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Naila Ayoub
9166 Barrick Street
Apt. 203
Fairfax, VA 22031
(703) 268-5367

Current Inspector: Charles Perkins (703) 309-3963

Inspection Date: Sept. 9, 2022

Complaint Related: No

Areas Reviewed:
?8VAC20-800 Administration
?8VAC20-800 Personnel
?8VAC20-800 Household Members
?8VAC20-800 Physical Health of Caregivers and Household members
?8VAC20-800 Caregiver Training
?8VAC20-800 Physical Equipment and Environment
?8VAC20-800 Care of Children
?8VAC20-800 Preventing the Spread of Disease
?8VAC20-800 Medication Administration
?8VAC20-800 Emergencies
?8VAC20-800 Nutrition
?8VAC20-800 Transportation
?8VAC20-800 Nighttime Care
?8VAC20-820 THE LICENSE.
?8VAC20-820 THE LICENSING PROCESS.
?8VAC20-820 HEARINGS PROCEDURES.
?8VAC20-770 Background Checks
?20 Access to minor?s records
?22.1 Background Checks Code, Carbon Monoxide
?54.1 Provider must be MAT certified to administer prescription medication.
?63.2 Child abuse and neglect

Technical Assistance:
Discussion of the forms reviewed during the initial inspection. The Family Day Home (FDH) has those model form originated from Fairfax County. While these forms contain vital information, they do not contain all of the required information listed in the state standards. The following blank copies of these sate model forms were sent to the FDH: Child?s Record, Health Forms, EP&RP, Information for Parents, the Policies of the Administration of Medication Form, Authorization to Apply Topical Skin Products Form, the Provisions of the EP&RP Form, and the Liability Declaration Form.

Comments:
This initial inspection was initiated by licensing staff and concluded on 09/09/2022, between the hours of 9:45 am to 11:30 am. There were 3 children present (7 points), ranging from toddler-age to preschool-age, with 1 caregiver supervising. The inspector reviewed compliance in the areas of administration; physical plant; staffing and supervision; programming; special care and emergencies; and nutrition. A total of 3 children records, 1 staff record, and 4 household records were reviewed.

Information gathered during the inspection determined that there were (4) non-compliances with the applicable standards, code, and/or law. These violations were documented on the Violation Notice issued to the home.

If you should have any questions, please call or send an email to charlie.perkins@doe.virginia.gov. Thank you.

Charlie Perkins,
Licensing Inspector
(703) 309-3963

Violations:
Standard #: 8VAC20-800-750-A
Description: Based on review and interview, a written authorization for topical skin products such as diaper ointment was not available.

Evidence -
1. On the date of inspection (09/09/2022), an authorization to apply topical skin products for Child #3 was not available for review.
2. The Provider stated (during an interview conducted on the date of inspection) that Child #3 was the only child in care who receives diaper ointment when changing their diaper.

Plan of Correction: All missing documentation and equipment will be obtained.

Standard #: 8VAC20-800-770
Description: Based on observation, a working portable battery-operated weather band radio (WB), and extra batteries were not kept in a designated area and were available to the caregiver at all times.

Evidence -
1. On the date of inspection (09/09/2022), a WB radio was not available.
2. The FDH had an AM\FM radio and not a WB radio.

Plan of Correction: All missing documentation and equipment will be obtained.

Standard #: 8VAC20-800-100-A
Description: Based on review, 3 of 3 children files indicated that the Provider did not obtain documentation of a physical examination (by or under the direction of a physician) within 30 days after the child's first day of attendance.

Evidence -
1. On the date of inspection (09/09/2022), did not have documentation of a physical examination of file.
2. The following children had the following start dates listed: Child #1 (start date - 12/02/2019), Child #2 (start date - 04/05/2021), and Child #3 (start date - 08/22/2022). All three were on site during today's inspection.

Plan of Correction: All missing documentation and equipment will be obtained.

Standard #: 8VAC20-800-70-A
Description: Based on review, 3 of 3 children files indicated that not all of the required information needed tp be given to each child's parent prior to their child's start was distributed.

Evidence -
On the date of inspection (09/09/2022), the following documentation was not available for review:
1. Information for Parents form (to include those state standards listed). The Provider had parents complete the forms from Fairfax County. Those forms do not list those state standards that notify each parent prior to care. This form was not available for 3 of 3 children.
2. The Provision of the Emergency Preparedness and Response Plan was not available for review for 3 of 3 children.
3. The Liability Insurance Declaration form was not available for review for 3 of 3 children/

Plan of Correction: All missing documentation and equipment will be obtained.

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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