Karter School of Cascades

8VAC20-780-270-A · Areas and equipment of the center shall be maintained in a clean, safe and operable condition.

A faucet in a preschool classroom had rusted on the top. In addition, there was an area of the wall in a two year old classroom that had paint chipping off.

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8VAC20-780-140-A · Physical examinations completed by a physician shall be obtained prior to the first day of attendance or within 30 days after the first day of attendance.

There was no physical examination in the record of child #5, who had been enrolled for 37 days.

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8VAC20-780-60-A-8 · Based on record review, an updated written care plan was not for each child with a diagnosed food allergy was not obtained annually.

Evidence: 1. Child #11 had an allergy action plan dated 06/12/2024.

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8VAC20-780-60-A · Based on record review and interview, the center did not obtain all the required information for each child's record.

Evidence: Child #5 is missing proof of identity and two emergency contacts.

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8VAC20-780-130-A · Based on record review and interview, the center did not obtain documentation of the required immunization record.

Evidence: 1. Child #2 did not have documentation of an immunization record that is required by the State Board of Health before their first day of attendance. 2. Child #2 start date is 11/02/2022.

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8VAC20-780-280-B · Based on observation and interview, hazardous substances such as cleaning materials were not kept in a locked place using a safe locking method that prevents access by children.

Evidence: A bottle of disinfectant spray and all-purpose cleaner was found in the Venice classroom's bathroom, on a shelf above the diaper changing table, not locked.

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8VAC20-780-40-E · Based on video observation and a review of the center?s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance.

Evidence: 1. On October 17, 2022, video footage shows Staff #1 taking a stuffed toy from Child #1 after a child claims Child #1 hit them. Staff #1 told Child #1 to apologize and then pushed Child #1's head twice. 2. On October 18, 2022, video footage shows several children on the playground holding and straddling Staff #1's legs and feet. After a while, Staff #1 appeared frustrated and pushed Child #3 on the head and Child #4 on the shoulder to prevent them from straddling their leg again. 3. Staff #1 failed to adhere to the center?s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?

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63.2-1509-A · Based on interviews, the center failed to contact the local department or the department's toll-free child abuse and neglect hotline to report an allegation of suspected child abuse or neglect.

Evidence: On October 27, 2022, the center received notification from the local authorities about a recording of Staff #1 rough handling Child #1, which occurred at the center on October 18, 2022. The facility did not contact the local department or the department's toll-free child abuse and neglect hotline to report the allegation as mandated.

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8VAC20-780-40-E · Based on video observation and a review of the center?s written policies, it was determined the center failed to comply with its own policies and procedures as it relates to behavior guidance.

Evidence: 1. On October 21, 2022, Staff #1 is seen on video pushing Child #1 (4-year-old), which causes the child to fall and hit the back of their head on a wooden chair after the child is seen pushing into them. 2. Staff #1 failed to adhere to the center?s written policy for the discipline of children, which states: ?Our number one tool for inappropriate behavior is redirection. Redirection requires the team member to guide the child to the appropriate behavior.?

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8VAC20-780-40-E · Based on staff interviews, it was determined the center failed to comply with its own policies and procedures as it relates to reporting incidents.

Evidence: 1. On 10/12/2022, child #1 informed multiple staff members that child #2 had grabbed and hit them several times in the private area. Staff members did not notify a leadership member within 30 minutes of the incident, and the parents of children #1 and #2 were not notified within 1 hour of the incident or immediately, as required by center policy. Incident reports were completed for both children after the parent of child #1 reported the incident to a leadership member. 2. The staff failed to adhere to the center?s policy, which states: ?When accidents or behavioral incidents occur, it is important to complete the appropriate form and notify a leadership member within 30 minutes of the occurrence. The parent must be notified within the hour of the incident and if the incident is severe the parent must be notified immediately. Report all incidents or accidents, no matter how minor they may seem, to leadership so that they can help assess the situation."

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8VAC20-780-160-A · Based on record review and staff interview, the center did not ensure that a tuberculosis screening was completed within the last 30 calendar days of the date of employment .

Evidence: 1. Date of employment for Staff # 2 was 5/23/22 and the tuberculosis screening on file was dated 06/07/2022. 2. Date of employment for Staff #3 was 8/22/22 and the tuberculosis screening on file was dated 12/2/2021.

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