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Mrs. Barbara Staples
9 Briar Hill Drive
Fieldale, VA 24089
(276) 629-6035

Current Inspector: Rebecca Forestier (540) 309-2835

Inspection Date:

Complaint Related: No

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on record review, the Licensee failed to 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: LI Anderson reviewed five (5) children records. Two (2) out of 5 records did not include documentation of the child's physical examination. Records for Child #2 and Child #3

Plan of Correction: Provider will request documentations of physical examinations from each parent

Standard #: 22VAC40-111-120-B
Description: Based on record review, the Licensee failed to have required documentation for assistants' and substitute providers. EVIDENCE: Record for Staff Member #4 did not include date of employment, emergency contact name address & telephone number and 2 or more references.

Plan of Correction: Will have each staff member complete required documentation.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the Licensee failed to have required documentation in each child's record. EVIDENCE: LI Anderson reviewed 5 children records. 1. Record for Child #7 did not include the child's parents work phone number, physicians information & medical insurance information. 2. Record for Child #8 did not include the child's parents work phone number, physicians information & medical insurance information. 3. Record for Child #2 did not include the date of enrollment 4. Records for Child #1 & Child #2 did not include written authorization for emergency medical care.

Plan of Correction: Provider will have parents complete documents.

Standard #: 22VAC40-111-70-A
Description: Based on record review, the Licensee failed to provide written information for parents before the child's first day of attendance. EVIDENCE: Record for Child #1 did not include provider/parent agreement information including hours & days of operation, schedule of fees and payment options and check-in/check-out procedures.

Plan of Correction: Provider will complete information & have parents to review & sign

Standard #: 22VAC40-191-60-B
Description: Based on record review, the Licensee failed to have Background Checks (Sworn Disclosure) completed for each staff member. EVIDENCE: Record for Staff Member #4 did not include documentation of Sworn Disclosure.

Plan of Correction: Staff will complete SD

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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