8VAC20-780-410-1 · The center failed to ensure that physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercise as punishment does not occur.

Evidence: A review of video footage for 3/21/24 shows staff #1 grab child #1 , 2 year old, between the wrist and elbow of one arm and lift her off the ground to move her to the wanted location on 2 separate occasions at approximately 8:21am. The childs feet were not able to touch the floor during the two incidents.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-780-340-A · Based on interviews and review of video the center failed to ensure the care of a child on 12/7/23 as required.

Evidence: Video and staff statements verified that on 12/7/23 a 2 year old child had become weak and lethargic on 2 separate occasions upon entering the building from outside play. Video shows the child entering the building from outside and promptly collapsing on the floor after entering. Staff were seen working to get all children inside the door, not paying attention to the child on the floor. Once staff got all the children thru the door, the staff then went to the child and had him stand up and walk to the room. Video shows the child getting up and doing the "drunk man walk" to the classroom where he goes to the cushioned chair in the middle of the room and plops down then slides to the floor. Staff still do not see the child laying on the floor at this time. Video shows staff going about getting the children inside the classroom and getting their coats off . At this time video shows the child still on the floor and another child sitting beside him and trying to comfort him. Video shows that the children entered from outside at approximately 10:44am, which is when the child first appears to collapse onto the floor. At approximately 10:45am the children move to the classroom, where the child enters and goes to the chair. At approximately 10:47am the first staff is seen checking the child and attempts to help the child stand, in which the child cannot and lays back on the floor. At approximately 10:48am the second staff comes over and speaks with the first staff and checks the child, immediately that staff gets up, pulls out her phone and leaves the room quickly. At approximately 10:49am the third staff arrives and is seen checking the child and moves the child semi onto her lap and continues assessment and talking to the child. At this time the second staff has notified the mother and the mother reportedly requested that 911 be called. At that time the third staff said 911 didn't need to be called as she was a former EMT and the child's vital signs were ok. At approximately 10:50am other staff are seen escorting the remaining children out of the classroom to another classroom. During this time the third staff appears to be continuing assessment on the child. At approximately 10:56am the child's mom is seen entering the classroom and promptly sits with her child and the staff on the floor. At approximately 10:59am the mother picks up the child and walks out of the classroom, and then leaves the building headed to the ER. Staff failed to ensure the care of the child during this incident by not calling 911 as requested as the child appeared to be having a possible medical emergency.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-400-B · Based on review of video the center failed to ensure that behavioral guidance is constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior.

Evidence: Video shows that on 11/2/23 at approximately 10:20am a staff member smack and push a child's arm from between the slates of a crib when the child was reaching into the crib, while standing outside of the crib, to retrieve a toy she had put in the crib. This action by the staff member was not appropriate behavior guidance.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-780-340-A · Based on review of the video and discussions with staff the center failed to ensure the care, protection, and guidance of the children.

Evidence: On 2/21/23 staff #1 picked up an infant from a seated position on the floor by using one hand to pick the child up holding on to the upper arm and under the arm pit to relocate the child a few feet away . The child was held away from and out front of the staffs body, which left the child raised in the air approximately 2 feet off the ground with no support except for the hand of the staff that was on the child's upper arm/arm pit. Video showed this incident and was reviewed by licensing during the self-report from center administration on 2/23/23 at 9:20am. Staff #1 failed to ensure the care and protection of child #1 when she inadequately picked the child up and moved her a few feet away to another area of the floor.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.