VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Melissa McKensie
218 Engleside Circle
Apt 2B
Henrico, VA 23222
(804) 321-1375

VDSS Contact: Florence Martus (804) 389-0157

Inspection Date: Oct. 28, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-665 Subsidy Program Vendor Requirements for Family Day Homes 22VAC40-665 General qualifications 22VAC40-665 Building or home maintenance. 22VAC40-665 Supervision and ratio requirements 22VAC40-665 Programs 22VAC40-665 Special Care Provisions & Emergencies 22VAC40-665 Special Services

Technical Assistance:

N/A

Comments:

An initial subsidy health and safety (SHSI) inspection was completed onsite on Thursday, October 28, 2021. The licensing inspector was onsite from approximately 10:30AM until 12:30 PM. There were three non-resident and three resident children present with one staff supervising. A monitoring inspection was also conducted on this date. Only subsidy requirements that are not covered in licensing standards were reviewed during this supplemental inspection. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program.

Violations:

Standard #:	22VAC40-665-170-B
Description:	Based on review of two children's records and interview, the vendor did not ensure two children's records contained the required information. Evidence: The records for Child #1 (first date of attendance 04/07/2021) and Child #2 (first date of attendance 08/22/2021) did not contain the following: proof of the child's identity; home and work address for each parent who has custody; address of at least one person designated by the parent to contact in case of an emergency if the parent cannot be reached; written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection for the provision of medical treatment on religious or other grounds; a written statement that the vendor will notify the parent when the child becomes ill and that the parent will arrange to have the child picked up as soon as possible if so requested by the vendor; and any written agreements between the parent and the vendor. The vendor stated the model forms asking for this information have been given to the families.
Plan of Correction:	I have given the model forms to the families and will gather the forms and add them to the record.
Standard #:	22VAC40-665-400-A
Description:	Based on documentation review, the vendor did not have a written emergency preparedness plan that addresses caregiver's responsibility and home readiness with respect to emergency evacuation, relocation, lockdown and shelter-in-place procedures. Evidence: The vendor had a model template for the emergency plan that was not completed. The plan is required to address the most likely to occur emergency scenario or scenarios, including but not limited to fire, severe storms, flooding, tornadoes, loss of utilities, earthquakes, intruders, violence on or near the premises, chemical spills, and facility damage or other situations that may require evacuation, lockdown or shelter-in-place.
Plan of Correction:	I did not realize the plan needed to be completed prior to the initial inspection. I will complete the plan and individualize it for my residence.
Standard #:	22VAC40-665-410-A-1
Description:	Based on documentation review and interview, the vendor did not ensure evacuation procedures were practiced at least monthly. Evidence: During documentation review, the vendor stated evacuation procedures have not been practiced at least monthly.
Plan of Correction:	I will start practicing monthly evacuation drills.