VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Cimbria Peterson
5205 Lindsay Street
Fairfax, VA 22032
(808) 285-2072

Current Inspector: Eureka Nance (703) 638-5968

Inspection Date: Feb. 1, 2022

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 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:

Discussion on household records

Comments:

This inspection was conducted by licensing staff using and alternate remote protocol, including telephone contacts, documents review, interviews and a virtual tour of the program. A renewal inspection was conducted on February 1, 2022. The provider was contacted by telephone and a virtual inspection was conducted. There were 7 children present directly supervised by 2 staff. The children were in transitioning from eating to outdoor play. Limited monitoring of child care requirements occurred during today?s visit. Licensing inspector monitored supervision of children, physical plant, staff/child ratios, adequate and approved space, programming, and nutrition. The Licensing Inspector reviewed on two child records and two household records. 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. Should you have any questions, please contact me at eureka.nance@doe.virginia.gov.

Violations:

Standard #:	8VAC20-770-40-C-1-c
Description:	Based on household record review, the provider did not obtain for household member a sworn statement and criminal history record check. Evidence: 1. Household member did not have a sworn disclosure statement and central history record check available for review during the inspection.
Plan of Correction:	Submitting sworn statement on 2/2/2022 Appt for criminal hx check on 2/3/2022
Standard #:	8VAC20-800-170-A
Description:	Based on review of household records, the provider did not obtain each adult household member prior to coming in contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form. Evidence: 1. Household member #1 did not have Tuberculosis Screening in record to review during the inspection.
Plan of Correction:	Submit copy of TB Test