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[quote=Anonymous]Technical Assistance:
Behavior Guidance for young children must be respectful, encourage children to make decisions and offer alternatives to difficult situations such as sharing and playing in a cooperative manner. Teachers must promote ways of getting along, model conflict resolution skills with children and their coworkers and be consistent in applying realistic expectations to child like behavior. Staff are never allowed to physically punish or handle a child roughly, make demeaning remarks to a child, punish a child for toileting accidents or withhold food. All childcare staff are mandated reporters as defined by the Code of Virginia. If an allegation of abuse or neglect is reported to the center director or regional manager, they have to make the call to Child Protective Services (CPS) within 72 hours. It is not the center's decision to report an incident, rather it is CPS's decision if they feel it meets their criteria or if they will screen it out to the local licensing agency. Staff who directly witness the incident are required to report the incident if Management does not make the call. Please note, this complaint investigation was conducted jointly with local agencies. However, the findings of these agencies are determined separate from those of the Virginia Department of Social Service's Licensing Division.
Comments:
An allegation of abuse was reported to Licensing during a separate complaint investigation. A joint investigation with a representative of a local government agency and the Arlington Child Care Office was conducted over a week period with 3 days on-site (June 17th, 20th and 21st). Interviews were conducted with direct care staff, Bright Horizon's Management team and parents. The investigation revealed a systematic deficiency in supervision, record keeping and mandated reporting as required by law. Based on the preponderance of evidence the complaint is founded and violations were issued. Due to the severity of the complaint, additional enforcement actions will be recommended. Ann Dramstad Licensing Inspector 703-277-3591
Violations:
Standard #:	 22VAC15-30-50-B
Complaint related:	 Yes
Description:	 1. Based on staff interviews, Staff # 4 and Staff #5 did not maintain a professional relationship when they verbally attacked one another in the classroom in front of one child who was not asleep. Findings: Both staff confirmed the fight occurred at the center and that staff #4 was crying as a result of the verbal altercation. 2. Bright Horizons Management has not demonstrated it is suitable to be entrusted with the care, guidance and protection of children when they knowingly investigated 7 incidents that occurred at the center involving supervision, care of children and behavior guidance but did not inform the local Child Protective Service Agency as required by the Code of Virginia as well as Arlington County Child Care Office or the State Licensing Inspector. The internal investigations were not given to the Licensing Inspectors when asked about supervision incidents but found in a separate file from the Licensing file for each staff member involved in the multiple incidents. Management initially refused to give Licensing the "Red" personnel files when they were requested on 6/17/2011 during the complaint investigation.
Action to be Taken:	 1. Staff will be expected to act in a professional manner at all times. 2. Admin. team will provide access to all requested files to Licensing Inspectors immediately.
Standard #:	 22VAC15-30-50-E
Complaint related:	 No
Description:	 Staff are not complying with the center's own policies and procedures for accounting for all children at all times using the "We Care" tracking sheets. Findings: Internal investigation documentation verify that staff were using the tracking sheets incorrectly and not making face to child recognition when transitioning between classes and activities. 5 incidents of children being unsupervised by the classroom teachers were verified.
Action to be Taken:	 Supervision will be monitored using a Master Center Ratio Sheet completed by the Admin. team, This will allow monitoring of ratios throughout the day and confirmed after the fact by matching with the We Care Sheet. We Care sheets will be consolidated to one sheet per room. Name to face counts will be conducted at all transition points (leaving the room, arriving at the destination, leaving new destination and arriving back in the classroom and when staff change). Type of transition will be clearly stated on the sheets. Admin. team will conduct and sign daily random checks of We Care Tracking Sheets and provide feedback regarding proper use. Retraining in all these strategies will take place-training agenda and documentation of completion must be sent to Arlington County Child Care Office. All new staff and current staff will be trained in the use of We Care Tracking procedures.
Standard #:	 22VAC15-30-310-A
Complaint related:	 No
Description:	 Staff did not receive the required orientation by the end of the first day of assuming job responsibilities. Findings: Staff #1 Date of Hire (DOH) was 11/24/08 and she has no documentation of orientation. Staff #2 Original DOH was 5/23/2007 and she received her orientation on 8/31/2007. Her rehire was 6/15/2009 and no orientation was conducted following her absence. Staff #3 DOH was 9/22/2008 for her lead teacher position. No orientation was conducted for her new job responsibilities. Staff #4 DOH was 1/5/2009. Her orientation was 2/6/2009.
