The TB Screening standard 8VAC20-781-90 requires TB test if a staff member shows signs of TB-which is a cough- this will cause potential wide spread staffing shortages as most respiratory illnesses include cough as well. Could administrators be given permission to screen for TB? 8VAC20-781-280  C Approved ratio changes could be very dangerous for staff and children.  Some programs are abusing this to make money. Just because they have no licensing violations doesn't mean this is safe or ok to do to children or staff.  H  Also assigning children to a different age group is being abused and should be rare.  8VAC20-781-490 Handwashing  Why before diapering and why not after children eat?  8VAC20-781 380 Behavior Guidance conflicting info, traditional Time out is is not a positive method of guiding behavior. Its a punishment that bans children from the group. Removing children from situation and guiding them through as to why they did something unsafe is more age appropriate.