VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Rosmery Salinas
5311 Danville Street
Springfield, VA 22151
(703) 628-4045

Current Inspector: Nancy Radcliffe (703) 268-3728

Inspection Date: Jan. 1, 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 Physical Environment and Equipment 22VAC40-111 Care of Children 22VAC40-111 Preventing the Spread of Disease 22VAC40-111 Medication Administration 22VAC40-111 Emergencies 22VAC40-111 Nutrition 22VAC40-111 Transportation 22VAC40-111 Nighttime Care 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Licensure and Registration Procedures

Technical Assistance:

I will send my inspector the results of the fingerprint and

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, including telephone contacts, documents review, interviews (if applicable) and a virtual tour of the program (if applicable). A monitoring inspection was initiated on November 5, 2021 and concluded on November 8, 2021. The provider was contacted by telephone and a virtual inspection was conducted. There were 11 children present, ranging in ages from birth to 12 years, with 3staff supervising. 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 11 child records and 3 staff 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.

Violations:

Standard #:	22VAC40-111-120-A
Description:	Based on review of three staff records, one record is incomplete. Evidence: The record for staff #1 does not contain documentation of name, address, verification of age, job title, date of employment, emergency contact information, and reference checks.
Plan of Correction:	I will make a record for staff.
Standard #:	22VAC40-191-60-B
Description:	Based on review of three staff records, one does not contain documentation of a completed sworn statement or affirmation. Evidence: The record for staff #1 does not contain documentation of a completed sworn statement or affirmation.
Plan of Correction:	I will have the sworn statement competed and signed.
Standard #:	22VAC40-191-60-C-2
Description:	Based on review of three staff records, one does not contain documentation of a follow up central registry report. Evidence: The record for staff #2 does not contain documentation of a non expired central registry report. Current documentation in report expired 9/8/2021
Plan of Correction:	I will complete and send in a new central registry form. I will send my inspector the results when they are received.
Standard #:	63.2-1720.1-B-2
Description:	Based on review of 3 staff records, one does not contain documentation of an eligible fingerprint before first day of employment. Evidence: The record for staff #1 does not contain documentation of an eligible fingerprint before the first day of employment.
Plan of Correction:	I will have the fingerprint completed and send my inspector the results. In the future I will have fingerprints completed before the first day of employment.