Action to be Taken:	 All staff will be given required Orientation by the end of the first day on the job. Current staff who have not had proper Orientation will be given such training by 7/12/2011.
Standard #:	 22VAC15-30-430-A
Complaint related:	 No
Description:	 Based on adult interviews and internal investigation documentation, the center has not ensured care and protection for children in care. Findings: November 5, 2010-Child #4 was injured at the center but no accident report, phone call to the parent or information was shared with the parent. The parent notified the center and questioned what had happened and how the mark on the child's forehead occurred. Staff were unable to explain what happened or provide documentation of any first aid the child received. The parent spoke to direct care staff, the center director and Bright Horizon management about the incident but was given no information. January 7, 2011-Child #5 was injured in the classroom bathroom. The child reported speaking to the direct care staff in the classroom. The parent saw the scratches on the child's back that evening and e-mailed the center director for an explanation as no accident report was given to the family. The parent of child #5 sent additional correspondence to the center's Regional Manager and the Vice President but no response was forthcoming. Bright Horizons did conduct an internal investigation to try and determine the cause of the scratches and the staff member was reprimanded. No report was ever received by the parent. May 3, 2011-A flyer was sent home with children requesting specific candies to be brought into the classroom for teacher appreciation week. Many of the candies listed on the favorite list contained specific allergens (peanuts and tree nut products). The center violated its own "Nut Free Center" policy posted on the front door when they requested the candy products. 8 children in care have documented peanut and tree nut allergies on the center allergy list.
Action to be Taken:	 Staff will properly document injuries and notify parents and Admin. team promptly. Copy will be sent to Regional Manager within 48 hours. All staff will abide by and enforce the Nut Free policy at the center.
Standard #:	 22VAC15-30-430-D
Complaint related:	 No
Description:	 Based on staff interviews the program leader in the Two's classroom is routinely supervising more that 2 aides. Findings: Staff #3 was supervising 3 staff in the 2's suite(staff #1,4 and 5) when the maximum that the program leader can supervise is no more than 2 aides.
Action to be Taken:	 Additional staff with Program Leader qualifications will be hired.
Standard #:	 22VAC15-30-430-F
Complaint related:	 No
Description:	 Based on documentation reviewed it was determined that children under 10 years of age were not kept in actual sight and sound supervision. Staff would not have been able to offer immediate intervention if necessary on 5 separate occasions. Findings: Center conducted and documented internal investigations on 5 separate occasions involving a lack of sight and sound supervision of children in their care. 06/30/2010-a child who had fallen asleep was left in the multi-purpose room when the school-age class transitioned to the playground. The child was left alone in the classroom for approximately 1 minute with no adult supervision. 08/03/2010-a child was left unattended on the playground as the class had returned back inside the center. 8/10/2010-Bright Horizons documentation of staff counseling for a supervision violation where a child was left unattended. 10/22/2010-a child was left unattended outside the center during a walking field trip to view the "Doppler vehicle". The parent arrived to pick her child up for the evening and realized that she had not walked back into the center with her classmates. The parent went to look for her child and found her daughter walking around the corner from the lobby unaccompanied by a teacher. 2/07/2011-a child was able to leave the classroom unsupervised and was found by another parent in the lobby area of the facility. The parent returned the child to the classroom.
Action to be Taken:	 Current staff will be retrained on the necessity of maintaining sight and sound supervision to children under 10 years of age. New staff will be trained on sight and sound supervision.
Standard #:	 22VAC15-30-440-A
Complaint related:	 No
Description:	 Based on staff interviews, documentation and observations, ratios were not maintained in multiple classrooms as required by standards. Findings: Documentation of an internal investigation on 2/9/2011 confirmed that ratios in the toddler classroom were not maintained on 2/8/2011 when the staff member (Staff #6) left the classroom to go on his lunch break leaving the class out of ratios. 6/21/2011-Arlington County Child Care representative observed ratios were not maintained during rest time in the preschool classrooms. Staff confirmed that they regularly leave the classroom prior to the children actually sleeping or being on their mats. Ratios in preschool class were 15:1 and preschool 2 was 18:1.
