Main Street Day Care Center, Inc.

22VAC40-185-340-A · Based on interviews the licensee failed to ensure the care, protection and guidance of a child in care.

Evidence: 1. Staff #1 and #3 confirmed that on June 7, 2021 on or about 5:00 p.m. child #1 was erroneously dismissed from his classroom for parent pick up. 2. Child #1 walked unsupervised down the hallway and exited through the facility?s main door. 3. Staff #3 confirmed that there was not a staff person present at the front desk or entrance to the facility at the time. 4. At approximately 5:15 p.m. a witness saw child #1 standing unsupervised in the parking lot ?about 10 feet from the first parking spot?. 5. Two witnesses stated that while child #1 was standing in the parking lot, there were multiple families picking up children from care and moving cars entering and leaving the parking lot. 6. Child #1?s father arrived to pick up child #1 and discovered him standing unsupervised in the parking lot.

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8VAC20-780-160-A · Each staff member shall submit documentation of a negative tuberculosis screening at the time of employment and prior to coming into contact with the children. The screening for Staff #1 was completed three weeks after hire.

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8VAC20-780-60-A-8 · A written care plan is required for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Child #1, who has been enrolled for more than a year, has a diagnosed food allergy and did not have a written care plan in their file.

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22.1-289.035-B-4 · (Repeat Violation) The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. The center did not request a search of the child abuse and neglect registry from one state for Staff #8, who has been employed for more than ten months.

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22.1-289.035-B-4 · (Repeat violation) The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #1, employed for more than 3 months, did not have documentation of requesting a central registry check from the state previously resided in within the past 5 years.

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22.1-289.035-B-4 · Based on review, facility did not ensure 1 of 10 staff have required background checks completed.

Evidence: The record for staff #4 (start date 10/30/2023) had documentation of living outside the state of Virginia within the past 5 years and there was not documentation of a child abuse and neglect registry search completed for that state.

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8VAC20-780-60-A-8 · *** REPEAT VIOLATION***

Based on a review of records and interview, the facility did not have a written care plan for each child with a diagnosed food allergy to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction. Evidence: The record for child #9 whose record contained documentation of an allergy to peanuts, did not contain a written care plan with instructions from child #9's physician in case of a reaction. The center confirmed that the allergy was documented in the child's record, but that a care plan was not present at the center for child #9. The same documentation was missing from child #9's record when it was reviewed on 5/24/2023.

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8VAC20-780-60-A-8 · Based on a review of records and interview, the facility did not have a written care plan for each child with a diagnosed food allergy to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction.

Evidence: The record for child #3 whose record contained documentation of an allergy to peanuts, did not contain a written care plan with instructions from child #3's physician on case of a reaction. The center confirmed that the allergy was documented in the child's record, but that a care plan was not present at the center for child #3.

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8VAC20-780-550-P · Based on a review of documentation and interviews, the licensee did not always maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence.

Evidence: The licensee self-reported to licensing that a parent was concerned that her toddler (child #1)Incurred marks on his face while in care. The parent noticed two small oval red marks, one on each of the child's cheeks, when she arrived during nap time to take her child home. The child's parent inquired about the marks with the two staff present in the classroom. However, these staff had just arrived in the classroom to relieve the morning staff whose shift ended and had not been informed of the marks or how they were incurred. The parent then voiced her concern about the red marks on her child's cheeks with the program director who confirmed the presence of the marks but stated that she was not aware of how or when they appeared, and said she would speak to the morning staff to get more information. The child's parent was not provided with any written report documenting the presence of the red marks on her child's cheeks on that day nor later. When the licensing inspector asked to view documentation of the minor injury which left marks on the child's cheeks, the program director was unable to demonstrate that a report had been written.

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22.1-289.035-B-2 · Based on a review of records and interview, the licensee was unable to demonstrate that each staff person working with children in the center submitted results of a federal criminal records review prior to employment.

Evidence: Ten staff records were reviewed. The record for staff #1 whose date of hire was documented as 9/1/2022, contained the results of a federal criminal records review which was dated 9/8/2022 (after the initial date of employment). The record for staff #2 whose date of hire was documented as 4/20/2022, contained the results of a federal criminal records review which was dated 4/21/2022 (after the The record for staff #6 whose date of hire was documented as 1/3/2023, contained the results of a federal criminal records review which was dated 1/10/2023 (after the initial date of employment). initial date of employment). The administrative staff who maintains staff records confirmed this documentation during the inspection.

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8VAC20-780-40-E · Based on a review of documentation and interviews, the licensee did not ensure that the center's activities, services, and facilities were maintained in compliance with the licensing standards and the center's own policies and procedures that are required by these standards.

Evidence: It was established through interviews that on 3/23/2022, three or four children, three years of age, were permitted to use a restroom located down the hall from their classroom suite and that they were not in direct sight and sound supervision of staff while still in transit and after reaching the restroom. Staff #1 confirmed that she was observing a group of three year old children in route to the restroom from the doorway of the classroom suite when she returned to the classroom to assist another child. Staff #2 stated that she came down the hallway from the end opposite to the classroom and saw child #1 standing in the hallway. Staff #2 confirmed that there were no other staff in sight at that time. The written injury prevention plan for the center, viewed on site on 10/11/2022, says ?The staff will always walk to the bathroom with each child or group of children and stay within sight and sound. Once all of the bathroom breaks are done and all children are accounted for you may return to the room with the children.? Staff #5 confirmed that the written injury plan was last updated in June of 2022. Staff #1 did not comply with the center?s own injury prevention plan when she allowed children to go to the restroom outside of staff sight and sound supervision on 3/23/2022 and a child was injured while running into the restroom.

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8VAC20-770-60-C-2 · Based on a review of records and interview, the licensee does not have a central registry finding for every staff member within 30 days of their employment or volunteer service.

Evidence: Four staff records were reviewed. The record for staff #4, whose date of employment was 5/20/2019, did not contain the results of a Virginia Search of the Central Registry. The record contained a response letter from the agency stating that the request form contained an error and needed to be resubmitted, but no results of the Search. The program director confirmed that the results were not present in the record at the time of inspection.

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