Lady L's Little Angels Daycare

8VAC20-780-130-A · The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. The physical examination in the record of Child #3 was obtained two months after the child began attending the center.

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8VAC20-780-500-B · The diapering area shall have a nonabsorbent surface for diapering or changing shall be used. Classroom #1 had a diapering pad with several tears, making the pad absorbent.

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8VAC20-780-150-B · Immunization records are required to be signed and dated by a physician, his designee, or an official of the local health department. The immunization record for child #4 was not signed or dated.

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8VAC20-790-600-F · Staff who work directly with children shall, in addition to preservice and orientation, annually attend at least 16 hours of training and staff development activities, to include the department?s health and safety update course. Training shall be related to child safety, child development, the function of the center, and any required department sponsored training. The records for Staff #2 and Staff #3 did not contain documentation of 16 hours of training, including the department?s health and safety update course from 2024. Staff #2 has been employed at the center for one year and one month. Staff #3 has been employed at the center for two years and eight months.

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8VAC20-780-160-C · A tuberculosis (TB) screening is required every two years from the last screening. Staff #5 updated screening was due 11 months ago.

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8VAC20-780-400-B · Based on staff interviews, the center did not ensure that behavioral guidance shall be constructive in nature, age, and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

Evidence: Staff 1 stated that when child 1 displays inappropriate behaviors staff will separate the child from others and have grabbed the child by the arms to prevent the child from hurting others. Staff 1 stated that child 1 often displays challenging behaviors such as throwing chairs, tantrums, and hitting others.

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8VAC20-780-60-A · Based on review of five (5) child records, the center did not ensure that all records were complete.

Evidence: 1. The record for child #2 (enrollment date 8/1/2023), child #3 (enrollment date 5/23/2022), and child #5 (enrollment date 3/6/2023) did not contain the parent?s work number. 2. The record for child #3 did not contain documentation of child updates and confirmation of up-to-date information the child?s record.

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22.1-289.035-B-4 · Based on record review, the center failed to obtain a copy of the results of a criminal history record information check, a sex offender registry check, and a search of the child abuse and neglect registry from any state in which the individual has resided in the preceding five years.

Evidence: The record for staff #3, indicated that they have lived in another state within the 5 years preceding the date of employment. The record did not contain documentation of a criminal history information check, a sex offender registry check, or a search of the child abuse and neglect from that state. Staff #3 was observed working in a classroom alone with children.

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8VAC20-780-400-B · Based on interview and documentation review, the center failed to ensure that behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior to resolve conflicts. Evidence: Interviews revealed that on May 8, 2023 child #1, age 4 years, was heard screaming. Staff #2 went into the classroom to investigate. Child #1 stated that staff #1 put her hands around child #1's neck. Child #1 had a large red mark on their neck. When interviewed by center administrators, staff #1 stated that she was trying to break up an altercation between child #1 and another child and she grabbed child #1 on the shoulder. Documentation review revealed that staff #1 was terminated on 05/15/2023.

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8VAC20-780-140-A · Based on records review, the center failed to ensure that each child has a physical examination within 30 days after the first day of attendance. Evidence: The record for child #1, date of enrollment, 11/18/22, did not contain documentation of a physical.

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8VAC20-780-140-A · Based on records review, the center failed to ensure that each child had a physical within 30 days of attendance at the center. Evidence: The record for child #2, date of enrollment 7/11/2022, did not contain documentation of a physical.

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22VAC40-185-60-A · Based on a review of children's records and interview, the provider did not ensure that each child's record contained the required information.

Evidence: 1. The records of child #4 (enrolled 5/2/22) and child #5 (enrolled 5/23/22) did not contain documentation of two people to call in an emergency. 2. The records of child #3 (enrolled 5/13/22), child #4 (enrolled 5/2/22) and child #5 (enrolled 5/23/22) did not contain documentation of parent agreements. 3. The record of child #5 (enrolled 5/23/22) did not contain documentation of doctor's name and phone number and did not contain documentation of immunizations.

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8VAC20-780-500-B · Based on observation and interview, the center did not ensure that diapers shall be disposed in a leak-proof or plastic lined storage system that is foot-operated or used in such a way that neither the staff member's hand nor soiled diaper touches an exterior surface during disposal.

Evidence: There was no leak-proof or plastic lined storage system that is foot-operated observed in the classroom where diapering occurs. Administration acknowledged the center did not have one.

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