VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Rocio Carrillo
1105 Shannon Place
Herndon, VA 20170
(571) 244-9345

Current Inspector: Kara Vaughan (703) 537-6241

Inspection Date: March 7, 2023

Complaint Related: No

Areas Reviewed:

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 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

Technical Assistance:

Licensing inspector discussed model forms, and corrective action with the provider.

Comments:

An unannounced monitoring inspection was conducted today from approximately 12:20pm-1:40pm. There was 1 child in the direct care and supervision of 1 caregiver. A sample of 1 child?s record, 1 caregiver's record, 1 pet's record and 2 household members' were reviewed. The child was observed napping, playing, eating and being diapered. Zero new caregivers have been hired since the last inspection. Areas of non-compliance are identified in this report. The exit interview was conducted with the provider. If you have any questions, contact Kimberly.Sawyer@doe.virginia.gov.

Violations:

Standard #:	22.1-289.036-B-2
Description:	Based on record review, a caregiver did not submit to fingerprinting after 5 years. Evidence: The fingerprinting results of Caregiver A expired January of 2023.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-770-40-C-1-c
Description:	Based on record review, adult household members did not have a complete sworn statement or affirmation. Evidence: Household Member A did not have a complete sworn statement of affirmation on file.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-770
Description:	Based on observation, a working battery-operated flashlight, a working portable battery-operated weather band radio, and extra batteries were not kept in a designated area and be available to caregivers at all times. Evidence: 1) Batteries were not available for the flashlight on site. 2) The radio on site was not battery operated.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-790
Description:	Based on observation, telephone numbers were not posted in a visible area close to the telephone. Evidence: 911 or local emergency numbers were not posted in the facility.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-800-B
Description:	Based on record review, the emergency plan was not reviewed annually. Evidence: The emergency plan was last reviewed in 2016.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-830-A
Description:	Based on record review, the emergency evacuation procedures were not practiced monthly. Evidence: The emergency evacuation procedures were not practiced in 2022 and January of 2023.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-830-B
Description:	Based on record review, shelter-in-place procedures were not practiced a minimum of twice per year. Evidence: Shelter-in-place procedures were not practiced in 2022.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-60-B
Description:	Based on record review, a child's record was missing required information. Evidence: The record of Child A was missing the first day of attendance, the insurance policy number, medication policy agreement, liability insurance disclosure, and a complete provisions of emergency preparedeness form.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-170-A
Description:	Based on record review, the provider did not obtain from each caregiver at the time of hire and each adult household member prior to coming into 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: Caregiver A, Household Member A and Household Member B did not have a tuberculosis screening on file.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-210-A
Description:	Based on record review, caregivers did not obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: Caregiver A did not have any training hours completed in 2022.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-240-A
Description:	Based on observation, areas of the home were not kept in a clean condition. Evidence: Unattended food and a stack of approximately 10 unclean pots were located in the kitchen.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-460-D
Description:	Based on record review, the provider did not maintain documentation of the current rabies vaccination. Evidence: The rabies vaccination on file expired in 2021.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-680-A
Description:	Based on observation, A caregiver did not wash their hands with liquid soap and warm running water. Evidence: Caregiver A did not wash their hands with liquid soap and running water before feeding Child A and after changing the diaper of Child A.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-680-B
Description:	Based on observation, a caregiver did not ensure that children's hands are washed with liquid soap and warm running water. Evidence: Caregiver A did not ensure that Child A washed their hands before eating.and after diapering.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-820-120-E-2
Description:	Based on observation, the findings of the most recent inspection of the facility were not posted. Evidence: The findings of the most recent inspection of the facility were not posted.
Plan of Correction:	Not available online. Contact Inspector for more information.