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Dina Revollo
6526 Roosevelt Street
Falls church, VA 22043
(703) 241-3827

Current Inspector: Anansa Archer-Hicks (703) 268-3295

Inspection Date: Nov. 20, 2014

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Household Members
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-111 Transportation
22VAC40-80 THE LICENSE.
63.2 General Provisions.
63.2 Child Abuse and Neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Comments:
An unannounced monitoring/renewal inspection was conducted today from 12:10pm-1:40pm. There were 11 children directly supervised by 3 staff. The home, 3 staff records, 4 children?s records, 2 household member?s records, evacuation drills, emergency supplies, and policies were inspected. There were no medications on site today. Children were observed playing freely, eating lunch, preparing for lunch and taking a nap. There was an abundant supply of books, toys, and materials for the children. The home was clean and organized. Areas of non-compliance are identified in this report. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 10 calendar days from today. If you have any questions regarding this inspection, please contact the Licensing Inspector. Keesha Minor (keesha.minor@dss.virginia.gov) 703-934-7301

Violations:
Standard #: 22VAC40-111-830-A
Description: Based on review, the provider failed to practice monthly emergency evacuation procedures on a monthly basis. Evidence: Reviewed the provider's emergency evacuation procedures and found that the provider failed to practice a monthly drill in October, 2014.

Plan of Correction: I will make sure to conduct the monthly drills on a prompt basis.

Standard #: 22VAC40-111-60-B
Description: Based on review, the provider failed to ensure that she maintained documentation of parent's annually reviewing/updating children's emergency information. Evidence: Reviewed 4 children's records and found that CH2 did not have documentation of annually reviewed/updated information. CH2's last review took place on 11/17/13.

Plan of Correction: I will make sure to comply with the yearly review in the future.

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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