Based on record review and interview on 02/07/2020, the center did not ensure that two of five staff resubmit tuberculosis (TB) test results at least every two years from the date of the first initial screening or testing, or more frequently as if recommended by a licensed physician or the local health department.
Evidence: 1. The most recent negative TB screenings in the record of Staff #1 (DOH: 12/28/16) were dated 07/18/17 and 08/27/19. 2. The most recent negative TB screenings in the record for Staff #5 (DOH: 12/28/16) were dated 01/03/17 and 01/08/19. 3. During interview, the administrator acknowledged the subsequent TB screenings/tests for Staff #1 and Staff #5 were not completed within the required two year time frame.
Plan of Correction:
Per the Center: "PLAN OF CORRECTION: As a reminder of time sensitive dates, the director and staff will continue to use a posted chart of upcoming updates. DATE TO BE CORRECTED: Staff #1 received documentation of a negative TB screening on 8/27/19 and Staff #5 on 1/8/19. This was prior to the inspection on 2/7/20."
Standard #:
22VAC40-185-40-J
Description:
Based on record review and interview on 02/07/2020, the center did not ensure injury prevention procedures were updated at least annually based on documentation of injuries and a review of the activities and services.
Evidence: 1. The center?s injury prevention plan was last updated in December 2018. 2. During interview, the administrator acknowledged the injury prevention procedures had not been reviewed or updated to date.
Plan of Correction:
Per the Center: "PLAN OF CORRECTION: The director will continue to train a staff member to review and update the Injury Prevention Plan annually. DATE TO BE CORRECTED: The plan will be updated by 2/28/20."
Standard #:
22VAC40-185-60-A
Description:
Based on record review on 02/07/2020, the center did not maintain a complete record for three out of five children?s records reviewed.
Evidence: 1. The records of Child #1 (DOE: 09/09/19) and Child #4 (DOE: 11/04/19) did not contain documentation of the address of two designated people to call in an emergency if a parent cannot be reached. 2. The record of Child #5 (DOE: 12/31/19) did not contain documentation of the name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached. 3. The record of Child #5 did not contain documentation of names of persons authorized to pick up the child. 4. The record of Child #5 did not contain documentation of viewing proof of the child?s identity and age.
Plan of Correction:
Per the Center: "PLAN OF CORRECTION: The director will promptly obtain this information. DATE TO BE CORRECTED: 2/28/20"
Standard #:
22VAC40-185-270-A
Description:
Based on observation and interview on 02/07/2020, the center did not ensure areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition.
Evidence: 1. Baseboards were removed from two classrooms and bathrooms in the center, exposing dry wall. Dry wall pieces and dust were on the floor. 2. There were several nails sticking out of the exposed drywall where the baseboards were, creating an exposed sharp object that could snag skin. 3. The administrator stated there was a flood in the building before Christmas and the repairs were in progress. 4. There was exposed drywall in a bathroom, from the back of a doorknob hitting the wall, approximately 2 inches in diameter. 5. The administrator acknowledged there needed to be a doorstop installed.
Plan of Correction:
Per the Center: "I am asking for a review of this violation. As the owner and director, I feel like measures have been taken to make the 2 classrooms and 3 bathrooms affected by significant water damage safe. As explained during the inspection, we suffered water damage due to a toilet malfunction. This occurred on November 17, 2019 (this is a correction to what I had previously said). On this day, SERVPRO was called to immediately remove the excess water, to treat carpet to prevent mold growth, and to begin a drying process with air movers and dehumidifiers that took 4 days. During the drying process, the classroom mostly affected was not used by children and staff. A SERVPRO specialist made a visit each day to check the drying process and to advise us when we could use the classroom and bathroom again. In order to continue our operations, I thoroughly cleaned the classroom and bathrooms and arranged the furniture to cover the perimeter of the room where the baseboards had to be removed for the drywall to dry completely. I was confident that covering as much of the exposed area as possible, day to day vacuuming of loose materials, and teacher supervision would make this a safe space for the staff and children to return to. From day #1, our insurance company was contacted and the process began. We worked around holidays and schedules to have drywall replaced, rooms painted, baseboards measured, cut, and stained, and carpet ordered and prepared to be installed. I will be sending a few pictures in a separate e-mail to give you a visual of what happened and can even provide additional documentation if need be. Also, I was surprised to see that the drywall exposed by the bathroom doorknob was included in this violation. At the end of the inspection, I do not recall you mentioning that this was going to be documented, too. All in all, I am respectful of your findings on 2/7/20. I hope you can review whether these temporary conditions should still be a violation of this standard. PLAN OF CORRECTION: Stated in the above explanation. DATE TO BE CORRECTED: The baseboards were replaced 2/8/20 and the carpet was installed on 2/15/20. Both dates were scheduled prior to the inspection on 2/7/20."
Standard #:
22VAC40-185-580-C
Description:
Based on observation on 02/07/2020, the center did not ensure that during transportation of children, Virginia state statutes about safety belts and child restraints are followed and stated maximum number of passengers in a given vehicle shall not be exceeded.
Evidence: 1. The licensing inspector observed approximately 10 booster seats in the center?s vehicles were expired. The expiration dates ranged from 2013-2019.
Plan of Correction:
Per the Center: "PLAN OF CORRECTION: During the inspection, the director disposed of all booster seats in the presence of the Licensing Inspector. DATE TO BE CORRECTED: New booster seats were purchased that day--2/7/20. The new expiration date is May 2029."
Standard #:
22VAC40-191-60-C-2
Description:
Based on a review of the records on 02/07/2020, the center did not ensure Central Registry results were obtained by the end of the 30th day of employment for one of five staff.
Evidence: The record of Staff # 4 (DOH: 9/17/19) had a Central Registry result dated 11/26/19. There was no documentation of further contact with the department?s Office of Background Investigations.
Plan of Correction:
Per the Center: "PLAN OF CORRECTION: If Central Registry results have not been received from the department's Office of Background Investigations within 30 days of employment, the director will document phone calls made and/or keep copies of e-mails sent regarding the delay. DATE TO BE CORRECTED: This staff member's results were received on 11/26/19. This was prior to the inspection on 2/7/20."
Disclaimer:
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