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Ana Daysy Ayala
1801 Sycamore Valley Drive
Apt# 301
Reston, VA 20190
(571) 485-1299

Current Inspector: Stephanie Salvatori (571) 389-0980

Inspection Date: March 15, 2023

Complaint Related: No

Areas Reviewed:
AREAS OF STANDARDS REVIEWED

? 8VAC20-790 Subsidy Regulations.

Comments:
A subsidy health and safety (SHSI) initial inspection was conducted on march 15, 2023. There was 1 caregiver/vendor present. The physical plant, policies and procedures, emergency supplies and procedures were reviewed along with 1caregiver/vendor record. The exit interview was conducted with the caregiver/vendor. Areas of non-compliance are identified in this report. Contact Nancy.Radcliffe@doe.virginia.gov or call 703-268-3728 if you have any questions regarding this inspection.

Violations:
Standard #: 8VAC20-790-210-A
Description: Based on review of caregiver's record, the tuberculosis (TB) screening documentation was not completed within the last 30 calendar days of the date of employment.
Evidence
Caregiver #1 has documentation of the TB screening being completed 10/15/2022.

Plan of Correction: I will redo my TB and send the results to the inspector this week.

Disclaimer:

A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

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