8VAC20-780-160-C · A tuberculosis (TB) screening is required every two years from the last screening.

Staff #1, staff #2, and staff #3 updated screening was due 5 months ago and Staff #4 updated screening was due 4 months ago. The updated screenings have not yet been completed.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-340-D · Based on record review and staff interviews, the center did not ensure that in each grouping of children at least one staff member who meets the qualifications of a program leader shall be regularly present.

1. In the private kindergarten classroom, staff #5 was left alone with 10 children. 2. Staff #5 is listed as an assistant teacher and does not have program leader qualifications documented in their record. 3. The director verified that staff # 5 is an assistant.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-780-40-E · Based on documentation review and interviews, the center failed to follow their own policies related to behavior guidance.

Evidence: 1. Review of document titled ?Positive Behavioral Guidance? states that ?teachers are encouraged to embrace strategies that help learn how to identify feelings and make safe choices to express those emotions. The following strategies are the core of the Positive Behavioral Guidance Police: Rules of the Roost, Positive Acknowledgment or response to Specific Prosocial Behaviors, identifying feelings and the use of appropriate words to describe them, redirection, providing choices, talk it out/conflict resolution, using the primrose friends puppets to support. Prevention is a key component of Primrose?s Positive Behavior Guidance approach. Knowing each child as an individual and implementing the Balanced Learning curriculum as intended are at the core of Positive Behavior Guidance. Developing in understanding of developmentally appropriate behaviors and their potential causes, will further help teachers anticipate and effectively respond to behaviors when they occur?. 2. Review of documented title Staff Prohibited Behaviors 7.6 located in the employee handbook states ?Employees are not permitted to display any of the following behaviors. Violation of this policy could result in disciplinary action, up to and including termination. The use of corporal punishment. Corporal punishment means punishment inflicted directly on the body including, but not limited to: Hitting, spanking (refers to striking a child with an open hand on the buttocks or extremities with the intention of modifying behavior without causing physical injury), shaking, slapping, twisting, pulling, squeezing, or biting?. 3. reported that staff #1 entered the infant classroom with child #2. As staff #1 and child #2 entered the classroom, child #2 was crying and upset. Child #2 went to put his fingers in his mouth when staff #1 pulled the child?s hands down forcefully while telling the child to ?put your hands down? harshly. Staff #1 was seen smacking child #2?s hand two times. 4. Staff #1 was witnessed having child#2 put their hands in their mouth and bite down on their hand to see how it felt as punishment for biting another child.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-780-270-A · (Repeat Violation) Based on observation, areas, and equipment inside and outside were not maintained in a safe and operable condition.

Evidence: The poured in place surfacing on the Pre-K playground, 3-year and 4-year-old playground, and the infant and toddler playground, had multiple circular areas approximately 4-5 inches inches wide where the poured in place surfacing was missing.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-40-M · Based upon staff interview, the facility has not ensured that a current written list of all children's allergies, sensitivities, and dietary restrictions is maintained and documented in the allergy plan that is dated and kept confidential in each room or area where children are present.

Evidence: 1. The dietary restrictions lists in the classrooms were posted in a way that the information was not covered or protected to keep it confidential.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-790-600-D-1 · Based on record review the center failed to ensure that all staff who work directly with children shall have within 90 days of the date of employment current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. The training shall include an in-person competency demonstration.

Evidence: 1. Staff #7's record did not contain documentation of a complete CPR certification. 2. An administrator verified that CPR was not completed for staff # 7.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-270-A · Based on observation, areas and furnishings of the family day home were found in an unsafe condition.

Evidence: 1. A blue child size chair in the reading area located in the PreK classroom, was torn on both arms of the chair exposing the webbing. 2. A child size red chair in the Early Preschool classroom, was torn on the corners of the arm exposing the webbing.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-780-270-A · Based on observation the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition.

Evidence: 1. A red chair in the 3 year old classroom, was torn in the middle of the chair and on the arms of the chair?s vinyl exposing the cushion. 2. A red chair in the 2 year old classroom had a tear on both arms of the chair exposing the cushion. 3. Chipped paint was observed in the 3 year old and 4 year old classrooms on the window frames. 4. The hot water knob at the sink in the 4?s classroom, was broken.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.