Appletree II

At least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening.

“Staff #5 had a TB test that was overdue by more than 3 weeks.”

Rule 8VAC20-780-160-C.

Documentation shall be maintained of emergency evacuation drills.

“There was no documentation of the emergency evacuation drill for March 2026 and July 2026.”

Rule 8VAC20-780-550-G.

Electrical outlets shall have protective covers that are of a size that cannot be swallowed by children.

“Three outlets in 2 rooms did not have protective covers on the outlet. The children were not in the classrooms at the time.”

Rule 8VAC20-780-290-3.

SYSTEMIC DEFICIENCY REPEAT VIOLATION Children under 10 years of age always shall be within actual sight and sound supervision of staff.

“On February 26, 2026, Staff 2 was observed in the hallway, approximately 20 feet away from the door of the classroom, leaving 10 children out of sight and sound supervision.”

Rule 8VAC20-780-340-F.

SYSTEMIC DEFICIENCY The required ratio for children ages 3 years to school-age is one staff per ten children.

“Staff 6 was observed leaving the classroom when there were 11 children present, to walk to the office to show the director the day’s art project. There was another staff member in the room with the 11 children.”

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

When staff are supervising children, they shall always ensure their care, protection, and guidance.

“On August 28, 2025, Staff 4 was observed outside of the class, in the hall approximately 25 feet away from the door, leaving 8 children alone in the classroom for approximately 3-5 minutes.”

Rule 8VAC20-780-340-A.

Children under 10 years of age shall always be within actual sight and sound supervision of staff.

“During the inspection, three year old children were left alone while staff 4 went down the hallway to assist getting a crying child into the classroom.”

Rule 8VAC20-780-340-F.

The licensee will follow the terms of the current license issued by the department.

“The current licensed age range is 3 years to 12 years. There were 4 children in attendance, since August 18, 2025 that were under the age of three. The youngest child is currently 22 months old.”

Rule 8VAC20-780-40-E.

Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children.

“Cleaning supplies, to include sprays and wipes, were in an unlocked cabinet in one classroom for children ages 3-4 years old.”

Rule 8VAC20-780-280-B.

Staff and children’s records shall be treated confidentially.

“2 of 10 written injury reports included the names of other children involved in the circumstance of injury.”

Rule 8VAC20-780-50-A.

When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

“The medication authorization for 1 of 7 medications on-site expired in November 2024. The medication was on-site (expired in April 2024).”

Rule 8VAC20-780-510-P.

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 time the parent was notified.

“1 of 10 written injury reports did not document the time the parent was notified.”

Rule 8VAC20-780-550-P.

A menu listing foods to be served for snack during the current 1-week period shall be dated, posted in a location conspicuous to parents, list any food substitutions and kept on-file for 1 week.

“There was no snack menu available and staff reported that it has not been done for a period of years.”

Rule 8VAC20-780-560-F.

Records shall be kept for each staff person and include documentation to demonstrate the education and/or certification required by the job position they were working.

“5 of 8 staff records did not include documentation of education to include a copy of a diploma or transcripts. Staff #1, #2, #4, #5, and #7.”

Rule 8VAC20-780-70.

Based upon review of ten children’s records and staff interview, the facility has not ensured that each child’s record includes documentation of the child’s first date of attendance.

“Evidence: 1. The record provided for all ten children did not include documentation of each child’s first date of attendance. 2. Assistant Director verified that the records did not have the first date of attendance documented.”

Rule 8VAC20-780-60-A.

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

“Evidence: 1. A container of disinfectant wipes, hand sanitizer, a spray bottle of glass cleaner and a bottle of carpet cleaner was found in an unlocked cabinet above the classroom counter near the classroom door. 2. A container of rubbing alcohol, eye contact solution and spray paint was found in an unlocked cabinet above the classroom counter near the wall.”

Rule 8VAC20-780-280-B.

Based on observation and interview, electrical outlets did not have protective covers.

“Evidence: 1. In the school library, the outlet behind the entrance door was uncovered. 2. In the Bluebird classroom, there was a surge protector with 5 out of 6 outlets uncovered above the classroom counter. 3. In the Billy Goat classroom, the outlet near the classroom door was uncovered.”

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

Based on record review and staff interview, evacuation drills were not practiced monthly.

“Evidence: January 2024 evacuation drill had not been practiced.”

Rule 8VAC20-780-550-D.

Based on record review and interview, documentation was not maintained for emergency evacuation drills.

“Evidence: There was no documentation of a January 2023 evacuation drill being practiced.”

Rule 8VAC20-780-550-G.

Based on record review and staff interview, 1 of 5 staff files indicated that the center failed to ensure all staff records had all the required documentation.

“Evidence: There was no documentation of education for Staff #2.”

Rule 8VAC20-780-70.

Based on record review and interview, the center failed to obtain an out-of-state child abuse and neglect search request and criminal history name check by the End of the 30th Day of Employment.

“Evidence: 1. The record of Staff #1 (hired 08/2022) did not contain documentation of an out-of-state criminal history check and central registry check. Staff #1 indicated living in another state other than Virginia within the last five years on their sworn disclosure statement dated 08/08/22. 2. The record of Staff #3 (hired 06/2022) did not contain documentation of an out-of-state central registry check. Staff #3 indicated living in another state other than Virginia within the last five years on their sworn disclosure statement dated 02/22/22.”

