar days of the date of employment.”

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