8VAC20-780-600-F · Staff who work directly with children shall, in addition to preservice and orientation training,

annually attend at least 16 hours of training and staff development activities, to include the department's health and safety update course. Staff #7 did not have documentation of completing the department's health and safety update course for the 2024 year.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

Staff #2 updated tuberculosis screening was due 17 days ago. The updated screening has not yet been completed.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-160-A · Based on review of five staff records and interview, the center did not obtain documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with children. The documentation shall have been completed within the last 30 calendar days of the date of employment.

Evidence: 1. The record of staff #4, employed 03/13/2024, contained documentation of a negative tuberculosis screening dated 03/14/2024, exceeding the first day of employment. 2. The director acknowledged the TB results for staff #4 were documented after the first day of employment.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-40-E · Based on interviews with staff and review of supervision policies, the facility failed to follow the center's own policies and procedures that are required by these standards.

Evidence: 1. On December 4, 2023, at approximately 9:30 am, staff #1 reportedly told management that child #1 and child #2 (both 3 years in age) could not be located. During interviews, it was reported that child #1 and child #2 were separated from their class while they were outside picking up sticks and leaves for a nature project. It is estimated the two children could not be located for at least 15 minutes. 2. The center's supervision policy states "If a situation occurs during which a child is unaccounted for, the manager in charge should be notified immediately.? and ?Children must be within sight and sound of the teacher at all times?. 3. A member of management stated staff #2 did not immediately notify management but rather notified staff #1.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-350-B-3 · Repeat Violation

Based on observation and interviews with center staff, the center failed to ensure the 1:8 staff-to-child ratio requirement was met for children ages 2 years old. Evidence: 1. During the inspection, the Stepping Stones room (two year olds) was observed via live video footage at approximately 3:10 pm to have 9 children with one staff. 2. During an interview with the Staff #2 and Staff #3, it was acknowledged that the center was out of ratio with 9 children being supervised by one staff. One additional staff was required.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-350-B-2 · Based on an interview with the center?s director, the center failed to ensure the 1:5 staff-to-child ratio requirement was met for children ages 16 months up to 24 months.

Evidence: During an interview with the director it was stated, ?This morning was a bit chaotic and we were over.? The director stated, that on 7/10/2023 at approximately 7:40 am, toddler room B (16 months-24 months) was out of ratio with 6 children being supervised by 1 teacher for approximately 10 minutes. One additional staff was required.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-160-A · Based on review of nine staff records, the center did not obtain documentation of negative tuberculosis screening at the time of employment and prior to coming into contact with child for one staff record.

Evidence: The record of staff #4, employed 04/18/2023, did not contain documentation of a tuberculosis screening. The director stated current results of a tuberculosis screening had not been obtained. Staff #4 was observed working with children on May 8, 2023.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-550-P · Based on a review of documentation on 02/01/2023, the center did not ensure that written injury records contained the required information.

Evidence: Two out of three written injury records reviewed did not contain the time when parents were notified of the injuries. The center should maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record should include the date and time of injury; name of injured child; type and circumstance of the injury; staff present and treatment; date and time when parents were notified; any future action to prevent recurrence of the injury; staff and parent signatures or two staff signatures; and documentation on how parent was notified.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

8VAC20-770-60-C-2 · Based on review of nine staff records and interview, the center did not obtain the results of the central registry background report within 30 days of employment for one staff member.

Evidence: The record of staff #1, employed 05/11/2022, contained the results of a central registry background report dated 08/17/2022 exceeding 30 days from employment. Documentation showed the request for the central registry portability had been made on 05/11/2022. The director stated she did not have documentation of a follow up as to the status of the request after 30 days from employment when the results had not been received.

Open Not marked corrected in the state record

Category: background checks. Open / not marked corrected.

8VAC20-780-210-A · Based on review of staff records, the center did not ensure one staff member met program

leader qualifications. Evidence: 1. The record of staff #2, employed 09/21/2020 and identified as a program leader, did not contain documentation of additional education or 24 hours of training within six months of beginning work or within 30 days after being promoted or beginning work. 2. The record contained documentation of a high school diploma and six months of programmatic experience, however there was no documentation of 24 hours of training.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

22.1-289.035-A · Based on a review of records and interview, the center did not have documentation of an updated central registry finding every five years from the date of the most recent central registry finding.

Evidence: The record for staff #3 had an updated central registry dated 4/06/2021. The central registry should have been updated prior to expiration of the last central registry finding dated, 02/05/16.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.