Action to be Taken:	 Review children's arrival and departure times biweekly and make adjustments as needed. Inform staff that they may be asked to adjust schedules early or later if needed to maintain ratios (ask for volunteers first to avoid disruptions to personal lives). Hire additional floaters assigned to age groups to maintain the stability of ratios.
Standard #:	 22VAC15-30-471-A-2
Complaint related:	 No
Description:	 Children who attend the center have a designated rest time that exceeds the maximum 2 hours. Findings: Multiple center staff confirmed that their classrooms have a rest time longer than the 2 hours allowed. Staff interviewed stated the naps were anywhere from 2 1/2 to 3 hours.
Action to be Taken:	 Staff will limit designated rest time to no more than two hours.
Standard #:	 22VAC15-30-484-A
Complaint related:	 Yes
Description:	 Based on staff interviews and statements, staff member #5 did not provide comfort, support or needed help. Findings: Documentation of an internal investigation confirmed that an incident on April 4, 2011 staff member #5 forced a child to go outside with his pants around his knees. The child was holding his coat and shoes as the teacher yelled at him to go outside. The child kept crying and asking for his shoes to be put on. The staff member was heard by multiple staff in the classrooms to "Hurry up, hurry up" and culminating with "If you don't stop crying and hurry up you will go outside like that". The child was sent outside partially dressed. The staff member did not assist the child with using the potty, putting on the pull-up or helping him with putting on his clothes prior to going outside. The child was crying hysterically and obviously distressed. The incident was witnessed by multiple classroom staff. (Child #3)
Action to be Taken:	 Staff member involved in this incident is no longer employed at center.
Standard #:	 22VAC15-30-487-5
Complaint related:	 Yes
Description:	 Based on interviews with staff it was determined that a staff member has practiced forbidden actions. Findings: Staff member #5 was seen withholding food from child #1. The child was removed from the lunch table and made to stand for up to 5 minutes when he was making "airplane noises" as witnessed by staff #4 and confirmed by staff #5. The child was only allowed to return to the table when he apologized to staff #5 for making the noises.
Action to be Taken:	 Staff member involved in this incident is no longer employed at center. Staff will be retrained in positive guidance strategies. New staff will be trained in positive guidance strategies. Improved monitoring of staff performance regarding guidance will be implemented.
Standard #:	 22VAC15-30-487-7
Complaint related:	 Yes
Description:	 Based on staff interviews it was determined that forbidden actions for toileting accidents was practiced on several incidents. Findings: Staff #5 was seen by multiple staff using a very forceful voice when reprimanding 2 children for wetting themselves or having problems with potty training. (Child #2 and #3). The teachers who observed the incidents stated staff #5 made the children cry and they were fearful if they had a toileting accident.
Action to be Taken:	 Staff will learn effective strategies regarding toilet training and feeding of children.
Standard #:	 22VAC15-51-60-C-2
Complaint related:	 No
Description:	 The Center did not deny employment when Staff #1 and Staff #7 were allowed to return to work after being placed on suspension as a result of having no Central Registry (CPS) search within 30 days of hire. Staff #1 had no CPS search on file with a hire date of 11/24/2008 and Staff #16 was hired 2/14/2011 with no CPS search on file. Management was told the staff could not return to work on 6/15 /2011 following the complaint investigation conducted by State Licensing. However, during the second complaint investigation on 6/20/2011 both staff were working in the classrooms without the completed CPS searches on-site at the center.
Action to be Taken:	 STaff will not be allowed to work past 30 days without a completed CPS search on file.
Standard #:	 63.2-1509-A
Complaint related:	 No
Description:	 Based on interviews and record reviews, it was determined that direct care staff and management failed to report 7 suspected cases of child abuse or neglect as required for mandated reporters who have the responsibility to report to the local DSS agency within 72 hours of the alleged incident. Findings: Despite staff having documentation of training on CPS mandated reporting, from August 2010 to April 2011 there were 7 cases of alleged abuse or neglect that were not reported to CPS as required b law.
Action to be Taken:	 Staff will be retrained in the responsibilities of a mandated reporter. All incidents of suspected abuse or neglect will be reported within 72 hours to the local DSS agency. One of the staff involved is no longer employed at the center. The other staff member received discipliniary action.[/quote]

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