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Karin Zacharias
1210 Summerfield Drive
Herndon, VA 20170
(703) 869-4931

Current Inspector: Sandra W D'Imperio (703) 479-4675

Inspection Date: July 29, 2015

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Emergencies
22VAC40-111 Nutrition
54.1-3408 Provider must be MAT certified to administer prescription medication.

Comments:
An unannounced monitoring inspection was conducted today. There are 8 children (17 points) with 2 adults present. One adult and one child's file was reviewed. See violation notice for missing information. Children were observed getting up from sleeping, playing with puzzles and using the bathroom. LI was present to day from 9:00 AM- 9:45 AM. If you have any questions regarding this inspection, please contact me at 703-479-4678. Follow up to conclude the insepcetion was conducted on 8/6/15.

Violations:
Standard #: 22VAC40-111-100-A
Description: Based upon a review of files, one child's file is incomplete. Evidence: Child #1's file does not contain documentation of a current physical past 30 days of enrollment. (Date of enrollment: 5/22/15)

Plan of Correction: The parent was told the child will not be able to come back until she has a physical.

Standard #: 22VAC40-111-110-B
Description: Based upon a review of files, one child's file is missing an acceptable immunization record. Evidence: Child 1#'s file doe not contain documentation of immunization that is signed, stamped or electronically signed bythe physician's office.

Plan of Correction: The parent was asked to have the shot record stamped by the doctor's office.

Standard #: 22VAC40-111-120-B
Description: Based upon a review of files, one adult file is incomplete. Evidence: Adult A does not have documentation of 2 references on file, prior to starting work.

Plan of Correction: I now have two references done for the Asst.

Standard #: 22VAC40-111-200-C
Description: Based upon a review of files, one adult file does not contain documentation of orientation having been conducted. (Adult A)

Plan of Correction: Orientation was conducted; however, I did not document it. I will complete the model form and put it in her file.

Standard #: 22VAC40-111-230-A
Description: Based upon a review of files, one adult file does not contain documentation of all required information. Evidence: Adult A's file is incomplete. Missing information includes but may not be limited to: documentation of education, experience and an emergency contact.

Plan of Correction: The Assistant record model form is now completed and will be placed in her file.

Standard #: 22VAC40-111-510-D
Description: Based upon direct observation, rest mats do not have at least one inch of cushioning. Evidence: 3 rest mats in use have less than one inch of cushioning.

Plan of Correction: I will replace the mats with the thicker mats.

Standard #: 22VAC40-111-510-E
Description: Based upon direct observation, multiple rest mats in use cannot be sanitized. Evidence: Multiple rest mats have tears or rips and can no longer be sanitized.

Plan of Correction: The rest mats have been replaced with new mats.

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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