8VAC20-800-240-A · Areas and furnishings of the family day home, inside and outside, shall be

maintained in a clean, safe, and operable condition. The wooden lattice that ran along the stair railing leading to the outdoor play area was broken and had two nails exposed that were accessible to the children in care.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-790-250-F · Repeat

Based on review of caregiver records, the provider did not ensure caregivers who work directly with children completed, in addition to preservice and orientation training, at least 16 hours of training to include the department?s health and safety update course annually. Evidence: The record of caregiver #1 contained documentation of the department?s health and safety updated training dated 09/29/2022. The record did not contain the health and safety updated course for the 2023 year exceeding the annual requirement. The provider stated she had not completed the training.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-800-700-C · Based on review of documentation, observation, and interview, the provider did not ensure when an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parents within 14 days shall be taken to a pharmacy for proper disposal.

Evidence: 1. The medication authorization for child #2 was dated 01/12/2024 and only signed by the parent. The parent?s written authorization shall expire or be renewed after 10 working days. The medication authorization for child #2 expired on 01/25/2024. Medication for child #2 was observed on site exceeding 14 days from the date of the authorization expiration. 2. The medication authorization for child #3 was dated 01/08/2024 and only signed by the parent. The parent?s written authorization shall expire or be renewed after 10 working days. The medication authorization for child #3 expired on 01/19/2024. Medication for child #3 was observed on site exceeding 14 days from the date of the authorization expiration. 3. The medication authorization for child #4 was dated 01/17/2024 and only signed by the parent. The parent?s written authorization shall expire or be renewed after 10 working days. The medication authorization for child #4 expired on 01/30/2024. Medication for child #4 was observed on site exceeding 14 days from the date of the authorization expiration.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-790-250-F · Based on review of caregiver records, the provider did not ensure caregivers who work directly with children completed, in addition to preservice and orientation training, at least 16 hours of training to include the department?s health and safety update course annually.

Evidence: The record of caregiver #1 contained documentation of the department?s health and safety updated training dated 09/29/2022. The record did not contain the health and safety updated course for the 2023 year exceeding the annual requirement. The provider stated she had not completed the training.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-800-700-A · Based on review of medication logs and interview, the provider did not ensure prescription and nonprescription medications were only given to a child with written authorization from the parents.

Evidence: 1. The record of child #5 contained a medication log listing nine dates where a prescription medication was administered to the child. The record did not contain a medication authorization completed by the parent. 2. The provider stated she had administered the medication and the parent had only verbally authorized the administration of the medication.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-800-830-A · Based on review of documentation and interview, the provider did not ensure emergency evacuation procedures were practiced monthly with all caregivers and children in care during all shifts that children are in care.

Evidence: The evacuation log had one evacuation drill documented on August 1, 2022. There were no drills documented for the months of September 2022 through December 2022. The provider stated she had only conducted the one evacuation drill.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.