Visions Child Development Center

8VAC20-780-150-B

***Repeat Violation and Systemic Deficiency*** Physical Examinations are required to be signed by a physician, his designee, or an official of the local health department. The physical examination for child #4 was not signed.

8VAC20-780-245-A

Staff shall complete a minimum of 16 hours of training annually, appropriate to the age of children in care. Staff #5 did not have documentation of 16 hours of training annually.

8VAC20-780-270-A

***Repeat Violation and Systemic Deficiency*** The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition. 1.The entry way to the playground had a piece of metal and five concrete edging stones laying on the ground with sharp edges posing a tripping hazard. 2. The playground had a large plastic storage box with a large hole in the top posing a risk of snagged skin. The storage container top was not attached to the bottom half of the container. 3. The playground had trash scattered on the playground consisting of plastic cups and styrofoam bowls. 4. Room # 2 had a broken cabinet, the door was hanging from a broken hinge. 5. Room #3, #4, #6 had peeling paint in multiple areas exposing dry wall.

8VAC20-780-280-B

***Repeat Violation*** Hazardous substances such as cleaning materials shall be kept in a locked place using a safe locking method that prevents access by children. 1. In room #5, had an unlocked closet with 1 container of bleach, one container of Lysol, one container of Shout cleaner, 1 container of Bisel Deep Clean Antibacterial, and one container of Borox. 2. In room # 2, one container of bleach and water was located in a cabinet with a broken door, unlocked and within reach of children.

8VAC20-780-420-E-3

Staff shall request at least annually parent confirmation that the required information in the child's record is up to date. The record for child #1, enrolled for over 433 days, did not have annual parent confirmation the child?s record is up to date.

8VAC20-780-130-A

***Repeat Violation and Systemic Deficiency*** The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center. 1. The record for child #4 had documentation of immunizations 35 days after the child began attending the center. 2. The record for child #5, enrolled for 20 days did not have documentation of an immunization record on file.

8VAC20-780-160-C

A tuberculosis (TB) screening is required every two years from the last screening. 1. Staff #1 had documentation of a TB screening that was overdue by 2 years and 11 months. 2. Staff #2 had documentation of a TB screening that was overdue by more than 11 months. Complaint related: No

8VAC20-780-80-A

For each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs. On 2/22/2026, six children were present in the infant room and the written record did not have their arrival documented. Complaint related: No

8VAC20-780-350-B-1

The Center is required to maintain the required supervision ratio of 1 staff to 4 infants age birth to 16 months old whenever children are in care. Staff #2 stated upon arrival at 8:00 am, staff #1 was supervising 5 children between the ages of birth up to 24 months. Complaint related: Yes

8VAC20-780-530-A

At least one staff in each classroom or area where children are present shall have current certification in cardiopulmonary resuscitation (CPR) and first aid. 1. Staff #1 stated he was alone with a group of children between ages of birth to 24 months during the morning of January 22, 2026. 2. Staff #2 stated she was alone with a group of children between ages of birth up to 24 months during the morning of January 22, 2026. Complaint related: No

8VAC20-780-160-A

***Repeat Violation*** Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment. Staff #7 had a TB screening dated 55 days after the date of hire.

8VAC20-790-600-D-2

***Repeat Violation*** All staff who work directly with children shall have a current certification in first aid appropriate to the ages of children in care. 1. Staff #1 did not have a current certification in first aid and was overdue by seven days. 2. Staff #3 did not have a current certification in first aid and was overdue by four days.

8VAC20-790-600-D-1

***Repeat Violation*** All staff who work directly with children shall have a current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care. 1. Staff #1 did not have a current certification in CPR and was overdue by seven days. 2. Staff #3 did not have a current certification in CPR and was overdue by four days.

8VAC20-780-600-F

***Repeat Violation*** Staff shall complete the department?s health and safety update course annually. 1. Staff #1 did not have documentation of the completed course and was overdue by more than five months. 2. Staff #3 did not have documentation of the completed course for 2024 or 2025. 3. Staff #5 did not have documentation of the completed course which was overdue by more than three years. 4. Staff #6 did not have documentation of the completed course and was overdue by more than three months.

8VAC20-780-570-A

***Repeat Violation*** When a child is placed in an infant seat the protective belt shall be fastened securely. Child #3 was sitting at the feeding table without the protective belt fastened.

8VAC20-780-540-A

A first aid kit shall be wherever children are in care. 1. In vehicle #2, there was not a first aid kit available. 2. In vehicle #3, the first aid kit was missing the following items: scissors, tweezers, adhesive tape, and thermometer. 3. In vehicle #4, the first aid kit was missing the following items: scissors, gauze pads, adhesive tape, band-aids, antiseptic cleansing solution/pads, and one triangular bandage.

8VAC20-780-500-B

***Repeat Violation*** Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal. In room #1, there was not a trashcan or disposal system that had a lid as required for soiled disposable diapers. Diapers were observed in the trash can.

8VAC20-780-450-A

Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. In room #2, two children did not have a bottom cover on their cot.

8VAC20-780-270-A

***Repeat Violation*** The center shall ensure that areas and equipment of the center, inside and outside, are maintained in a clean, safe and operable condition. 1. In room #2 the half wall moves back and forth when opening the door to the room. Part of the wall is coming away which poses a risk for pinching of skin. 2. On the playground, broken Styrofoam was observed in multiple places. The plastic storage container was cracked with jagged edges.

8VAC20-780-150-B

***Repeat Violation*** Immunization records are required to be signed and dated by a physician, his designee, or an official of the local health department. The immunization record for child #4 and child #6 were not signed.

8VAC20-780-130-E

***Repeat Violation*** The center shall obtain documentation of additional immunizations once every six months for children under the age of two years. 1.The record for child #3 did not have documentation of updated immunizations and was over due by 57 days. 2. The record for child #6 did not have documentation of updated immunizations and was overdue one year and five months.

8VAC20-780-580-C

The center shall ensure that during transportation of children, Virginia state statutes about safety belts and child restraints are followed as required by the Code of Virginia, to assure the safety of children. In vehicle #4, two children were observed unbuckled upon entering the shopping center where the child day center is located. Complaint related: No

8VAC20-780-580-B

Any vehicle used by the center for the transportation of children shall meet the safety standards set by the Department of Motor Vehicles. 1. In vehicle #2, the door used for loading and unloading children on the facility used for transporting children would not open, so the children were using the front passenger door. The door lock was hanging outside of the van. Complaint related: No

8VAC20-780-500-A

***Repeat Violation*** Staff shall wash hands with soap and running water before and after a diaper change. Staff did not wash hands after changing a child?s diaper. Complaint related: No

8VAC20-780-410-6

The following actions or threats thereof are forbidden; verbal remarks which are demeaning to the child. On November 21, 2025, staff #1 used inappropriate and threatening language during a verbal interaction with child #2. Complaint related: Yes