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Roina Mustafa
7702 Tanner Robert Court
Springfield, VA 22153
(703) 569-4084

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

Inspection Date: Oct. 19, 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
22VAC40-111 Transportation
22VAC40-111 Nighttime Care
22VAC40-80 THE LICENSE.
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 renewal inspection was conducted today. Observed 6 children (20 points) directly supervised by 2 caregivers. Ratio and supervision were in compliance. A sample of 2 children's records, 2 caregiver records, and 1 household member were reviewed. The physical plant, emergency supplies and procedures were also reviewed. No medications were reported to be on site. The children were engaged in various activities, to include: snack time, free play, and infant care. Areas of non-compliance are identified in this report. The exit interview was conducted with the provider. Inspection conducted 9:30am-10:45am. If you have any questions regarding today's inspection, please contact Ana Dally at (703) 577-0270 or anailim.dally@dss.virginia.gov

Violations:
Standard #: 22VAC40-111-770
Description: Based upon observations made, the family day home did not have a working portable battery-operated weather band radio. Evidence: The portable-operated weather band radio was not working.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-111-180-A
Description: Based upon documentation reviewed, the provider did not obtain for each caregiver a current Report of Tuberculosis Screening (TB) form within the allowable two years time frame. Evidence: Caregiver #1 did not have a current TB test/screening on file; last TB test/screening was dated 08/16/2013.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-111-320-B
Description: Based upon observations made, a child-resistant protective cover was not installed on all unused electrical outlets accessible to children under five years of age. Evidence: An electrical outlet located right next to the an infant crib did not have one of the two required protective covers. A total of 6 children were in attendance and under five years of age.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-191-40-D-1-c
Description: Based upon documentation reviewed, background checks were not repeated within the three year allowable time frame. Evidence: 1) Caregiver #2 did not have a current sworn statement or affirmation form (SDS) on file; last SDS was dated 06/25/2012. 2) Household member #1 did not have a current SDS form, criminal history record check (CRC), and search of central registry (CPS) check on file. Last SDS form was dated 06/26/2012. Last CRC check was dated 09/11/2012. Last CPS check was dated 09/17/2012.

Plan of Correction: Not available online. Contact Inspector for more information.

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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