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Dina Revollo
6526 Roosevelt Street
Falls church, VA 22043
(703) 241-3827

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

Inspection Date: March 22, 2016

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
22VAC40-80 THE LICENSE.
63.2 General Provisions.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
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.

Technical Assistance:
**Discussed with the provider that emergency evacuation drills must be practiced and documented once a month. Shelter-in-place drills do not take the place of an emergency evacuation drill, but is done twice a year in addition to the emergency evacuation drills. There must me documentation of a total of 14 drills completed in a 12 month period - 12 emergency evacuation drills plus 2 shelter-in-place drills.

Comments:
An unannounced monitoring inspection was conducted today from 9:45am to 11:00am. There were 10 children (34 points) directly supervised by 3 staff. The home, 3 staff records, 3 children?s records, evacuation drills, emergency supplies, and policies were inspected. There were no medications on site today. Children were observed playing freely, dancing and napping. Diapering procedures were also observed. There was an abundant supply of books, toys, and materials for the children. The home was clean and organized. Areas of non-compliance are identified in this report. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 10 calendar days from today. If you have any questions regarding this inspection, please contact the Licensing Inspector. Keesha Minor (keesha.minor@dss.virginia.gov) (703)479-4680

Violations:
Standard #: 22VAC40-111-830-A
Description: Based on review,the provider failed to ensure that emergency evacuation procedures are practiced monthly with all caregivers and children. Evidence: Reviewed the emergency evacuation procedure drill log and found that none were practiced in December and January.

Plan of Correction: We practiced the emergency evacuation procedures as requested later that day.

Standard #: 22VAC40-111-180-A
Description: Based on review, the provider failed to ensure that each caregiver has a current Report of Tuberculosis Screening every two years from the date of the first screening or more frequently as recommended by a physician or the local health department. Evidence: Reviewed 3 staff records and found that Staff 1's last TB screening was on 11/8/13.

Plan of Correction: I will visit the clinic on Monday in order to comply with the requirement of a Tuberculosis Screening exam.

Standard #: 22VAC40-111-320-A
Description: Based on observation, the provider failed to ensure that small electrical appliances such as, but not limited to curling irons, toasters, blenders, shall be unplugged unless being used. Evidence: Observed the following small appliances plugged in in the kitchen and not in use: toaster, toaster over, blender.

Plan of Correction: I will be more conscious to disconnect the electrical appliances mentioned when not in use.

Standard #: 22VAC40-111-530-F
Description: Based on observation, no soft bedding of any kind shall be used under or around infants including, but not limited to pillows, quilts, comforters, sheepskins or stuffed toys. Evidence: Observed in the nap room, stuffed toys in 3 different cribs with sleeping infants.

Plan of Correction: We removed the soft bedding as requested.

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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