VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Mrs. Rochelle Westmoreland
16039 Eagle Roost Court
Woodbridge, VA 22191
(703) 232-3707

Current Inspector: Cathy Aylor (540) 222-6352

Inspection Date: Dec. 8, 2023

Complaint Related: No

Areas Reviewed:

8VAC20-800 Administration 8VAC20-800 Personnel 8VAC20-800 Household Members 8VAC20-800 Physical Health of Caregivers and Household Members 8VAC20-800 Caregiver Training 8VAC20-800 Physical Equipment and Environment 8VAC20-800 Care of Children 8VAC20-800 Preventing the Spread of Disease 8VAC20-800 Medication Administration 8VAC20-800 Emergencies 8VAC20-800 Nutrition 8VAC20-800 Transportation 8VAC20-800 Nighttime Care 8VAC20-820 The License 8VAC20-820 The Licensing Process 8VAC20-770 Background Checks 22.1 Background Checks Code, Carbon Monoxide

Technical Assistance:

1. Reviewed with the provider standard 730D which is the need for all medications to be kept locked. 2. Consultation provided on the need to update medication authorizations when the duration of that authorization expires, please refer to standard 700C

Comments:

An unannounced monitoring inspection was conducted today with the provider who was present with one assistant and 7 children ranging in age from 12 months to 4 years. The inspection took place from 9:10 am to 10:20 am. Today was fun Friday where the children have free choice and were playing with each other during the inspection. Two children had 4 medications on site. The provider has Medication Administration Training (MAT) which was dated 5/12/21 and does not expire until 5/12/24. Five children and five caregiver/household member's files were reviewed at this inspection. The provider reported that there have been no injury/accidents requiring documentation. The vaccination records for 4 household pets were up to date.The areas of non compliance are outlined on the violation notice.

Violations:

Standard #:	8VAC20-800-700-C
Description:	Based on a review of medication authorizations and interview with the provider, it was determined that a medication authorization had not been renewed or returned to the parents within 14 days. Evidence: The parent's authorization for Albuterol for child A had an effective until date of 12/2/22 and the physician's authorization had an effective until date of 3/14/23. The medication authorizations had not been renewed nor had the medication been picked up by the parent within 14 days.
Plan of Correction:	We will not store medications for children when they have persistent and reocuring astmatic episodes and the medication is not expired or because medication is not needed at that time. We will no longer get medication authorizations from parents as needed for albuterol but will require a medication authorization to be active even when child is not taking the medication. We will give medications back and forth as astmatic episodes occur and will only keep an active medication authorization on file in the childcare not the actual medication. We will not ask about any expiration dates for medications that will result in violations. We will not ask questions of the inspector going forward to prevent allerting to any potential violations happening. We will do our dillengence to figure out questions on our own merit. Corrected- 12/08/2023 During the inspection the mother of child arrived after she was called by the childcare provider and immediately retreived her child's albuterol.
Standard #:	8VAC20-800-730-D
Description:	Based on observation it was determined that medications were not kept locked. Evidence: The Licensing Inspector observed 4 medications for two children ( Child A and B) sitting on an open shelf in the first classroom. The medications were not locked. Interviews revealed that a second location where the medication is usually stored was in an upper cabinet in the kitchen area. This second location is not kept locked.
Plan of Correction:	We will not remove medications for questions from their normal storage area of 3 years in a cabinet 8feet high, in seperate containers labeled with each childs name with locking mechanism that are completely unaccessible to any children (staff can only reach the medications by ladder) when we know licensing is coming due to a phone call recieved. We will not place the removed medications from the 8 foot high shelf on another shelf over 5.5 feet tall completely unaccessible to any children while we wait her arrival to get our questions answered. We will not ask questions about expiration dates that will result in subsequent violations. We will not ask for any clarification from the inspector. Appeal to be filed. Corrected- 12/08/2023 During Inspection inspector was told medication is not stored there and was told it was only there to not to forget to ask questions and medication was returned to its normal spot 8feet high cabinet, in individual containers with child's name and locking mechanism, and zip tie added on 8feet cabinet during inspection.