Children of America Warrenton, LLC

8VAC20-780-340-A · Based on staff interviews, the center did not ensure when staff are supervising children, they always ensure their care, protection, and guidance.

Evidence: Interviews revealed that infants are regularly put to sleep in a swing or a reclined bouncer and not in a crib in the Infant A room. Staff #1 stated that infants are "only in swings if they're napping" and advised when it is time for them to go down for their nap they are placed in the swings or reclined bouncers. Staff #1 stated that the infants "don't sleep well in the cribs and they sleep better in the swings". Staff #1 further stated the staff is "too short to get the babies in the crib". Staff #1 stated they were provided a step stool but they didn't feel comfortable using it to aid them in getting the infants into the crib as it would make the staff feel unsteady.

View state record

8VAC20-780-70 · Staff records shall contain documentation that the individual has completed orientation training as required.

Staff #4's record did not contain documentation that they have completed orientation training.

View state record

8VAC20-780-340-D · Each grouping of children shall have at least one staff regularly present who meets lead teacher qualifications.

Staff #2, who did not meet lead teacher qualifications, was alone with a group of toddler children throughout the inspection.

View state record

8VAC20-780-80-A · Repeat Violation

The center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs for each group of children. In the Infant B room there were five children signed in on the attendance and four children present. In the Infant A room there were three children signed in on the attendance and three children present.

View state record

8VAC20-780-80-A · For each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.

In the Preschool 1A classroom there were six children present and 5 were signed in on the tablet and 8 were signed in on the paper attendance sheet.

View state record

8VAC20-780-260-B · The center is required to obtain annual approval from the health department for meeting requirement for water supply, sewage disposal system, and food service.

The annual health inspection has not yet been completed and was one week overdue at the time of the inspection.

View state record

8VAC20-780-170-A · REPEAT VIOLATION

When there is evidence the safety of children may be jeopardized by contact with a staff member due to their mental health the center is required to obtain documentation from a physician or clinical psychologist skilled in the diagnosis and treatment of mental illness before staff return to work. This documentation shall confirm any risk to children has been eliminated or can be reduced to an acceptable level by reasonable accommodations. Staff #1 was placed on leave following concerns regarding their mental health after Staff #1 reported becoming so overwhelmed and stressed that they would regularly have to stop caring for children to go bang their head on the wall until they calmed down and could resume their duties. Staff #1 was allowed to return to work on 9/5/2024 with a note indicating they should have no more than one hour of working independently. However, this note is signed by a nurse and not a doctor or clinical psychologist skilled in the diagnosis and treatment of mental illness as required by the standards. In addition, information was gathered that Staff #1 has been working independently 2-3 hours daily, exceeding the one hour limitation.

View state record

8VAC20-780-40-E · The center is required to follow their own policies and procedures that are required by the licensing standards.

The center did not follow their supervision policy the morning of 9/6/2024 which resulted in Child #1, aged five years old, to be left unsupervised for approximately 45 minutes. The center's supervision policy requires when a class is moved from their room, attendance is taken by matching faces to names on the attendance sheet. In addition, before leaving a location, staff are to check the area, including bathrooms, behind furniture, and doors for children. Staff #1 stated they did not do a head count or name to face matching when taking school age children to the bus stop and did not check the School Age room for children before leaving for the bus stop on 9/6/2024.

View state record

8VAC20-780-570-A · Based on observation, the center did not ensure that infants under 12 months are placed in high chairs, infant carrier seats or feeding tables when they are not held while being fed.

Evidence: Staff #1 positioned Child #1 (Age 11 months) in a Boppy pillow on the floor and gave the infant a bottle for feeding while Staff #1 went to complete other classroom tasks.

View state record

8VAC20-780-170-A · Based on interview, the center did not obtain documentation from a physician or clinical psychologist skilled in the diagnosis and treatment of mental illness to confirm that any risk has been eliminated or can be reduced to an acceptable level by reasonable accommodations when there is evidence that the safety of children may be jeopardized by contact with a staff member because of the mental health of such staff member.

Evidence: 1. Interviews revealed on 6/11/2024 at approximately 4:00pm in the Infant A room, Staff #1 was visibly "frustrated and angry", made a gesture using both hands and stated "[Child #1] has been screaming and screeching all day, I want to strangle [Child #1]". 2. Interviews revealed management is aware that Staff #1 is "overwhelmed and stressed out". 3. Interview revealed that on a regular basis when Staff #1 reaches their limit Staff #1 will "put the baby down, walk away and go bang my head on the window until I can calm down". 4. Interviews revealed Staff #1 is regularly the only direct caregiver in the Infant A classroom.

View state record

8VAC20-780-80-B-2 · Based on interview and review of injury reports, the center did not inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurs while the child is under the supervision of the center and requires outside medical attention.

Evidence: On 5/22/2024 at approximately 2:30pm Child #1 sustained an injury while at the center and was transported to the emergency room. The center did not notify the department regarding this incident within two days of its occurrence.

View state record

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

Evidence: 1. In the 2's classroom, the interior of the sink cabinet in the bathroom was covered in black mold. The cabinet was not locked and a potty training seat was stored in the cabinet. 2. In the 2's classroom, one of the cabinet doors on the base of the changing table had a broken hinge creating a large gap. There were cleaning supplies, diaper creams, and sunscreen stored in the cabinet. 3. In the 2's classroom, an upper cabinet near the children's cots had a cabinet door that was hanging by one hinge as the other hinge was broken. 4. In the 2's classroom, a fan was on and pointed towards children napping and the fan blades and fan blade cover was covered in a thick layer of dust. 5. In the Preschool I classroom, the top of one of the shelves was cracked and covered by peeling tape. 6. In the Infant room, the play mats in the corner were torn on each of the edges exposing fraying material and peeling plastic.

View state record