VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Knights of Columbus Summer Day Camp
5115 Little Falls Road
Arlington, VA 22207
(703) 536-9656 (324)

Current Inspector: Leslie Perez (703) 537-6013

Inspection Date: July 26, 2022

Complaint Related: No

Areas Reviewed:

8VAC20-780 Administration. 8VAC20-780 Staff Qualifications and Training. 8VAC20-780 Physical Plant. 8VAC20-780 Staffing and Supervision. 8VAC20-780 Programs. 8VAC20-780 Special Care Provisions and Emergencies 8VAC20-780 Special Services. 8VAC20-770 Background Checks (8VAC20-770) 20 Access to minor?s records 22.1 Background Checks Code, Carbon Monoxide 63.2 Child Abuse & Neglect

Technical Assistance:

Discussed with program Director: Fall zones, medication authorization forms, background checks, pool area and pump room, posting requirements, preservice training.

Comments:

An unannounced monitoring inspection was conducted today from 11:00am-1:15pm. There were 129 children (school age) directly supervised by 25 staff. The physical plant, 4 staff records, 4 children?s records, medications, evacuation drills, injury reports, emergency supplies, and policies were inspected. Children were observed participating in group play, swimming, playing outside, and eating lunch. There was an adequate supply of materials for the children. Information gathered during the inspection determined non-compliances with applicable code sections and violations were documented on the violation notice issued to the facility. If you have any questions regarding this inspection, please contact the Licensing Inspector, Maria Soto at maria.soto@doe.virginia.gov or (571) 835-5058.

Violations:

Standard #:	22.1-289.035-B-4
Description:	Based on record review, the center did not obtain results of a criminal history record check from a state in which staff had resided in the preceding five years prior to the first day of employment. Evidence: The records for Staff #1 and Staff #2 (DOH: 5/21/2022) did not include out of state criminal record checks. Staff #2's (DOH: 5/21/2022) record did not include out of state criminal record checks for two
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-191-70-A
Description:	Based on record review, the program did not obtain references as to character and reputation as well as competency before employment for all staff members. Evidence: 1. The records for Staff #2 and Staff #4 did not contain 1 of 2 required references. 2. Staff #3's record did not contain 2 of 2 required references.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-245-L
Description:	Based on record review and interview, there was not at least one staff member on duty who had obtained within the last 3 years instruction in performing the daily health observation of children. Evidence: There was not one staff member on duty with a current Daily Health Observation certification.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-780-550-P
Description:	Based on review of injury reports, the program's written records of children's injuries did not include all required information. Evidence: Six minor injury reports were reviewed and they were missing following information: 1. Six reports were missing the future action to prevent injury. 2. Four were missing the date the parent was notified. 3. Four were missing the time the parent was notified. 4. Two were missing one of two signatures and one was missing two signatures. 5. Three were missing how the parent was notified.
Plan of Correction:	Not available online. Contact Inspector for more information.