Little Blessings Child Care, Inc.

8VAC20-780-60-A-8 · A written care plan is required for each child with a diagnosed food allergy, to include instruction from a physician regarding food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

Child 2 (age 3 years), enrolled for more than two years, has a diagnosed food allergy; there was not a written care plan available. Child 3 (age 3 years), enrolled for more than one year, has a diagnosed food allergy; there was not a written care plan available.

22.1-289.035-A · The center is required to have employees undergo a background check every five years.

The central registry for Staff 3 is overdue by one month. The sworn statement for Staff 4 is overdue by 10 months.

8VAC20-780-340-F · Children under 10 years of age always shall be within actual sight and sound supervision of staff.

Staff 5 was the only staff member supervising the pre-k class. Staff 5 left the group of children to use the restroom. The children were not within actual sight and sound supervision of staff during the time Staff 5 was in the restroom.

22.1-289.035-B-2 · REPEAT VIOLATION

Based on record review, the center failed to ensure that no person shall be hired for compensated employment prior to the facility obtaining an employment eligibility letter upon the completion of a fingerprint background check as required by the Code of Virginia. Evidence: The record for Staff 3 contained a documented hire date of 10/11/2023. The eligibility letter for Staff 3 was dated 10/13/2023.

8VAC20-780-510-I · Based on observation and interview, the center failed to ensure that those drugs that were dispensed from a pharmacy and maintained in the original, labeled container.

Evidence: In the medicine box, there was one epi pen in a plastic Ziploc labeled with a name and one inhaler in a Ziploc bag labeled with a name.

22.1-289.035-B-2 · Based on document review and staff interviews, the center failed to ensure that no person shall be hired for compensated employment prior to the facility obtaining an employment eligibility letter upon the completion of a fingerprint background check as required by the Code of Virginia.

Evidence: The record for Staff 4 contained a documented hire date of 01/17/2023. The eligibility letter for Staff 4 was dated 01/23/2023.

8VAC20-780-40-K · Based on document review, the center failed to 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: The written procedure for prevention of shaken baby syndrome or abusive head trauma did not include safe sleeping practices.

8VAC20-780-160-A · Based on document review and discussion with staff, the center failed to ensure that each staff member shall submit documentation of a negative tuberculosis screening prior to coming into contact with children and that the documentation shall have been completed within the last 30 calendar days of the date of employment.

Evidence: 1. The record for Staff 1 did not contain documentation of a negative tuberculosis screening prior to coming into contact with children; the documentation of a tuberculosis screening in the record for Staff 1 did not contain a name to identify who was screened. 2. The record for Staff 4 contained a documented hire date of 01/31/2022. The date on the tuberculosis screening was 08/26/2021. The tuberculosis screening had not been completed within the last 30 calendar days of the date of employment.

22VAC40-185-140-A · Based on record review and discussion with staff, the center failed to ensure that each child shall have a physical examination by or under the direction of a physician before the child's attendance or within one month after attendance.

Evidence: The record for Child 1 had a documented start date of 05/10/2021. There was not documentation of a physical examination in the record for Child 1 during the 09/08/2021 inspection.