Rule 22.1-289.035-B-4.

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

“Evidence: 1. In the butterflies classroom, two cans of air freshener were found on a shelf above the toilet in the bathroom. 2. In the hallway bathroom, next to the butterflies classroom, a can of disinfectant spray and toilet cleaner were found in a mirror cabinet above the sink. 3. In the Bears classroom, a container of disinfectant wipes was found on a wooden shelf.”

Rule 8VAC20-780-280-B.

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

Rule 8VAC20-780-350-F.

Based on record review and interview, the center did not develop written procedures for prevention of abusive head trauma.

“Evidence: There was no documentation of a written policy and procedure for prevention of abusive head trauma.”

Rule 8VAC20-780-40-K.

Based on observation and interview, the facility did not ensure that all medication was kept in a locked place, using a safe locking method that prevents access by children.

“Evidence: observed that there was over the counter pain medications (ibuprofen and acetaminophen) inside a bathroom mirror cabinet, that was not locked.”

Rule 8VAC20-780-510-L.

Based on record review, the center did not have documentation of at least one staff member on duty who has obtained, within the last three years, instruction in performing the daily health observation of children.

“Evidence: 1. Staff #1 Daily Health Observation Certificate was expired on 4/1/2019. There was no one else on site with a current Daily Health Observation certification.”

Rule 8VAC20-780-245-L.

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

“Evidence: 1. In the Zebras classroom, a container of disinfectant wipes was located on a counter accessible to children and not kept in a locked place. 2. In the Toucans classroom, a container of disinfectant wipes was located on a bathroom sink accessible to children and not kept in a locked place.”

Rule 8VAC20-780-280-B.

Based on observation, cots or rest mats were not provided for children during the designated rest period.

“Evidence: Rest mats were not provided for 14 children during the centers designated rest period. 1. In the Monkeys classroom, there were 6 students without a rest mat or cot . 2. In the Sloths classroom, there were 3 students without a rest mat or cot. 3. In the Elephants classrooms, there were 5 students without a rest mat or cot.”

Rule 8VAC20-780-440-A.

Based on observation, not all of the food containers brought from home were clearly dated and labeled in a way that identifies the owner.

“Evidence: 1. 6 of 13 lunchboxes were missing the owner’s name. 2. 10 of 13 were missing the date.”

Rule 8VAC20-780-560-G.

22.1-289.035-B-2

“Based on record review, 1 reviewed staff record did not contain the results of a national criminal history check prior to hire. Evidence: Staff 1 has a date of hire documented as 2/8/21. The criminal history results are dated 2/11/21.”

Rule 22.1-289.035-B-2.

22VAC40-185-160-C

“Based on record review, one of the reviewed staff records did not contain the results of a Tuberculosis screening every two years rom the date of the first initial screening or testing, or more frequently as if recommended by a licensed physician or the local health department. Evidence: The Tuberculosis screening for Staff 6 was last conducted on 10/9/2018.”

Rule 22VAC40-185-160-C.

22VAC40-185-340-F

“Based on observation, children under 10 years of age were not always within actual sight and sound supervision of staff. Evidence: 1. At 11:54am a child was observed to enter the Bluebirds classroom from the playground to use the bathroom without supervision. 2. At 11:55am a child was observed to enter the Bluebirds classroom from the playground to use the bathroom without supervision. 3. At approximately 12:30pm a child was observed leaving the Yellowbirds classroom to walk down the hallway to use the restroom without supervision.”

Rule 22VAC40-185-340-F.

22VAC40-185-70-A

“Based on record review, 1 reviewed staff record did not contain all required information. Evidence: The record for Staff 2 did not contain the signature of the person conducting reference checks.”

Rule 22VAC40-185-70-A.

8VAC20-780-245-A

“Based on record review, 2 of 7 staff records reviewed did not contain documentation of the required 16 hours of annual training. Evidence: 1. Staff 3’s record contained documentation of 4 hours of annual training. 2. Staff 4’s record contained documentation of 4 hours of annual training.”

Rule 8VAC20-780-245-A.

8VAC20-780-270-A

“Based on observation, not all areas of the center were maintained in a safe condition. Evidence: 1. On the monkey bars a plastic sign, denoting acceptable equipment age ranges, was observed to be broken and had sharp edges. 2. On the playground, felt ground cover was observed to be exposed and frayed creating a tripping hazard.”

Rule 8VAC20-780-270-A.

8VAC20-780-280-B

“Based on observation, not all hazardous substances were kept in a locked place using a safe locking method that prevents access by children. Evidence: The Butterflies classroom had a canister of air freshener on an open shelf in the bathroom and a container of floor cleaner in the closet, which had a key in the lock.”

Rule 8VAC20-780-280-B.

8VAC20-780-290-A-3

“1. In the Redbird classroom, a powerstrip behind the shelf was observed without installed protective covers. 2. In the Bluebird classroom, an outlet was observed without a protective cover installed.”

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

8VAC20-780-330-B

“Based on observation, fall zones around playground equipment included barriers. Evidence: A temporary fence was observed within 2 feel of a merry-go-round.”

Rule 8VAC20-780-330-B.

8VAC20-780-560-G

“Based on observation, food brought from home was not clearly labeled with the child’s name or current date. Evidence: Out of 10 lunches observed on a shelf in the hallway, 8 were observed without a name and 10 were observed without a date.”

Rule 8VAC20-780-560-G.