22.1-289.035-B-4 · The center is required to obtain background checks from any state in which the individual has resided in the preceding five years.

The record for Staff #2 (employed for two weeks) did not contain documentation of requesting an out of state sex offender check or an out of state child abuse and neglect search for one state, which is required. Staff #2 was observed working on the day of the inspection.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

8VAC20-790-600-D-1 · Repeat Violation

All staff who work with children shall have current certification in cardiopulmonary resuscitation (CPR) that includes an in-person competency demonstration. The record for Staff #1 (employed for two years) did not have documentation to show that the required CPR in-person competency demonstration was completed.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-160-C · At least every two years from the date of the initial screening or testing, or more frequently if recommended by a licensed physician or the local health department, staff members shall obtain and submit the results of a follow-up tuberculosis (TB) screening.

The records for Staff #2 and Staff #3 were missing documentation of a follow-up TB screening, which is required.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-60-A · REPEAT VIOLATION

Based on record review and interview it was determined the center did not ensure that a record for each child enrolled was maintained and kept at the center. Evidence: 1. There was no record for child #3, at the center. Child #3 was in care during this inspection. 2. Staff #1 confirmed this record was not available during this inspection. 3. Staff #3 confirmed there was no electronic means to access the record at this center at the time of the inspection.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-790-600-D-1 · REPEAT VIOLATION

Based on record review and interview it was determined the center did not ensure that each staff have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. Evidence: 1. The record for staff #3(hired 9/19/22) did not contain current certification in CPR. 2. Staff confirmed this documentation was not available during this inspection. 3. Staff #5 reported at the previous inspection that staff #3 had refused to take the CPR certification class and they had not been rescheduled to take it.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-40-E · Based on record review and interview it was determined that the center did not maintain compliance with their own policies and procedures.

Evidence: 1. The center's policy in the parent handbook states "If your child has an injury that may require more than our first aid skills allow or your child has been bumped on the head, we will make an immediate attempt to contact you.". 2. While in the care of staff #2 and #3, child #5 lost consciousness and fell to the ground, sustaining a concussion, and a bruise/knot on his forehead. 3. Staff #2 and #3 confirmed they did not follow the center's injury policy. When child #5 lost consciousness sustained a concussion and a bruise/knot on his forehead, while in care. 4. None of the center staff contacted the child's parent.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-60-A · Based on record review and interview it was determined the center did not ensure that each child's record contained all of the required information.

Evidence: 1. The record for child #5 did not contain the addresses for the two required emergency contacts. 2. 5 out of 5 records reviewed did not contain information on previously or concurrently attended child care programs. 3. Staff confirmed this information was not available.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-790-600-D-1 · Based on record review and interview it was determined the center did not ensure that each staff have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.

Evidence: 1. The record for staff #2(hired 9/19/22) did not contain current certification in CPR. 2. Staff confirmed this documentation was not available during this inspection.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

22.1-289.035-B-2 · Based on record review and interview it was determined the center did not ensure that each staff member submit to fingerprinting prior to employment.

Evidence: 1. The record for staff #2 (hired 9/19/22) did not contain documentation of fingerprint background check. 2. Staff confirmed this documentation was not available during this inspection.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

8VAC20-780-160-A-1 · Based on record review and interview it was determined staff did not have documentation of TB screening at the time of employment and prior to coming into contact with children.

Evidence: 1. Staff #4(hired 10/22/21) did not have documentation of a TB screening and was working with children during this inspection. 2. Staff #4 confirmed they did not have documentation of a TB screening.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

22VAC40-185-130-A · Based on record review and interview it was determined the center did not obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center.

Evidence: 1. There were no immunization records available for child #4 and child #5 at the time of the inspection. Both children were present during the inspection. 2. Staff confirmed that these records were not available

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-350-B · Based on observation and interview it was determined the center did not ensure that when children aged school eligible to nine years old are in care a ratio of 1:18 (staff:children) is maintained.

Evidence: 1. On 9/28/21 inspector observed: - 2:32pm there were 75 5-9 year olds being supervised by staff #1 in the cafeteria - 2:37pm there were 77 5-9 year olds being supervised by staff #1 and staff #2 in the cafeteria - 3:32pm there were 43 6-9 year olds being supervised by staff #1 in the cafeteria - 3:32pm there were 21 6-9 year olds being supervised by staff #3 in the gym - 3:50pm there were 92 5-9 year olds being supervised by staff#1, #2, #3, and #4 2. Staff reported children get released from their classes to the after school program at 2:04pm and as of 9/2/21 there were 134 children on roster. Not at all staff are not available when the children begin to arrive. Staff #4 arrives daily between 2:45-3:00pm. Staff #5 arrives at 4:00pm. 3. Staff confirmed during this inspection that they have been out of ratio for at least some portion of the program's operating hours daily since school began 9/7/21.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.