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Ms. Audrey Stafford
10245 Sunset Lane
Unionville, VA 22567
(540) 854-5262

Current Inspector: Diann S. Reed (540) 280-0742

Inspection Date: April 5, 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
22VAC40-111 Nutrition
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
We discussed the requirements for outdoor equipment, children's records, TB statements and updated background checks. The risk assessment for violations was provided. We talked about storage of hazardous substances used outside. Also, we talked about movement of playground equipment if it will be used, such as slides. The bleach solution takes two minutes to sanitize the diaper mat.

Comments:
Thank you for your assistance during today's unannounced monitoring inspection conducted from 12:33 PM to 4:40 PM. Today, there were eight children, ages infancy through school age (twenty points), with one to two caregivers. I viewed daily routines, staffing, supervision, interactions with children, equipment, posted information, emergency supplies and drill records, injury records, activities, snack, four records for children, three records for caregivers/staff, training for a fourth caregiver, diapering procedures, indoor and outdoor areas. The children enjoyed access to indoor toys and materials and outdoor play. There have been spring art activities conducted with the children. The provider was observed responding to infant's needs for feeding, comfort, attention and rest. Let me know if you need any assistance. 540/430-9259

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on a review of four records for children, and an interview with the provider, there was not a physical examination report obtained within thirty days of attendance for child 2 (Repeat violation.). Evidence: Child 2 began attending on June 29, 2015 and there were only immunization reports in the file.

Plan of Correction: The provider will speak to the parent during pick-up time and request a copy of the physical examination record for child 2. The record will be obtained for the file. In the future, the provider will keep track of the information provided at the time of enrollment for new children by using the checklist on the registration form. Physical examination records will be obtained within thirty days.

Standard #: 22VAC40-111-180-A
Description: Based on a review of three records for caregivers/residents, and an interview with the provider, the updated TB screenings and statements for caregiver/resident 1, 2 and 3 were not obtained by two years from the date of the most recent TB statement. Evidence: The February 4, 2014 TB statement for caregiver/resident 1 was obtained late on February 24, 2016. The statement for caregiver/resident 2 dated February 7, 2014 was obtained late on February 24, 2016. The statement for caregiver/resident 3 from February 5, 2014 was obtained late on February 22, 2016.

Plan of Correction: The provider will resume using a list with dates for records to view regularly so that arrangements are made to update records in advance of the due dates. TB screenings and statements will be obtained no later than two years from the date of the previous statement.

Standard #: 22VAC40-111-500-C
Description: Based on observation of the outdoor play equipment, and measurements in the use zones, the perimeter of a component of a Little Tikes composite structure was less than six feet from an obstacle. Evidence: The exit area of the tall pink slide, with a height of thirty inches, was three feet and eight inches from the outbuilding wall.

Plan of Correction: The provider will arrange for family members to assist with moving the equipment so that the slide and any play component is at least six feet from the outbuilding and any other obstacle. The provider will make sure the requirement for the fall and use zones are maintained when moving play equipment.

Standard #: 22VAC40-111-570-A
Description: Based on observation of the children in care with the provider, an interview with the provider, and the determination of the ages of the children and use of the point system, from 12:30 PM to about 2:00 PM, the provider was alone while there were more than sixteen points and the need for a second caregiver. Evidence: Upon arrival at 12:33 PM, the provider was alone with eight children (two infants, one toddler, four preschool age children and a school age child). The provider indicated that she was aware she had too many points (twenty points) and that the assistant caregiver left just before the arrival of the licensing inspector to go attend to a sick family member.

Plan of Correction: The provider immediately called a resident family member who arranged to leave work early and arrived to assist with the children by 2:00 PM. The provider will hire a substitute assistant caregiver in case resident caregivers are not readily available when the regularly scheduled assistant needs to leave early or is not available.

Standard #: 22VAC40-191-40-D-1-c
Description: Based on a review of three records for caregivers/residents, and an interview with the provider, the updated sworn statements and background checks for caregivers/residents 1, 2 and 3 were not obtained by three years from the dates of the last records. Evidence: The most recent sworn statements in the records were completed on January 12, 2013. The criminal history records for caregiver/resident 2 and 3 were dated February 9, 2013. The criminal history record for caregiver/resident 1 was dated March 26, 2013. The most recent central registry clearances in the files were dated February 22, 2013. The provider indicated that request forms have not been completed and sent to Richmond.

Plan of Correction: The provider will have everyone complete another sworn statement. Also, the provider will obtain the request forms and have everyone complete the information needed to obtain updated criminal history records and central registry checks. In the future, the provider will use the paper with the listed dates so that she can determine the time to update the sworn statements and background checks before they are due every three years.

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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