Unique Little Hands Inc.

22.1-289.035-B-4 · The center is required to obtain background checks from any state in which the individual has resided in the preceding five years. Staff #5, employed for two days, did not have documentation of requesting a criminal history check from two states and a sex offender search from three states.

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8VAC20-780-60-A · (Repeat violation) Each center shall maintain and keep at the center a separate record for each child enrolled that contains all of the required information. The record for Child #3, enrolled for three months, was missing physician name and phone number. The record for Child #5, enrolled for eleven months, was missing parents' employment phone numbers.

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8VAC20-780-150-B · The center must obtain, for each enrolled child, dated results of a physical examination and dates immunizations were received, signed by a physician, his designee, or an official of a local health department. Child #4's immunization record was not signed by a physician, his designee, or an official of a local health department. Child #5's immunization record and physical exam results were not signed by a physician, his designee, or an official of a local health department.

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8VAC20-780-60-A · Each center shall maintain and keep at the center a separate record for each child enrolled which shall include the following information: The name, home address, and home phone number of each parent who has custody; Work phone number and place of employment of each parent who has custody; Name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached; Name of any additional programs or schools that the child is concurrently attending and the grade or class level.

The record for Child #1, who has been attending the program for over 8 months, did not contain the place of employment for one parent or the name of any additional programs or schools that the child is concurrently attending. The record for child #2, who has been attending the program for 4 years, did not contain the name of any additional programs or schools that the child is concurrently attending. The record for Child #5, who has been attending the program for 1 week, did not contain the home address of either parent, the work phone number for either parent, the city state and zip code of the two designated people to call in an emergency if a parent cannot be reached or the name of any additional programs or schools that the child is concurrently attending.

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8VAC20-790-600-F · Based on a review of records and interview, the licensee did not ensure that each staff annually completes the department's health and safety update course.

Evidence: 7 staff records were reviewed. The record for staff #4 contained the last health and safety update training which was dated more than 12 months ago (4/10/2023). The record for staff #5 contained the last health and safety update training which was dated more than 12 months ago (3/5/2023). The assistant director confirmed that more recent training certificates were not available.

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22.1-289.035-B-2 · Based on a review of records, the licensee did not ensure that staff are not employed prior to the receipt of a Criminal Record Search.

Evidence: The record for staff #2 contained documentation of staff#2 obtaining orientation training on 3/11/2024. However, staff #2's results of the Criminal Record Search (fingerprints) were dated after that date, on 4/3/2024. Staff must not be employed (which encompasses orientation, training or other activities in addition to working directly with the children) until the results of the Criminal History background check results are received back.

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8VAC20-780-340-A · ***REPEAT VIOLATION***

Based on a review of video footage, written documentation, and interview, staff did not always ensure the care, protection and guidance of children they were supervising. Evidence: 1. Staff failed to ensure child #1's care protection and guidance when a two-year-old child (child #1) was bitten in the face by another child during a physical struggle between the two children in the Waddler classroom on 1/23/2024. There were 7 children between the ages of 12 months and 2 years of age in the care of two staff in the classroom at the time. 2. Classroom footage of the Waddlers classroom (ages 12 months through 2 years old) showed four children, to include child #1 and child #2, playing on the rug in the front room of the classroom. No staff were present in the front room of the two-room open suite which is divided by a large open archway. Child #2 pushes child #1 over from a sitting position, and lays on top of child #1. Staff #1 walks from the back half of the classroom down a side corridor within the classroom as child #1 is pinned underneath child #2, kicking her legs. Child #2 lowers his face to child #1's face for several seconds before sitting upright, still on top of child #1. Child #1 raises her hands to cover her face. Approximately 10 seconds pass between when child #1 was pushed over by child #2 and when staff #1 lunges to quickly move a table blocking the corridor from the classroom and separates the children. Staff #2 is then seen walking into the view of the camera from the furthest rear portion of the classroom. 3. Interviews reveal that staff #1 was hanging the children's artwork to dry in the corridor with her back to the children when she heard child #1 cry out. Staff #2 was hanging up the children's coats on the coat hooks at the far side of the back room. Staff were unaware that a physical struggle was talking place for approximately 10 seconds before child # 1 cried out upon being bitten by child #2. 4. A photograph taken of child #1 following the incident on 1/23/2024 shows a dark red bite mark on child #1's cheekbone under her right eye. 5. The incident report written following child #2 being bitten states that child #1 was bitten by another child who was "playing aggressively".

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8VAC20-780-340-A · *** REPEAT VIOLATION ***

Based on interviews, incident report and additional, related documentation, staff did not always ensure the care, protection and guidance of children in attendance at the center. Evidence: The Program Director self reported an incident in which a child's elbow was dislocated while in care. Interviews with staff and written documentation describe a two and a half year old child (child #1) incurring an injury to her arm on 1/10/2024 which resulted in a diagnosis of "nurses elbow" by the child's medical provider. Interviews and written reports state that staff #1 held child #1 by her by her arm when child #1 "fell out" in response to being told it was time to transition from her current activity. Interviews confirm that staff are trained to never hold a child by their arm. However, staff #1 stated that "it was reflex" to catch child #1 by her arm, to keep her from falling to the floor.

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8VAC20-780-340-A · Based on interviews, review of documentation and photographs, and inspection of the physical plant, staff did not always ensure the care, protection and guidance of the children in their care.

Evidence: 1. Staff failed to ensure the care, and protection of a two and a half year old child (child#1) who was bitten twice while in care at the center on April 13, 2023. Child #1?s parent observed two large bruises on child #1?s left arm after picking up child #1 from the center on April 13, 2023. Child #1 was examined by a physician on April 14, 2023 and a written report was obtained confirming that the bruises on child #1?s arm were consistent with human bite marks. The staff who cared for child #1 on April 13, 2023 were unable to tell the parent the circumstances surrounding child #1 being bitten and stated that they were not aware that child #1 had been bitten. 2. Staff failed to ensure the care, and protection of three year old child (child#1) when child #1 was able to open the exit door leading from the classroom to the exterior of the center where a parking lot is located. On October 20, 2023 staff reported to child #1?s parents via the center?s digital communication application that she observed child #1 independently open the classroom door that leads directly outside. On 12/8/2023, the licensing inspector pushed the actual exit door without touching the crash-bar and the door opened. The door was not closed sufficiently to engage the latch that secures it closed. After re-closing the door tightly, the door would not open without engaging the crash-bar. On 1/18/2024 the licensing inspector pushed the actual exit door without touching the crash-bar and the door did not open. The program director stated that sometimes another class will exit through that door to take their group outside and may have engaged the deadbolt so that the door would not close completely and they could re-enter the building without the door being locked to them, outside. The program director demonstrated how this could have been done

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8VAC20-790-600-D-1 · Based on a review of records and interview, the licensee did not ensure that all staff who work directly with children shall have within 90 days of the date of employment, current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care.

Evidence: Five staff Records were reviewed. The record for staff #5, whose date of hire was documented as 2/28/2023, did not contain documentation of certification in cardiopulmonary resuscitation (CPR). The program Director confirmed that this documentation was not present in the record.

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8VAC20-780-70 · ***REPEAT VIOLATION***

Based on a review of records and interview, the licensee did not always keep all of the required records for each staff person. Evidence: Five staff records were reviewed. The record for staff #1(employed 7/25/2023) contained documentation for only one of the two required references as to character and reputation as well as competency having been checked before employment. The record for staff #1 did not contain the name, address, and telephone number of a person to be notified in an emergency which must be kept at the center.

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