The Virginia Department of Social Services cited licensed day care provider Gainesville Children's Center, located at 8171 Linton Hall Rd., with 20 violations in a renewal inspection June 5.
"At the time of the inspection, there was no one qualified to respond [to the inspection report]," DSS inspector Sharon Ball said.
Due to the number of violations, the owner of Gainesville Children's Center, a newly-hired center director and Ball met June 28 to review the inspection, she said. They submitted a full response July 10.
The DSS previously inspected the facility Feb. 19.
Virginia Department of Social Services Comments:
An unannounced renewal inspection was conducted beginning at 10:45 a.m. and ending at 6:30 p.m. Children ages 3 months old to 12 years old were present. Eight children's files, six staff files, and medication for six children were reviewed. Health and fire inspections are current. Children were observed in quiet and active play, centers, teacher-directed activities, lunch and naptime.
Standard #: 22VAC15-51-70-A
Description: Based on a review of applicant records and staff interviews, original background checks are not kept on site for all applicants involved in the day-to-day operation of the center. Evidence: There are no original background checks for staff A , the applicant, who is involved in the day-to-day operation of the center.
Action to be Taken: Staff A is aware that an original copy of background check is needed. Staff A was told on June 28th, 2013. He was given two weeks to get his original copy. The handbook is in the process of getting redone but until then the director will not pass them out and will put together a packet with the policies. This violation will be corrected by July 15, 2013.
Standard #: 22VAC40-185-40-E
Description: Based on a review of center's policy, center does not always comply with its own policies required by the standards. Evidence: The center's written injury prevention plan states that injury reports are to be reviewed monthly. There is no documentation that this has ever been done and administrative staff were not aware of this policy. The written food policy states that lunch is served, everyday, however, all children bring their own lunch and lunch is not served at the center. The policy also states that the center will furnish drinks and asks the parents not to bring in drinks, however drinks are brought in.
Action to be Taken: Injury reports are going to be reviewed monthly starting on July 1, 2013. Management will be paying attention to the injury prevention plan. The handbooks will not be handed outuntil they are fixed. Until they are fixed the director will put together a packet of the policies. This violation will be corrected by July 25, 2013.
Standard #: 22VAC40-185-60-A
Description: Based on a review of eight children's files, not all children's files are complete. Evidence: There is no documentation of written authorization for emergency treatment for children A, E, or G. There is no physical or current immunization record for child G. There is no written agreement that states the parents of child A agree to notify the center within 24 hours of the child or a family member developing a contagious disease. There is no statement signed by a physician or physician's designee indicating that child G has been adequately immunized.
Action to be Taken: All of the files were looked through by the director and every child that needed an updated paper that stated transmitted and treated were sent home with parent in June 2013 and asked to be returned within a week. For the ones that have not been returned back yet those parents will be given a letter and will need to have the form filled out by July 15, 2013.
Standard #: 22VAC40-185-70-A
Description: Based on a review of six staff records and staff interviews, there is not a complete file for each staff. Evidence: There is no file for staff A. There is no documentation of orientation for staff B, hired 4/9/13 or for staff C, hired 4/22/13. Orientation for staff D, hired 2/8/13, was dated 3/12/13. Orientation is required by the end of the first day. Staff were given copies of some of the policies, but no one reviewed the policies with the staff, and there is no one qualified to do so. There is no documentation of staff qualifications for staff D or F, both program leaders.
Action to be Taken: Staff B, C, and F are no longer with Gainesville Children Center.
Standard #: 22VAC40-185-190-A
Description: Based on staff interviews and a review of records, the acting program director does not meet any of the program director qualifications. Evidence: The designated program director does not meet any of the educational requirements of the program director.
Action to be Taken: There is a new staff member that is here for the position of the qualified director that started June 10, 2013. New staff members file is in the center so that the inspector is able to view it.
Standard #: 22VAC40-185-240-B
Description: Based on a review of the staff handbook received during the renewal inspection, staff do not receive all required policies in writing. Evidence: There was no written policy regarding procedures for supervising children who may arrive after scheduled classes or activities including field trips have begun; procedures for confirming the absence of a child when when the child is scheduled to arrive from another program or from an agency responsible for transporting the child to the center; or procedures for identifying where attending children are at all times, including procedures to ensure that all children are accounted for before leaving a field trip site and upon return to the center.
