VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Neelam Abbas
1607 Heron Way
Woodbridge, VA 22191
(571) 243-5249

Current Inspector: Morgan Bryson (540) 270-0057

Inspection Date: Aug. 15, 2023

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 8VAC20-770 Background Checks 22.1 Background Checks Code, Carbon Monoxide

Technical Assistance:

Provided consultation on: Ensure that the gate at the bottom of the stairs is securely closed. Repairs may be needed to ensure that it is working properly. Provide technical assistance on: 1) Standard 600B: infants shall spend no more than 30 minutes of consecutive time during waking hours confined in a crib, play pen, high chair, or other confining piece of equipment (swing, exersaucer, bouncy chair, etc.) The intervening time period between confinements shall be at least one hour. 2) Standard 750A: Topical skin products shall have authorization forms noting any adverse reactions, be in the original container and be labeled with the child?s name. 3) Standard 920: Menus shall list any substituted food provided

Comments:

An unannounced renewal inspection was conducted from 9:45 - 11:45 am with the provider and her two assistants. There were 11 children, ranging from six months to four years of age, for a total of 34 points. Children were observed eating snack, playing with age-appropriate toys and singing/dancing to an age-appropriate video. Five child records and six provider/household member records were reviewed. The emergency drill log, daily attendance, menu, required posted information and annual training were reviewed. It was reported that there were no medications on site, however the provider has current certification in Medication Administration Training (MAT). Please complete the columns for "Plan of Correction" and "Date to be Corrected" for each violation cited on the violation notice, and then return a signed and dated copy to the licensing office by 4:00pm on Monday, 8/28/23. If you have further questions about this inspection please contact Donna Liberman at 540-359-5244 or Donna.Liberman@doe.virginia.gov.

Violations:

Standard #:	8VAC20-800-750-A
Description:	Based on observation, and a review of documentation, the provider did not ensure all topical skin product requirements were met. Evidence: There were five diaper ointments that were not labeled with the child's name and the written parent authorization forms did not have complete information as required.
Plan of Correction:	Going forward, all topical skin products will be labeled, and complete authorization forms will be obtained.
Standard #:	8VAC20-800-880
Description:	Based on observation, the provider did not ensure that the provided snack followed the most recent age-appropriate requirements of the USDA. Evidence: the children were given apples and juice for their morning snack. A snack is required to have foods from two different food groups.
Plan of Correction:	Going forward will ensure that all snacks and meals are provided according to USDA requirements.
Standard #:	8VAC20-800-960-B
Description:	Based on observation, the provider failed to ensure that infants who cannot hold their own bottles are picked up and held for bottle feeding. Evidence: A caregiver was observed holding a bottle to feed a six-month old infant who was seated in an infant bouncy chair.
Plan of Correction:	Going forward, all babies will be held when fed.
Standard #:	8VAC20-800-60-A
Description:	Based on review of six child records, not all records contained all required information. Evidence: the records for child #2, child #3 and child #4 were missing written authorization for emergency medical care. The record for child #2 was missing proof of the child's age and identity.
Plan of Correction:	Asked parents for missing information.
Standard #:	8VAC20-800-320-A
Description:	Based on observation and interview, the provider failed to ensure that small electrical appliances were unplugged while not in use. Evidence: there was a Keurig coffee maker sitting on the kitchen counter plugged in and the provider stated that it was not in use.
Plan of Correction:	Keurig was unplugged during the inspection.
Standard #:	8VAC20-800-460-C
Description:	Based on review of documentation, and an interview with the provider, not all pets were vaccinated as required. Evidence: The last documented rabies shot for the cat, ?Tiger,? was dated: 3/31/20.
Plan of Correction:	"Tiger" received a rabies vaccination on 8/23.
Standard #:	8VAC20-800-530-B
Description:	Based on observation, not all cribs in use had tight fitting sheets. Evidence: four cribs had loose sheets. One of the four cribs was being used by an infant in care, according to the provider. Loose crib sheets are a suffocation hazard and increase the risk of sudden unexplained infant death.
Plan of Correction:	Provider stated she will get tight fitting sheets.
Standard #:	8VAC20-800-540-A
Description:	Based on observation, not all infant seats and high chairs/feeding tables were used according to the manufacturer's instructions when occupied by a child, using a safety strap that is securely fastened. Evidence: two children were observed seated in a low high chair/feeding table and were not strapped in. One infant was placed in a bouncy chair and was not strapped in.
Plan of Correction:	Going forward will ensure that all children are securely fastened into seats.
Standard #:	8VAC20-800-680-A
Description:	Based on observation, it was determined that not all caregivers washed their hands with liquid soap and warm running water before feeding or helping children with feeding. Evidence: A caregiver was observed feeding an infant a bottle and the caregiver did not wash their hands beforehand.
Plan of Correction:	Going forward all caregivers will wash their hands before serving children meals and snacks and bottles.
Standard #:	8VAC20-800-680-B
Description:	Based on observation, it was determined that not all caregivers washed the children's hands with liquid soap and warm running water before eating. Evidence: A caregiver was observed feeding an infant a bottle and the caregiver did not wash the infant's hands beforehand.
Plan of Correction:	Going forward caregivers will wash all children's hands before meals and snacks and bottles.