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

Current Inspector: Alyssa Simons (571) 423-6392

Inspection Date: Aug. 5, 2021

Complaint Related: No

Technical Assistance:
Background checks must be resubmitted every 5 years.

All caregivers are required to obtain 16 hours of training annually.

By September 1, 2021, all facilities that care for children are required to have functioning Carbon Monoxide Detectors installed.




08/05/2021

Comments:
This inspection was conducted b licensing staff using an alternate remote protocol, including telephone contacts, documents review, interviews ad a virtual tour of the program.
A monitoring inspection was initiated and concluded on August 5, 2021. There were no children present with one caregiver. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming medication, special care and emergencies and nutrition. A total of three children's records and 2 caregiver's records were reviewed.
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.
If you have any questions, please contact me tanya.johnson@doe.virginia.gov.


08/05/2021

Violations:
Standard #: 22VAC40-111-60-A
Description: Based on a review of children's records, the provider failed to obtain all required documents for each child enrolled in the program.

Evidence:
1. Child #2, #2 and #3's record do not contain documentation of names of persons other than the custodial parents who are authorized to pick up the child.
2. Child #2's records did not contain the name, address and phone number of two designated persons to contact in case of an emergency if the parent cannot be reached.
3. Child #1 and #2's records do not contain documentation of proof of the child's age and identity.
4.Child #3's record does not contain written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately.

Plan of Correction: I will have the parents provide the correct information and will then put information into the children's records.

Standard #: 22VAC40-111-90-A
Description: Based on a review of children's records, the provider did not obtain documentation that the child has been adequately immunized by the first day of attendance.

Evidence:
Child #3's record shows that the child was not show proof of immunizations by the first day of attendance. First day of attendance was 5/24/2021 and the proof of immunization is dated 5/26/2021

Plan of Correction: I will ensure that all newly enrolled children will have proof of immunizations on the first day of attendance.

Standard #: 22VAC40-191-60-C-2
Description: Based on a review of caregiver records, the provider failed to obtain a central registry finding with 30 days of employment.

Evidence:
Caregiver #2's records do not contain documentation of a current central registry finding within 30 days of employment. First Day - 10/20/2014

Plan of Correction: I will have the assistant fill out another CPS registry form and submit it on
August 9th, 2021. I will notify inspector when form is emailed to me.

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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