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. 63.2 Child Abuse & Neglect
Comments:
An unannounced complaint inspection was initiated on 02/27/2024 in response to multiple complaints received regarding care and protection of children, documentation of children's injuries and toileting.
The inspector conducted additional inspections of the facility on 03/01/2024, 03/08/2024 and 03/15/2024 to determine compliance with the areas of concern.
Based on the information gathered which included staff interviews, classroom observations, review of center video and review of written injury reports the complaint is found to be valid in the areas of care and protection of children and injury documentation. The concern regarding toileting was found to be not valid.
The violations are listed on the violation notice issued to the facility and were reviewed with the program director at the exit interview.
Based on staff interviews, observations and a review of center video and injury reports, the center failed to ensure the care and protection of children.
Evidence: 1. A review of injury reports for the two-year old classroom indicated approximately 122 injuries from approximately 12/02/2023 - 03/12/2024. a. 60 of these injuries were of children being bitten by another child; b. 39 of these injuries were of children being scratched, pushed or hit by toys thrown by another child. 2. Center staff interviewed, staff 1, staff 2, staff 3 and staff 4 described the two-year old classroom as "lacking structure," "chaotic," and difficult to manage. a. Staff additionally indicated that they did not feel they had the training or skills needed to manage children's behavior challenges especially biting. b. Staff also stated there were multiple children in the classroom with identified behavior challenges nevertheless, they had not received any training specific to these children or been apprised of any plan in place to address the behavior challenges. 3. A review of center video in the two-year old classroom, from approximately 8:10 am - 8:20 am on 03/08/2024, showed multiple incidents of children being injured by other children. a. One child was observed throwing toys while a second child hit another child. b. The video also showed ten children roaming around the room, climbing over overturned chairs, and attempting to climb up the diaper changing table while the two staff responsible for supervising the classroom of twelve children were occupied as they were assisting the other two children during this time. c. The lack of available activities and supervision for the ten children, resulted in the children occupying themselves in activities that increased the risk of injury. 4. During a classroom observation on 03/15/2024 child 1, who has been identified by all staff in addition to written records as having behavior challenges, bit another child while playing by the cots at approximately 11:10 am. a. During a planned activity, child 1 was not being supervised closely by staff which resulted in a "crowding" situation near the cots where child 1 was able to bite child 2.
Plan of Correction:
Two-year old class has been relocated to a smaller classroom and the number of students enrolled has been reduced. A new daily schedule and routine has been introduced. Room set up has been rearranged to promote a more productive learning environment. New toys and activities were added to engage children and encourage appropriate exploration.
New staff have been hired and remaining staff went through retraining in March 2024 during one-on-one meetings with Center Director. We will continue to complete ongoing coaching on positive behavior guidance, active supervision, and child development. Staff trainings in March 2024 were completed covering our behavior support procedures, Behavior Action Plans implemented for children with behavior challenges, and teachers coached on the action plans to better support children.
At lease one teacher over the required ratio is present in the classroom whenever possible, to assist with potty training, transitions, child engagement, and behavior redirection. Lessons Plans are posted and reviewed by management to ensure appropriate child engagement throughout the day. Weekly classroom observations are completed to ensure compliance.
Standard #:
8VAC20-780-550-P
Complaint related:
Yes
Description:
Based on record review, the center failed to ensure that the written record of children's serious injuries in which entries are made the day of occurrence lacked all of the required elements.
Evidence: 1. A review of more than 100 injury reports from 12/02/2023 through 03/17/2024 found the following required documentation lacking in written injury reports: a. 27 lacked either a parent or second staff signature; b. 69 lacked documentation of the time and method of parent notification; c. 16 lacked documentation or a staff and parent signature or 2 staff signatures; d. All of the injury reports reviewed lacked any documentation of how to prevent recurrence of the injury.
Plan of Correction:
Moving forward, all incident reports will be reviewed by a member of management at the time they are written. Staff have been directed to notify a member of management immediately of any incidents, so they may guide staff through the steps of completing the incident report, observe the child, administer first aid if necessary, and notify a parent/guardian.
Staff were re-trained in May 2024 on the correct way to complete an incident report and all classrooms were given an example of a properly completed incident report to use as a guide. In the moment coaching will continue as staff fill out the reports under management supervision.
Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.
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