Precious Pearls

22.1-289.035-A · The center is required to have employees undergo a background check every five years. The most recent central registry check for staff 1 was overdue by a year and one month.

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8VAC20-780-70 · Staff records shall contain all the required information. The record for staff 1 does not contain documentation to demonstrate that they possess the educaction and experience required by the job position of program leader. During the inspection, staff 1 was working alone in a classroom.

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22.1-289.035-B-2 · The center must obtain a completed national criminal background check prior to the employee's first day of employment. Staff 1 began employment before the results of their national criminal background check was received.

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22.1-289.057-A · The program is required to submit to VDH and implement a plan to test potable water for lead.

The program did not have evidence of a testing plan submitted to VDH.

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

On July 8, 2024, child 1, who is a 13-year-old with special needs, was left out of sight and sound supervision of staff for approximately eight minutes. Staff 1 stated that she left child 1 in the classroom to use the restroom while she took the other children to the playground. Child 1 then exited the building and was unable to get back inside. The child was found alone outside by a person not associated with the facility. Staff 1 stated she found child 1 in the parking lot of the facility with staff from a neighboring business approximately 8 minutes after first leaving her in the classroom.

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8VAC20-780-340-A · When staff are supervising children, they shall always ensure their care, protection, and guidance. A child received several injuries while engaged in rough housing with another child while supervised by staff.

1. Child #1 (age 3) and Child #2 (age 4), were wrestling directly in front of Staff #1 on April 23, 2024. A third child in the classroom attempted to get Staff #1?s attention on two separate occasions pointing at the two children wrestling. Staff #1did not respond, and continued to sit and scroll on their personal cell phone. 2. The two children continued to wrestle in another area of the classroom and Staff #1 did not redirect them but continued to stay on their personal cell phone. The children were wrestling for at least 10 minutes. While wrestling, one child received several bite marks and bruises on their back. 3. Staff #1 confirmed that children were wrestling and stated and confirmed that they did not physically intervene to redirect them. 4. Staff #1 confirmed that personal cell phone usage is prohibited, per the center?s policy, and admitted doing ?personal stuff? on their phone while in the role of supervising children.

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8VAC20-780-160-C · Based on record review and interview, the center did not ensure that staff members shall obtain and submit the results of a follow-up tuberculosis screening at least every two years from the date of the initial screening or testing.

Evidence: 1. Staff 1's most recent tuberculosis screening is dated 11/19/21. Staff 1 was due for an updated TB screening in November 2023. 2. Staff 1 confirmed that her TB screening is overdue.

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8VAC20-780-550-O · Based on staff interviews, the center did not ensure that parents shall be notified of any known minor injuries by the end of the day.

Evidence: 1. The parent of child 1 reported that after picking the child up from the center on 9/11/23 they observed what appeared to be bite marks on the child. a. Child 1's parent stated that they were not notified of any injuries to the child when she was picked up from the center that evening and were only told that child 1 had been bitten by another student the following morning when the director was questioned about the marks to the child. 2. Staff 1 stated that on 9/11/23 she observed a red mark on child 1's leg after another child bit her. Staff 1 stated that she did not inform child 1's parent of the injury at pick-up that evening. 2. Staff 2 stated that she observed a red mark to child 1's leg on 9/11/23. Staff 2 confirmed that the parent was not notified of the injury until the following morning when the parent inquired as to how child 1 sustained the mark to her leg.

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8VAC20-780-510-I · Based on a review of medication and interview, the center did not ensure that when prescription medication is administered to a child that would normally be administered by a parent or a guardian that written parental authorization is obtained.

Evidence: 1. Child 1 is prescribed an ADHD medication. The medication authorization form located at the center for child 1 did not include the parent's signature for the center to administer the medication. a. Child 1 was administered the prescribed medication at the center nine times between 6/27/22 and 8/4/22. 2. The center director confirmed that the medication authorization form for child 1 was not signed by the parent and that the center had administered the medication to the child.

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8VAC20-780-500-B · Based on staff interviews, the center did not ensure that a nonabsorbent surface for diapering or changing shall be used and that for children younger than three years, this surface shall be a changing table or countertop designated for changing.

Evidence: 1. Staff 1 and staff 2 stated it is usual practice to change the diapers and pull-ups of children under the age of 3 years while they are standing up in the bathroom instead of on the changing table. 2. Staff 3 (center owner) and staff 4 (center director) confirmed that it is the usual practice of the center to change children under the age of 3 years while they are standing up in the bathroom instead of on the changing table in the bathroom.

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8VAC20-780-70 · Based on record review and interview, the center did not ensure that staff records contain written information to demonstrate that the individual possesses the education and experience required by the job position.

Evidence: 1. The records for staff 1 (date of hire: 6/30/21) does not contain documentation to demonstrate that they possess the education and/or experience required for the program leader position. a. The center director stated that staff 1 was hired as a program leader. 2. The center director confirmed that the record for staff 1 does not contain documentation of education and/or work experience necessary for the qualification of program leader.

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