VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Nassiba Ishchanova
9653 Blake Lane
Fairfax, VA 22031
(703) 281-3594

Current Inspector: Sheila F Nelson (804) 629-7489

Inspection Date: Oct. 5, 2021

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 Emergencies 22VAC40-111 Nutrition 22VAC40-80 THE LICENSE. 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Licensure and Registration Procedures

Technical Assistance:

Multiple background checks were missing for one household member during today's inspection. The provider is aware that their renewal application cannot be processed or reviewed for approval until all household member background checks have been reviewed by the inspector. The provider has agreed to forward all missing background checks to the inspector as soon as the results have been reviewed.

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, including telephone contacts, documents review, interviews and a virtual tour of the program. A renewal inspection was initiated on 10/1/2021 and concluded on 10/5/2021. The Provider was contacted by telephone and a virtual inspection was conducted. The inspector reviewed compliance in the areas of administration, staffing and supervision, programming, special care and emergencies and nutrition. A total of 4 child records, 2 caregiver records and 1 household member record 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.

Violations:

Standard #:	22VAC40-111-880
Description:	Based on a review of the food menu and interview, the provider is not following the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: 1. On Monday, Thursday and Friday of this week, juice is being served at breakfast and snack. The USDA recommends no more than one serving of juice per day. 2. On Monday, Tuesday, Wednesday, Thursday and Friday of this week, there is no fruit being served at lunch. The USDA recommends a fully serving of fruit during lunch.
Plan of Correction:	I didn't know there were changes to requirements. We will update the menu starting next week.
Standard #:	22VAC40-111-60-A
Description:	Based on record review, children's records did not contain all required information. Evidence: Child #2 record does not contain documentation of the families medication insurance policy number.
Plan of Correction:	I will contact the parents and get the number today.
Standard #:	22VAC40-111-170-A
Description:	Based on record review and interview, the provider has not obtained a tuberculosis (TB) screening for each household member. Evidence: Household member #2 moved into the residence with the provider in May of 2021. The provider confirmed that they have not yet obtained a TB screening for this household member.
Plan of Correction:	We will get it done as soon as possible.
Standard #:	22VAC40-111-180-A
Description:	Based on record review and interview, the provider has not submitted a tuberculosis (TB) screening every two years. Evidence: The providers most recent TB screening is dated 8/13/2019. The provider stated that they completed another screening but is waiting for the results.
Plan of Correction:	I did a TB test this week and I'm waiting for the results to get mailed to me.
Standard #:	22VAC40-191-40-D-4-a
Description:	Based on record review and interview, the provider has not obtained a sworn disclosure statement and a central registry background check for each household member over 14 years of age. Evidence: Household member #2 moved into the residence with the provider in May 2021. The provider confirmed that they have not yet obtained a sworn disclosure statement or central registry findings for household member #2.
Plan of Correction:	We will get it done as soon as possible.
Standard #:	63.2-1721.1-B-2
Description:	Because on record review and interview, the provider has not obtained a criminal history background check via fingerprinting for each household member over 14 years of age. Evidence: Household member #2 moved into the residence with the provider in May 2021. The provider confirmed that they have not had household member #2 complete their fingerprinting background check.
Plan of Correction:	We will get it done as soon as possible.