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Maria Enciso
21472 Rusty Blackhaw Square
Sterling, VA 20164
(703) 406-4342

Current Inspector: Stephanie Salvatori (571) 389-0980

Inspection Date: Dec. 1, 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 Emergencies
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

Comments:
Today an unannounced monitoring visit was conducted beginning at 12:10pm. There were 4 children (13 points) present with the Provider and assistant caregiver. Children were napping during this inspection. One new child's records and two new caregiver records were reviewed. Please let me know if you have any questions regarding paperwork and documentation needed for caregivers. Required annual training hours for all caregivers will be reviewed at the next unannounced visit. This inspection, including the exit interview, ended at 1:20pm. Should you have any questions, please call.

Violations:
Standard #: 22VAC40-111-120-B
Description: Based on record review, four caregiver records (#3,6,7 and 8) are missing complete required documentation in their record. Evidence: Caregivers #3,6,7 and 8 are missing documentation of an emergency contact in their record. Caregivers #6,7 and 8 are missing documentation of their job title documented in their record. Caregivers #6 and 7 are missing documentation of a sworn statement filled out within 30 days of their start date. (Start date of 9/25/14 for caregiver #6 and start date of 4/30/15 for caregiver #7). Caregiver #8 does not have completed background checks (search of central registry and criminal history) within 30 days of their start date (10/13/15).

Plan of Correction: I will use the form that has all this information on it for all caregivers to fill out completely. I will have each of them fill it out on their next shift. We have sent the background checks for caregiver #8. We will check the status or resubmit them and be sure that this caregiver is not left supervising children alone until the results are returned. We will make sure staff who do not have sworn statements fill them out on their next shift.

Standard #: 22VAC40-111-200-A
Description: Based on record review, there is no documentation that two caregivers (#7 and 8) have received orientation training by the end of their first week of assuming job responsibilities. Evidence: Caregiver #7 began employment 4/30/15 and caregiver #8 began employment 10/13/15. Neither caregiver has documentation of receiving orientation in their record.

Plan of Correction: I did the training for both caregivers the same day. I will review the orientation with them and make sure that it is documented in their file.

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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