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Fatemeh Ranjbarkohan
745 Bonnie Ridge Drive, NE.
Leesburg, VA 20176
(703) 729-0899

Current Inspector: Maria Robles-Lopez (703) 397-3827

Inspection Date: May 21, 2015

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
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
63.2 General Provisions.
63.2 Child Abuse and Neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
Discussion was held on the topics of current enrollment and current staffing.

Comments:
The following inspection took place between the hours of 10 am through 1 pm. Today, I met with the Provider on site at her Family Day Home (FDH) located in Leesburg, Virginia. At the start of this unannounced monitoring inspection there were a total of 8 children (20 points) with 2 caregivers. A total of 10 children?s files and 2 staff/household member?s files were reviewed. The children were engaged in the following: freeplay, learning, inside play due to the weather, and other organized activities. If you should have any future questions, please call. Thank you. Charlie Perkins, Licensing Inspector (703) 309-3963

Violations:
Standard #: 22VAC40-111-780-B
Description: Based on review, 4 of 10 children's files reviewed indicated that the provider did not annually review with the parent the emergency contact information (required in 22 VAC 40-111-60 B 2) to ensure the information is correct, and obtain the parent's signed acknowledgment of the review. Evidence - 1. On the date of inspection (05/21/2015), the following children were without a signed acknowledgment of review for their parent's emergency contact information: Child #3 (last acknowledged - 01/27/2014), Child #4 (last acknowledged - 01/12/2014), Child #7 (last acknowledged - 01/21/2014), and Child #8 (last acknowledged - 01/03/2014). 2. This was confirmed on the date of inspection by the Provider.

Plan of Correction: All applicable information will be reviewed, updated where needed, and signed as an acknowledgment.

Standard #: 22VAC40-111-100-A
Description: Based on review, 1 of 10 children's files reviewed indicated that the Provider did not obtain documentation of a physical examination (by or under the direction of a physician prior to a child's attendance or) within 30 days after the first day of attendance. Evidence - 1. On the date of inspection (05/21/2015), documentation of a physical was not available for review for Child #10. 2. The start date for Child #10 was listed as 01/21/2015.

Plan of Correction: A physical will be obtained for Child #10 and placed on file.

Standard #: 22VAC40-111-90-C
Description: Based on review, 3 of 10 children's files reviewed indicated that the Family Day Home (FDH) did not obtain documentation of additional immunizations for children (who were not exempt from the immunization requirements according to subsection B of this section) once every six months for children under the age of two years. Evidence - 1. On the date of inspection (05/21/2015), the following children had immunization documentation older than 6 months: Child #5 (immunization documentation - 10/02/2014), Child #7 (immunization documentation - 09/10/2014), and Child #9 (immunization documentation - 08/18/2014). 2. On the date of inspection, based on the information on file at the FDH, all listed children were under 2 years of age.

Plan of Correction: All applicable immunization documentation will be updated and placed on file.

Standard #: 22VAC40-111-140-B-3
Description: Based on review and interview, 1 of 2 staff/household member's files reviewed indicated that a current certification in cardiopulmonary resuscitation (CPR) (as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current CPR certification) issued within the past two years (by a community college, a hospital, a rescue squad, or a fire department) was not available. Evidence - 1. On the date of inspection (05/21/2015), current documentation in CPR was not available for review for Member #1. 2. Member #1 stated (during an interview conducted on the date of inspection) that she has still yet to take the second part (in person skills test) of this course. The instructor has yet to schedule it.

Plan of Correction: Will follow up with instructor to finish this course.

Standard #: 22VAC40-111-180-A
Description: Based on review, 1 of 2 staff/household member's files reviewed indicated that the Provider did not obtain for each caregiver and adult household member a current Report of Tuberculosis Screening (TB) documentation (in accordance with the requirements in 22 VAC 40-111-170), every two years from the date of the first screening or more frequently as recommended by a physician or the local health department. Evidence - 1. On the date of inspection (05/21/2015), the most recent TB documentation on file for Member #2 was dated - 02/08/2013. 2. This was confirmed on the date of inspection by the Provider.

Plan of Correction: Updated TB documentation will be obtained for Member #2.

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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