VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Shima Mohammad
923 N. Edgewood Street
Arlington, VA 22201
(703) 547-7026

Current Inspector: Alyssa Simons (571) 423-6392

Inspection Date: Dec. 6, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-111 Administration 22VAC40-111 Personnel 22VAC40-111 Household Members 22VAC40-111 Physical Health of Caregivers and Household Members 22VAC40-111 Caregiver Training 22VAC40-111 Physical Environment and Equipment 22VAC40-111 Care of Children 22VAC40-111 Preventing the Spread of Disease 22VAC40-111 Emergencies 22VAC40-111 Nutrition 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Child abuse and neglect 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs

Comments:

An unannounced renewal inspection was conducted today from 8:30 am until 1:30 pm. There were 9 children (26 points) present with 3 caregivers. The children were observed eating breakfast, playing, singing, playing outside, eating lunch and preparing for nap. The children were also observed hand washing and during diaper change. Lunch consisted of cheese pizza, carrots, grapes, oranges, milk and water. The entire physical plant, children's records, caregiver records, household member records, attendance records, evacuation records, cribs, the emergency plan and emergency supplies were inspected. There were no medications on site. Areas of non compliance were cited on the Violation Notice. If you have any questions, please contact me at Tanya.Johnson1@dss.virginia.gov or call 571.423.6392.

Violations:

Standard #:	22VAC40-111-830-A
Description:	Based on a review of the evacuation logs, the provider failed to ensure that emergency evacuation procedures shall be practiced monthly with all caregivers and children in care. Evidence: The provider did not have documentation for an evacuation practice procedure for November 2019
Plan of Correction:	I will remember to conduct drills monthly.
Standard #:	22VAC40-111-920
Description:	Based on observation and review of posted menu, the provider failed to ensure that when meals or snacks are provided by the family day home, the menu for the current one week period shall list any substituted food. Evidence: The breakfast menu for 12/6/2019 was listed as a Jelly Sandwich, grapes and carrots; however what was served was bread, grapes and bananas and yogurt and the substitutions were not listed on the menu.
Plan of Correction:	When I make substitutions, I will list them on the menu.
Standard #:	22VAC40-111-120-A
Description:	Based on a review of caregiver's records, the provider failed to ensure that caregiver's records are complete. Evidence: Caregiver #4's record only includes documentation on one reference.
Plan of Correction:	I will get a second reference.
Standard #:	22VAC40-111-60-A
Description:	Based on a review of children's records, the provider failed to ensure that records are up to date for each enrolled child. Evidence: 1) Child #2's record did not include documentation of the names of persons other than the custodial parents who are authorized to pick up the child. 2) Child #3's record did not have documentation of a work phone number for the father. 3) Child #3 (immunization date 11/6/18), #5 (immunization date 2/21/19) and #8's (immunization date 10/15/18) records did not have 6 month check ups. 4) Child #4's records did not have documentation of work phone numbers for mother or father. 5) Child #5's records did not have documentation of a phone number for the first emergency contact or a copy of the medication policy. 6) Child #7 and #8's records did not have documentation of an annual update. 7) Child #8's record did not include documentation of a work address for mother or father and did not have documentation of work phone numbers for mother or father. 8) Child #4's record did not have documentation of proof of identification or authorization for emergency care.
Plan of Correction:	I will get information from parents and put in files.
Standard #:	22VAC40-111-200-B
Description:	Based on a review of caregiver's records, the provider failed to ensure that substitutes and assistants shall have orientation by the end of their first week of assuming job responsibilities. Evidence: Caregiver's #2, #3 and #4's records do not have documentation of orientation by the end of their first week of employment.
Plan of Correction:	I will look for the forms, as all 3 had orientation.
Standard #:	22VAC40-111-210-A
Description:	Based on a review of training certificates, the provider failed to ensure that in addition to satisfactory completion of first aid and CPR training, caregivers shall obtain a minimum of 16 clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1) Caregiver #2's records did not have documentation of completion of first aid an CPR training or completion of 16 hours annual training. 2) Caregiver #4's records did not have documentation of 16 training hours.
Plan of Correction:	Caregiver #2 completed first aid and CPR, I need to locate form. I will ensure that caregivers complete 16 hours of training annually.
Standard #:	22VAC40-111-240-A
Description:	Based on observation, the provider failed to ensure areas of the family day home inside shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or could snag skin. Evidence: In the bathroom that the children use, the paint in the corner is bubbled and peeling from the wall.
Plan of Correction:	I will have it repaired.
Standard #:	22VAC40-111-320-A
Description:	Based on observation, the provider failed to ensure that small appliances shall be unplugged unless being used by the caregiver or with the children under close supervision. Evidence: There were two small appliances that were not unplugged and not in use in the kitchen during the inspection.
Plan of Correction:	I will remember to unplug all small appliances when not in use.
Standard #:	22VAC40-111-320-B
Description:	Based on observation, the provider failed to ensure that child resistant protective covers larger than 1 and 1/4 inches in diameter shall be installed on all unused electrical outlets and surge protectors accessible to children under the age of 5. Evidence:The surge protector on the shelf did not have child resistant protective covers at all outlets.
Plan of Correction:	Corrected during inspection.
Standard #:	22VAC40-111-680-B
Description:	Based on observation, the provider failed to ensure that children's hands were washed with liquid soap and warm running water before eating. Evidence: The children did not wash their hands before eating breakfast.
Plan of Correction:	I will remember to wash hands before meals and when dirty.
Standard #:	22VAC40-191-40-D-5-a
Description:	Based on a review of household member's records, the provider failed to ensure that a person living in the home obtained a Child Protective Services Central Registry Check with 30 days of becoming 14 years old. Evidence: Household member #4 - dob 3/30/2004 does not have documentation of a Central Registry Check within 30 days of becoming 14 years old.
Plan of Correction:	I have submitted the form.
Standard #:	63.2-1721.1-B-2
Description:	Based on a review of household member's records, the provider failed to ensure that adult household members 18 years or older obtain and submit criminal records history withing 30 days of their becoming 18 years old. Evidence: Household member #3's file did not include documentation of a current criminal history check.
Plan of Correction:	Household member has an appointment tomorrow 12/7/2019.