VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Primrose School at Cahoon Commons
660 Grassfield Parkway
Chesapeake, VA 23322
(757) 842-6589

Current Inspector: Rene Old (757) 404-1784

Inspection Date: Aug. 19, 2022

Complaint Related: No

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Staff Qualifications and Training. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies 8VAC20-780 Special Services. 8VAC20-820 THE LICENSE. 8VAC20-770 Background Checks (8VAC20-770) 63.2 Child Abuse & Neglect

Comments:

An unannounced monitoring inspection was conducted on 08/19/2022 from 11:35 am - 1:05 pm in response to a self reported incident of a child accessing a staff person's vape. Based on the information gathered which included interviews, record review and a review of the facility the report is found to be valid. Violations found in the areas of administration, hazardous chemicals and care of children are listed on the violation notice issued to the facility.

Violations:

Standard #:	8VAC20-780-40-E
Description:	Based on record review and staff interviews, the center failed to ensure that the operational responsibilities of the licensee shall include ensuring that the center's activities, services, and facilities are maintained in compliance with these standards, the center's own policies and procedures that are required by these standards, and the terms of the current license issued by the department. Evidence: 1. Staff 2 failed to follow written center policies regarding tobacco and harmful substances when she brought a vape into the center, stored in her vest pocket, on 08/17/2022. a. Written center policy indicates that staff shall not store harmful agents in pockets that are accessible to children. Additional written policies state that all tobacco products, to include vapes, are prohibited from being in the workplace. 2. Staff 2 signed the center hand book on 12/21/2022 acknowledging receipt and review of the facility employee handbook. The signature additionally acknowledged commitment to following the policies, rules, standards and requirements set forth in the hand book. 3. Staff 2 confirmed that she had signed the facility hand book on 12/21/2022 however, she was not aware of the tobacco/vape policy for the school as she had not read the facility hand book.
Plan of Correction:	Center is aware of operational responsibilities and uses its policies and procedures to hold all staff accountable for their actions as was done for this incident. Staff 2 was interviewed by school director and admitted to wrongdoing and was immediately terminated as per our policy. Evidence: 1. Staff 2 was aware of policy and blatantly disregarded it. Staff had no prior counseling write-ups for this or any other policy. 2. Staff 2 acknowledged in writing with signature that the Handbook was received and received. During Onboarding with Director the Handbook is reviewed and employees are reminded about the importance of reading the Handbook thoroughly. 3. During school administration initial interview after the incident, staff #2 stated they were aware of the policy and that they were sorry it happened.
Standard #:	8VAC20-780-280-H
Description:	Based on staff interviews, the center failed to ensure that harmful agents shall not be stored in areas, purses or pockets that are accessible to children. Evidence: 1. Child 1, age three years, was observed holding a disposable vape by staff 1 at approximately 10:00 am on 08/17/2022. a. Staff 1 stated that child 1 had a blue object in her hand which was being held up to her mouth. Child 1 then gave the object to staff 1. b. Staff 1 stated she did not know what this object was however, staff 2 came over and indicated that this object was a vape that belonged to her. c. According to staff 1, staff 2 indicated the vape had been in her pocket and somehow had been taken out of her pocket by child 1. 2. Staff 2, who was responsible for the care of child 1, confirmed that the vape belonged to her. a. Staff 2 verified that she had brought the vape into the classroom which was stored inside of her vest pocket. b. Staff 2 stated she did not know how child 1 accessed the vape but assumed that child 1 had reached inside of her zipped pocket and pulled it out. c. Staff 2 verified that she observed child 1 with the vape in her hand. 3. The packaging for this vape, Elf Bar BC 5000-sweet menthol flavor, indicates the product contains nicotine and "for their protection, keep out of reach of children and pets." Additional warnings indicate, "this product can expose you to chemicals including nicotine, which is known to be harmful."