Action to be Taken: Field trips started June 24, 2013 and there are attendance check list and a list of children that aren't leaving center. There is a binder with an attendance list that always goes with the teachers at all times and the Director will make sure of that every time the teachers go on field trips.
Standard #: 22VAC40-185-240-C
Description: Based on a review of six staff files and staff interviews, not all staff have received the required 16 hours of annual training. Evidence: Staff E and F have not received any of the required 16 hours of training.
Action to be Taken: Director scheduled some trainings for July and August they should be finished by September 9, 2013.
Standard #: 22VAC40-185-240-D-4
Description: Based on a review of staff files for Medication Administration Trained (MAT) staff and staff interviews, there is not always someone present with (MAT) certification documentation when children in need of medication are present. Evidence: There is no one present from 4:30 p.m. to 6:30 p.m. (closing) with MAT certification.
Action to be Taken: There is a staff that is MAT trained but that staff member is only in the building from 7-2 p.m. The director and another staff member is a scheduling training for July 21, 2013. The director and other staff member are in the building from 10:30-6:30pm. Until the director and staff member gets MAT trained the other staff member that is already MAT trained work hours will get changed. This violation will be corrected starting July 15, 2013.
Standard #: 22VAC40-185-240-D-5
Description: Based on a review of staff files and staff interviews, there is not always someone present who has obtained daily health observation training in the past three years. Evidence: There is no one present with daily health observation training from 4:30 p.m. until 6:30 p.m., when the center closes.
Action to be Taken: The director is in the process of trying to find trainings. A couple trainings are scheduled for the months of July - August 2013. They should be finished by September 2013.
Standard #: 22VAC40-185-270-A
Description: Based on observation during a tour of the facility, not all areas were maintained in safe condition. Evidence: There were nail pops throughout all areas of the playground fence. There were at least eight cracked/split fence planks. The top rails of the fence and the gate leading to the infant/toddler playground were warped and sticking out. Nail pops were at levels where they could poke a child in the eye, scratch or puncture a child or catch on a child's clothing. Fence planks were potential splinter and pinch hazards.
Action to be Taken: Maintenance fixed all our planks starting on June 29, 2013. Maintenance is going to come out weekly to check on the fence.
Standard #: 22VAC40-185-340-A
Description: Based on an interview with staff in the junior kindergarten room, not all staff are aware of how many children are present. Evidence: When asked how many children were present, staff stated there were 13. There were 14 present at the time. Staff need to be aware of how many children are present at all times in case of an emergency.
Action to be Taken: Staff were told by Director to always keep count of all the children that are present and on the roll at all times. They were told when the Director started in June 2013.
Standard #: 22VAC40-185-400-B
Description: Based on observation during the inspection, behavior guidance is not always constructive in nature and does not redirect children to appropriate behavior and resolve conflicts. Evidence: Preschool age children who did not behave appropriately were brought to the front area to sit on a bench. They were in a public area and everyone who came through knew the children were there for behavioral reasons. Once they were brought to the bench, no one spoke to them or redirected them to appropriate behavior. Children sat for different lengths of time and then went back to their classrooms. On the day of the inspection, two children were brought up individually, at different times, and two other children were brought up together and sat together on the bench.
Action to be Taken: The director explained to staff members that when children are not behaving appropriately you are supposed to explain to the child what they were doing and why you shouldn't and then to always redirect them. The director and manager will monitor the classrooms and teachers to make sure this is being done from here on out this started 6/13.
Standard #: 22VAC40-185-420-A
Description: Based on a review of the Parent Handbook received at the renewal inspection, not all required policies are included and given to parents prior to the child's first day of attendance. Evidence: The non-pick-up policy does not include emergency situations including, but not limited to, inclement weather or natural disasters. There is no sunscreen, diaper ointment, or insect repellent policy. There is no documentation of established lines of authority. There is no daily schedule. The discipline policy does not include acceptable and unacceptable measures of discipline, but states "Handling children's discipline and "behaviors that don't work" is primarily the responsibility of the parents even if the behavior is only displayed at school."
Action to be Taken: There is a sunscreen and diaper ointment policy given to the parents by the director that has to be signed and dated.
