8VAC20-790-600-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 #2 and staff #5 did not have record of a completed 2024 health and safety update.

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 #5's updated screening was completed over 8 months late.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

8VAC20-780-40-E · Based on a review of documentation, video footage, and interview, the center did not ensure that their operational responsibilities included ensuring that their activities and services were maintained in compliance with the center's own policies and procedures that are required by these standards.

Evidence: 1. The standards require the center to have a procedure for identifying where attending children are at all times, including procedures to ensure that all children are accounted for before leaving a field trip site and upon return to the center. In interview, administration identified a name to face procedure in the handbook. The policy states that each time the class enters or exits through any door in the building, a name to face check must be completed on the Check In/Out Sheet BEFORE entrance or exit. The handbook states that staff are not permitted to exit the vehicle if students are aboard. The handbook also contained a policy that upon arriving to the center from a trip, the driver must 1. call the center to request a MANAGER for a bus sweep. If a manager is unavailable, a staff may be sent as a designee. 2. Walk to the back of the bus to ensure that all children are awake and alert. Only drivers can push the red safety button, and under no circumstances can a child push the red safety button. 3. With a Manager or Staff Member present, use the check on/off list to exit the bus. Name to face recognition must be used. 4. After all students have exited the bus a manager, staff member or driver will verify that all children have been removed by walking to the back of the bus. The Manager or designee will also confirm that all children not checked on and off are absent and a confirmation call has been made to the parent if parent communication has not already been made. Manager/Designee initials required. 2. In interview, staff #1 and staff #2 acknowledged that they did not conduct a name to face before the children entered the building from the bus and acknowledged that the staff exited the vehicle with the child unknowingly left aboard. Administration stated that they were not called to perform a bus sweep. 3. Administration acknowledged that the center's written procedures were not followed.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

22.1-289.035-A · Based on a review of six staff records and interview, the center did not ensure to obtain a repeat fingerprint background check for one staff every five years as required.

Evidence: 1. The record of staff #6 (date of employment: 6/3/2019) contained a fingerprint background check dated 5/9/2019. 2. Administration acknowledged that the repeat background check had not been completed within 5 years.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-340-A · Based on a review of video footage, documentation and interview, the center did not ensure that when staff are supervising children, they shall always ensure their care and protection.

Evidence: 1. On 2/9/2024, child #1 (date of enrollment: 11/6/2023) sustained injuries on her arms when she was roughly placed on her cot by staff #1 (date of employment: 5/10/2023). In video footage, staff #1 is observed placing child #1 on a cot and subsequently checking the undersides of her arms on two separate occasions. The areas of the child?s injuries were consistent with fingernail marks and were located in the areas where staff #1?s hands were placed as well as where staff #1?s areas of focus were during her examinations. The parents of child #1 discovered the injuries and reported that child #1 received medical attention. 2. Administration acknowledged that child #1 was not properly cared for.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-270-A · Based on observation and interview, the center did not ensure that areas and equipment of the center, inside and outside, were maintained in a clean, safe and operable condition.

Evidence: 1. On the school age playground, the support bases of two basketball hoops were observed to be cracked/ broken. 2. Administration acknowledged that the equipment was broken and required maintenance.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-340-A · Based on review of documentation and interview, the center did not ensure that when staff are supervising children, they always ensure their care and protection.

Evidence: 1. On 12/2/2022, the Department of Education received a self-report of a serious injury that occurred at the center on 12/1/2022. Video documentation was reviewed and interviews were conducted. In a video recording from 12/1/2022 observed on 12/7/2022, staff #1 (date of employment: 5/18/2022) was observed working on an activity in the corner of the classroom while another teacher was engaging with the children in the center of the room. In interview, staff #1 stated that she was cleaning toys and was not required in the teacher to ratio. In the video, child #1 (age two) and child #2 (age 2) are seen walking over to the area where teacher #1 was cleaning toys. Teacher #1 is observed taking both children by the hand/wrist area. Staff #1 takes few steps to get around the tables, lifting the children off the ground towards the middle of the classroom. When teacher #1 returns child #1?s feet to the ground, child #1 is observed crying. Teacher #1 is observed rubbing the child?s arm and holding the child. In an interview with administration, teacher #1 reported the injury immediately. Child #1 was treated for a dislocated elbow and wrist injuries. In an interview, Staff #1 stated that she was cleaning toys when the two children approached her. She stated that she was ?trying to return the children safely back to the group and away from the cleaning supplies? when she ?lifted child #1 and accidentally hurt him.? 2. Administration acknowledged that staff are trained to how lift children safely. They acknowledged that child #1 was cared for improperly when staff #1 lifted him by one arm which resulted in injury.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

8VAC20-780-140-A · Based on a review of 5 children?s records and interview, the center did not ensure that 1 child had a physical examination by or under the direction of a physician: 1. before the child's attendance; or 2. within 30 days after the first day of attendance.

Evidence: 1. The record of child #4 (DOE: 06/14/2022) did not contain a physical examination report. 2. Administration acknowledged that the physical examination report was not obtained.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

8VAC20-780-40-E · Based on review of documentation and interview, the center did not maintain compliance with the center's own policies and procedures that are required by these standards.

Evidence: 1. The center's policy states, "All the following actions are forbidden and will result in immediate termination: Enclosure in a small, confined space or any space that the child cannot freely exit himself." (pg. 38) 2. On 3/28/2022, teacher #1 placed child #1 in time-out in the bathroom with the door closed. It was reported that child #1 cried and teacher #1 did not immediately respond. 3. Administration acknowledged in their written incident evaluation that the actions of teacher #1 were "not in compliance with our behavior guidance policies and procedures."

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.