Plan of Correction:	1. On page 31 of our employee handbook 7.8 explains our smoke/tobacco free workplace. Our policy is written to include nicotine vapors. It states these products are not permitted inside or near any of our company's offices, facilities or worksites. On page 36 of our employee handbook section 9.3 talks about personal property - it states all personal property must be kept away from children. Our policy states and it is true that each classroom has a designated cabinet out of reach of children. These cabinets are required to be locked and are out of reach of children. The signature page of our handbook asks teachers to sign agreeing they fully understand our policies. It is our daily practice to walk the building and step into classrooms. When leadership steps in we scan for hazardous items. None were observed the morning of the incident and leadership had been in the classroom. When leadership called teacher #2 into the office to ask about the incident, she admitted that she had forgotten to leave it in her car that morning and knew it wasn't supposed to be in the building. When teacher #1 stepped into the classroom to allow teacher #2 a bathroom break, this was a good opportunity for teacher 2 to put her vape in her car. However, when she was called into the office, she still had the vape on her person. Even after a child got a hold of her personal belongings, she still made the choice to keep it on her person.
Standard #:	8VAC20-780-340-A
Description:	Based on staff interviews and record review, the center failed to ensure that while staff are supervising children, they shall always ensure their care and protection. Evidence: 1. Staff 2 confirmed that she had brought a vape into the classroom in her pocket and that it had been accessed by child 1, who staff 2 was responsible to supervise. 2. Center staff failed to call poison control immediately after suspicion that a three-year old child, child 1, had ingested nicotine from a vape. a. Staff 1 stated that when she entered the three-year old classroom at approximately 10:00am on 08/17/2022 she observed child 1, age three years, coughing in such a way that she thought the child might have been choking. b. Staff 1 stated that she went over to child 1, who continued to cough for approximately 30 - 45 seconds. Staff 1 further noted that child 1's face was red. 3. Written warnings regarding these products indicate if it is suspected that a child has been exposed to liquid nicotine poison control should be contacted immediately. a. The label on the vape child 1 was holding contains E-liquid of 12 ml with a nicotine level of 50 mg. The label further indicates +5000 puffs per device. b. Administrative staff stated that while they did not know how much, if any of the vape had been ingested by child 1, staff 2 had indicated to them that the vape had been purchased prior to her shift that morning and used once. c. Staff 2 stated that the vape had been given to her by a friend, that morning before work. She was therefore unsure how much, if any, vape liquid was inside the product. Staff 2 further indicated she had not used the vape but planned to use during her lunch break. 3. Administrative staff confirmed they did not contact poison control. 4. The parent of child 1 arrived approximately 15 minutes after notification at which time child 1 was taken to urgent care at the recommendation of the child's pediatrician. a. The parent of child 1 stated that poison control was contacted by the staff of the urgent care. b. Poison control recommended that the child be observed for six hours for signs or poisoning and distress. c. Poison control contacted the parent later that day to ensure child 1 was doing well. 5. The parent of child 1 stated that the physician could not determine if his child inhaled or ingested any of the nicotine nevertheless, he assumed she possibly inhaled some of the contents as her voice was hoarse for the remainder of the day and the day after.
Plan of Correction:	1. School utilizes very strict hiring practices based on federal, state, local and VDOE requirements. School ensures all employees are background checked and fingerprinted and central registry. Additional checks are required if previously out of state. Employees are required to have Professional and Personal references. Employer onboards each employee individually and reviews the employee hand book with them. Employees are required to complete 10 hours of State Training and 12-19 hours of Primrose School Training during a week of classroom training. All of this onboarding training is then followed with a week of in classroom training for their specific program and licensing regulations, exercises and "on the job training." Specific to this violation we followed policies and confirmed employee policies were violated. In addition, we provide continuous training with each teacher required to complete 21 hours a year. During the interview process it was evident that Staff #1 understood Primrose School policies and procedures, by notifying administration immediately about the incident. We followed the VDOE guideline as required to verify, train and evaluate employees on an annual basis. 2. Parents were called immediately following the incident rather than Poison Control. Primrose administration will update school's Safe School Plan to include calling Poison Control before calling parents. We will include a "Note" that Poison Control must be called if a child is suspected to have digested or inhaled a substance, regardless of symptoms not being present. 3. There was NO label on the vape canister and the employee did not have the original box. School Administration researched the model on the internet, while waiting for the parents to pick-up. Child #1 was being monitored while waiting for parents and no signs of distress were present. 4. The center has done everything it could do to prevent an incident of this nature. The incident occurred because Staff 1 did not follow the school policies.