Standard #: 22VAC40-185-440-J
Description: Based on observation during a tour of the facility, there is not always 30 inches on the service side of occupied cribs. Evidence: There was approximately 15 inches of space on the service side of an occupied crib.
Action to be Taken: There is 30 inches between all the cribs in the infant room. This violation was corrected June 2013. The teachers were told by the director that had to stay that way because it would be easier even if the children were absent for the day.
Standard #: 22VAC40-185-440-L
Description: Based on observation during a tour of the facility, pillows are sometimes used for children under two years of age. Evidence: A pillow was being used for a toddler.
Action to be Taken: No one under two has a pillow in the class because management told them that were not supposed to have them. This was taken care of in June 2013.
Standard #: 22VAC40-185-500-B
Description: Based on observation during a tour of the facility, not all required diapering procedures were followed. Evidence: Soap and water is not used to clean the diaper changing pad. Although paper sheets are used on the changing pad, parts of the children's body touch the pad and the pad was dirty and had been written on with markers.
Action to be Taken: Each classroom (infants, toddlers, jk, and school age) has bottle of bleach and a bottle of soapy water.
Standard #: 22VAC40-185-510-A
Description: Based on a review of medication for six children, there is not written authorization to administer all medications and not all medication authorizations have durations. Evidence: The authorization to administer Budesonide to child I expired 5/3/13. The medication was administered through 6/3/13. There was no parent signature on the authorization to administer Diazepam Acudial to child J, dated 5/20/13, and no duration. There was no current authorization to administer Diphenhydramine HCL to child K.. The authorization was from 10/9/12 - 10/19/12. There was no authorization to administer Xopenex to child M and there was no duration to administer EpiPen, Jr. dated 12/17/12, to child M. There was no authorization to administer Benadryl to child N.
Action to be Taken: The medicines are up to date and have an authorization form attached to them. The parent also has to give permission every 10 days. Separate forms are to be given and filled out if there is more than one medication. New forms were given out in the month of June 2013 and the parents had a week to return them
Standard #: 22VAC40-185-550-D
Description: Based on a review of the emergency drill log and staff interviews, there is not always documentation of a minimum of two shelter-in-place drills. Evidence: There is no documentation of any shelter-in-place drills.
Action to be Taken: Fire drills are going to be done monthly starting July 1, 2013 also shelter-in-place drills twice a year. There will be a log with these drills so that they are able to be viewed.
Standard #: 22VAC40-185-550-D
Description: Based on a review of the vehicle notebooks and staff interviews, emergency information for the buses is not complete. Evidence: There is no documentation of hospital information on the buses.
Action to be Taken: The director put directions to Heathcoat, Prince William Hospital in all of the bus binders on July 1, 2013. They will stay in the binders and will not be removed.
Standard #: 22VAC40-185-570-I
Description: Based on observation during a tour of the facility, review of the infant emergency supplies, and staff interviews, there is not always a complete one day emergency supply of formula for all infants. Evidence: There was one packet of powdered formula to be made in a one quart pitcher. There was no pitcher and this was not enough formula for one day for the seven infants present during the inspection. Not all infants present used that brand of formula.
Action to be Taken: Parents were given a letter in June 2013 by management stating that they need extra formula (ready-made). Not every child has brought in extra formula so they will be given a letter from the director July 11, 2013 stating that they have a week to bring in extra formula.
Full reports of each provider are located online and are available for public viewing.
The Virginia Department of Social Services inspects all licensed child welfare agencies at least twice a year, with at least one unannounced inspection each year.
“In order to determine continued compliance with standards during the effective dates of the license, the department’s licensing representative will make announced and unannounced inspections of the facility or agency during the hours of its operation,” the agency states on their website. “The licensee is responsible for correcting any areas of noncompliance found during renewal or monitoring inspections.”
VDSS cautions that a compliance history is in no way a rating for a facility, and online compliance reports do not include consideration that some information regarding “adverse actions” may be the subject of pending appeals.
According to the agency, “Through the administration of the licensing program, the Department of Social Services assumes responsibility to ensure that licensed facilities and agencies provide children and adults with at least a minimum level of care in accordance with regulations prescribed by the State Board of Social Services and Child Day-Care Council.”
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