River's Bend Children's Center

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

The updated screening for staff #5 was due 1 month ago.

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

1. The most recent central registry check for staff #3 was overdue by 4 months. 2. The most recent central registry check for staff #4 was overdue by 6 weeks. 3. The most recent criminal background check for staff #3 was overdue by 5 months.

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8VAC20-780-160-A · Based on a review of five (5) staff records and interview, the center did not ensure to obtain documentation of a negative tuberculosis screening within the required time frame for one (1) staff. 1. Documentation of the screening must be submitted at the time of employment and prior to coming into contact with children. 2. The documentation must have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.

Evidence: 1. The record of staff #3 (date of employment: 4/17/2023) contained a negative TB screening dated 5/30/2022. 2. Administration acknowledged that the TB screening was submitted prior to employment but was not completed within the last 30 calendar days of the date of employment.

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8VAC20-780-40-M · Based on observation and interview, the center did not ensure to maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present.

Evidence: 1. The allergy lists were observed to be posted in the infant, toddler and two year old classrooms. The lists were not posted in a way to maintain confidentiality as required. In the art room and one of the school age rooms, a list was not available. 2. Administration acknowledged that the postings were not kept in a confidential manner and available in all rooms where children were present.

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8VAC20-780-60-A-8 · Based on a review of 5 children's records and interview, the center did not ensure to obtain a written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

Evidence: 1. The records of child #4 (DOE: 1/5/2022) and child #5 (DOE: 9/8/2020) contained written documentation of confirmed food allergies. The records did not contain the required written care plans. 2. Administration acknowledged that the written care plans had not been obtained.

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22VAC40-185-560-F · Based on review of documentation and interview, the center did not ensure when meals or snacks are provided, that the most recent age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA) are followed.

Evidence: 1. Four menus were reviewed which documented that juice was regularly served at 2 snacks per day. Cookies and cereal bars were listed on the menu as a grain component for several snacks. 2. The most recent USDA/CACFP meal patterns limits juice to once per day. Grain based desserts are not to count as a grain component. 3. Administration acknowledged that the menu did not meet the USDA/CACFP nutritional requirements for the snacks.

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