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Dawn Johnson, Sullivan
2601 Strasburg Road
Front royal, VA 22630
(540) 622-2236

Current Inspector: Amy Tomblin (804) 629-3923

Inspection Date: Oct. 14, 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
8VAC20-770 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.

Comments:
An unannounced monitoring inspection was conducted on 10/14/2022 from 10:50 a.m. to 12:00 p.m.. There were 4 children present, ranging in ages from 3 to 4 years old, with 1 staff 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 4 child records and 1 staff record and 2 household members 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 or concerns, please contact the Licensing Inspector at (804) 629-3923.

Violations:
Standard #: 8VAC20-770-40-D-4-a
Description: Based on review of records and interview, the provider failed to ensure that central registry results were obtained within 30 days of residency for household members.
Evidence:
1. The provider confirmed that Household member #2 began living in the home in early July of 2022.
2. The provider did not have documentation of a central registry check for House Member #2.
3. The provider confirmed that they did not obtain central registry results for Household Member #2 within 30 day of residency.

Plan of Correction: These record were attempted. The USPS did not do their part. So appropriate paperwork was submitted once again along with astronomical overnight fee. We are awaiting a result.

Standard #: 8VAC20-800-170-A
Description: Based on review of records and interview, the provider failed to ensure that each adult household member obtained a tuberculosis screening.
Evidence:
1. The provider did not have documentation of Household Member #2?s tuberculosis screening.
2. The provider confirmed that Household Member #2 did not obtain a tuberculosis screening.

Plan of Correction: This is awaiting results.

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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