8VAC20-780-140-A · Based on review, 1 of 5 children files indicated that each child did not have a physical examination (by or under the direction of a physician) within 30 days after the first day of attendance.

Evidence - 1. On the date of inspection (05/02/2024), documentation of a physical examination was not available for review for Child #3 (start date - 08/14/2023). 2. It was noted within the record (included with the immunization page) that a physical examination was conducted on 05/18/2023 for Child #3, but no further documentation of the physical itself was provided.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-270-A · Based on observation, equipment used in the center was not maintained in a safe condition.

Evidence: In the Dinosaur's classroom, a bin used for storing toys was found to have broken edges. The bin was on the floor where the children were playing.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-40-E · Based on documentation review and staff interview, the center did not follow its own policies and procedures and did not ensure that the center's activities were maintained in compliance with the standards.

Evidence: 1. The center?s playground safety plan does not include information about methods of maintaining resilient surfacing. 2. The center?s ?Lost or Missing Child? policy includes ?Takes routinely count of the children? and ?Always know the number of children that are present? as two of the four preventative steps. 3. Staff # 7 stated that on 3/14/23 she did not count the children before they came inside from the playground at approximately 11:55 am.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-780-40-E · Based on records review and staff interview, the center does not follow its own written policy for discipline and behavior management.

Evidence: 1. The center?s discipline policy states that, ?Staff shall always try to redirect behavior of a child to prevent negative behavior. Staff shall use positively worded directions to help guide the behavior of the children. If a child is frustrated and/ or upset, ask the child to express their feelings with words (If age appropriate). Time out shall be used only when extremely aggressive behavior is being demonstrated by the child and the above acceptable methods of discipline were ineffective or bringing harm to another child?. 2. Staff # 1 stated that two systems were used in the Dinosaurs classroom for behavior management. One system was color-coded (green, yellow and red), with green reflecting good behavior, yellow indicating that a child had to be given reminders or spoken to; and red meaning that the child was not listening and /or following directions. 3. Staff # 1 stated that the alternative system involves putting check marks next to children?s names on a white board when they are observed exhibiting negative or disruptive behavior in the classroom, and when it has been determined that the color-coded system will not work for the child. For example: if seen running in the classroom, a check mark will be placed on the white board next to their name. Each check mark results in a loss of 2-3 minutes of their outside time. 4. Staff # 2 stated that timeout is used when children ?don?t do things well? and have been spoken to. Staff # 2 showed a sand timer that was designed to complete a timeout for 5 minutes which exceeds the time limit for the age group (3 yrs. old) that Staff # 2 supervises and cares for.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-130-A · Based on records review, the center did not obtain documentation of immunization for each child before the child can attend the center.

Evidence: 1. Child # 1's first day of attendance was 10/24/22. 2. Immunization records Child # 1 have not been obtained to this date.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-40-E · Based on records review and staff interview, the center does not follow it's own written policy for discipline and behavior management.

1. The center?s discipline policy states that, ?Staff shall always try to re-direct behavior of a child to prevent negative behavior. Staff shall use positively worded directions to help guide the behavior of the children. If a child is frustrated and/ or upset, ask the child to express their feelings with words (If age appropriate). Time out shall be used only when extremely aggressive behavior is being demonstrated by the child and the above acceptable methods of discipline were ineffective or bringing harm to another child?. 2. Staff # 1 stated that when handling children that are misbehaving, and when using their behavior management technique, they give ?a verbal warning the first time, a second verbal warning, and the third time you use a chair and put time out for 3 minutes?.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-780-160-A-2 · Based on records review, the documentation for a new employee's Tuberculosis (TB) screening was not completed within the last 30 calendar days of the date of employment.

Evidence: 1. Staff # 1's first date of employment was 2/14/22. 2. Staff # # 1's TB test was dated 12/24/21, and not completed within the last 30 calendar days of the first date of employment.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.