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Khalida Kazimi
25814 Turlough Terrace
Chantilly, VA 20152
(571) 245-2103

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: April 16, 2024

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
54.1 Provider must be MAT certified to administer prescription medication.
63.2 Child abuse and neglect

Comments:
An unannounced monitoring inspection was conducted today from 8:20am- 9:45am. There were 7 children directly supervised by the provider and 1 assistant caregiver. The home, 2 caregiver records, 4 children?s records, 2 household member?s records, evacuation drills, and policies were inspected. Children were observed having breakfast and playing freely. Areas of non-compliance are identified in the Violation Notice.
If you have any questions regarding this inspection, please contact the Licensing Inspector at jessica.willis@doe.virginia.gov or 571-352-1453.

Violations:
Standard #: 8VAC20-800-730-D
Description: Based on observation, medications prescribed to children were not kept in a locked place using a safe locking method that prevents access by children.

Evidence:
1. Medication prescribed to Child #3 was located in the child's backpack.

Plan of Correction: The medication was put on a high shelf for the remainder of the day. A lock box will be purchased to store children's medication.

Standard #: 8VAC20-800-120-B
Description: Based on record review, 1 of 2 caregiver records reviewed did not contain all required documentation.

Evidence:
1. The record for Caregiver #2 did not contain documentation of the name address and telephone number of a person to be notified in an
emergency

Plan of Correction: The information will be added to the caregiver's record.

Standard #: 8VAC20-800-60-B
Description: Based on record review, 1 of 4 children's records did not contain all required information.

Evidence:
1. The record for Child #3 did not contain the child's first date of attendance.

Plan of Correction: The records will be updated.

Standard #: 8VAC20-800-70-A
Description: Based on record review, parents were not provided with all required information in writing before the child's first day of attendance for 2 of 4 children.

Evidence:
1. Forms providing information regarding medication administration and declaration of liability insurance in the record for Child #3 were not filled out.
2. The medication administration form in the record for Child #4 did not contain the names of caregivers with Medication Administration Training.

Plan of Correction: Parents will be provided with complete information and documented in the records.

Standard #: 8VAC20-800-80-C
Description: Repeat violation

Based on record review, the provider did not document all required proof of identity information for 3 of 4 children reviewed.

Evidence:
1. The documentation of verification of proof of identity for Child #1 and Child #3 did not include the date of review and signature of person viewing the proof of identity document .
2. The documentation of verification of proof of identity for Child #4 did not include the method of verification.

Plan of Correction: The records will be updated.

Standard #: 8VAC20-800-200-A
Description: Based on record review, the provider did not orient the assistant by their first week of assuming job responsibilities.

Evidence:
1. Caregiver #2 began employment on 01/05/2024.
2. The record for Caregiver #2 did not contain documentation of orientation training.

Plan of Correction: The provider will provide and document orientation in the caregiver's record.

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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