8VAC20-780-510-G · Medication shall be labeled with the child?s name, the name of the medication, the dosage amount, and the time or times to be given.

Medication #1 was not labeled with the dosage amount or the time or times to be given.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-340-A · When staff are supervising children, they shall always ensure their care, protection, and guidance.

On April 7, 2025, while diapering Child #1 (age fifteen months) Staff #1, who knew child #1 could roll over, stepped away from the counter the child was lying on, while not looking at, nor touching the child, to get diapering supplies. Child #1 fell approximately 3 feet to the bare floor hitting their forehead on the handles of the lower cabinet and body on the bare floor, resulting in the child crying and having a red mark and bruise on the child?s forehead.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-40-E · The operational responsibilities of the licensee shall ensure that all the center?s activities, services, and facilities are maintained in compliance with the center?s own policies and procedures that are required by the standards.

The standards require procedures for identifying where children are at all times. The center?s staff handbook states ?Staff shall maintain accurate attendance records at all times. This is to all children are accounted for at all times. Center staff are responsible for conducting head counts after each transition, to and from the classroom, to and from the playground area and to and from any field trips or walking trips? and ?Staff will always know the location of all children and be within sight and/or sound of children in their care. Head count of children will be completed in each classroom or group every 5-10 minutes to ensure that all children are accounted for? On April 4, 2025, fifty minutes passed without head counts being conducted in Classroom #1 to include a transition of the children from Classroom #1 to the playground. As headcounts were not conducted, Staff #1 did not realize Child #1, four years of age, was missing from the group until another staff inquired about the child.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-500-A · Staff shall wash their hands with soap and running water before and after a diaper change.

Staff # 8 changed a child?s diaper in Classroom #1 and did not wash their hands with soap and water after the diaper change.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-320-B · Each restroom area provided for children shall be equipped with soap, toilet paper and disposable paper towels.

The two downstairs restrooms did not have paper towels.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-780-40-M · REPEAT VIOLATION

The center is required to keep a current list of all known allergies, sensitivities, and dietary restrictions in each room or area where children are present. The three-year-old classroom did not have the allergies, sensitivities, and dietary restrictions list.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-270-A · COMPLAINT RELATED VIOLATION

REPEAT VIOLATION Based observation and interview, the center failed to ensure that all areas and equipment of the center are maintained in a clean, safe, and operable condition. 1. The pink foam mat in the 2?s room, the ABC foam mat in the waddler room, the chevron striped foam mat in the waddler room, the grey and white foam mat in the older infant room and the white foam mat in the infant room all were cracked in various places and exposing the material inside. (photos attached). 2. The sun and rainbow rug in the 2?s room, the ?I am feeling?? rug in the 2?s room, the grey rug in the older infant room and the grey and white foam mat in the older infant room were all visibly dirty. (photos attached). 3. The walls in the 2's room do not reach the ceiling of the room. An unsecured box fan was sitting on top of a plank of wood that was placed diagonally across the where two of the walls meet in the corner of the room. An unattached screw was observed on the bottom of the fan and the electrical cord was wrapped around the plank, leaving the fan unsecured. The fan was over the play area of the classroom. 4. The walls in the Waddler room do not reach the ceiling of the room. An unsecured box fan was leaning against a small pipe and tank. The fan was over the play area of the classroom. 5. Interviews revealed an unsecured box fan that had been in use in the older infant room had previously fallen into an unoccupied crib.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-40-M · Based on observation, the center failed to ensure that in each room or area where children are present, there is a current written list of children?s allergies available to staff.

Evidence: 1. In the older 3?s classroom, there was no written allergy list available to staff. Staff #7 confirmed that at the time of the inspection, there was no written allergy list available to staff.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-340-A · Based on observation and interview, the center failed to ensure when staff are supervising children, they always ensure their care, protection, and guidance.

Evidence: 1. Staff #1 reported to the department that on 03/13/2024, Child #1 and another child pulled a shelf over which fell on top of the two children. Staff #1 reported that Child #1 had bruising on their face as a result of the incident. 2. Video provided by the center shows two children pulling the shelf over which fell on top of the two children. 3. Staff #1 disclosed that the shelf was not attached to the wall at the time of the incident.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-40-M · Based on observation, the center failed to ensure that the list of children?s allergies, sensitivities and dietary restrictions is available to all staff who work with children and is kept confidential in each room or area where children are present.

Evidence: 1. In the older three?s classroom, infant room, PreK fours? room, fours? classroom and two?s classroom, the list of children?s allergies, sensitivities and dietary restrictions was posted but not in a confidential manner. 2. In the younger three?s classroom, staff were unable to locate the list of children?s allergies, sensitivities, and dietary restrictions.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-280-B · Based on observation, the center failed to ensure that all hazardous items were kept in a locked location.

Evidence: 1. In the restroom located next to the Infant Classroom there was a four pack of Great Value Disinfect Wipes on a shelf. The manufacturer's label stated "keep out of reach of children", and "hazardous to humans and domestic animals." 2. The door to the restroom was open. Staff #2 verified that the restroom was used for children and that the wipes were not in a locked location.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

8VAC20-780-310-E · Complaint Related

Based on interview, the center failed to ensure that when children are on the outdoor play area, at least 75 square feet of space per child is provided. Evidence: 1. Staff #2, Staff #3 and Staff #4 confirmed that a small portable fence had been used to contain Child #1 during outside play time. 2. Staff #2 stated that the fence had been used for Child #1 regularly until ?about a week and a half ago?. 3. The area that the portable fence provided was measured and determined to be 16 square feet. Staff #2 confirmed that the 16 square foot area was the space that was previously provided for Child #1 during outside play time.

Open Not marked corrected in the state record

Open / not marked corrected.

8VAC20-780-200-A · Complaint Related

Based on interviews and review of documentation, the center failed to have a qualified program director or a qualified back-up program director who meets one of the director qualifications who is regularly on site at least 50% of the center's hours of operation. Evidence: 1. During interview on 07/18/2023, Staff #1 confirmed that Staff #10 is the only program director and that there is not a qualified back-up program director. 2. Staff #10 was not present during the inspection conducted at the center between the hours of 2:00 p.m. and 4:00 p.m. on 07/18/2023. 3. Two of the eight staff members interviewed said the program director is present at the center at least 50% of the center?s operating hours. 4. One of the eight staff members interviewed responded that ?it doesn?t seem like it? when asked if the director is regularly at the center at least 50% of the center?s operating hours. 5. One of the eight staff members interviewed does not work a full-time regular shift and was unsure if Staff #10 is regularly present at least 50% of the center?s operating hours. 6. Four of the eight staff members interviewed stated that the program director is not regularly at the center 50% of the center?s operating hours.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-270-A · Based on observation and interview, the center failed to ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition.

Evidence: 1. Under the awning of the infant room door there was one wasps nest observed. Under the awning of the two-and-a-half-year-old to four-year-old room door, there were 3 wasps nests observed. Staff #1 confirmed the presence of the wasp?s nest. 2. In the infant room, the wall paneling was loose and had gaps in the corners. Staff #1 confirmed that the wall paneling was loose and had gaps in the corners. 3. One ceiling light cover was missing in the infant room. One cover to an unknown fixture in the infant room ceiling was missing. There were two unknown fixture holes in the main ceiling missing a cover. Staff #1 confirmed that the covers were missing.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.