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Mrs. Deborah Bell
1536 Andrew Road N.W.
Roanoke, VA 24017
(540) 904-3188

Current Inspector: Julia Kimbrough (276) 608-4267

Inspection Date: April 26, 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
22VAC40-111 Transportation
22VAC40-111 Nighttime Care
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
22VAC40-80 SANCTIONS.
22VAC40-80 HEARINGS PROCEDURES.
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
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
LI Anderson discussed the topical skin product procedures/requirements with the Provider. Provider was reminded: when topical skin products (sunscreen, diaper ointment/lotion, oral teething medicine & insect repellent) are used, the must have written parent authorization, product must be in the original container, manufacturer?s instructions must be followed, Caregivers without medication administration training may apply the product unless it is a prescription medication, in which case the storing and administration must meet prescription medication requirements.

Comments:
An unannounced monitor inspection was conducted on 4/26/2016. There were five (5) children ages 17 months to 4 years old, the Provider & 2 assistants present during the inspection. Two (2) additional household members arrived during the inspection. Children present totaled thirteen (13) points under the direct care of three (3) caregivers. Children & staff records were reviewed during today?s inspection including records for recently enrolled children. There have been slight changes in household members since the previous inspection. Provider continues to participate in the Child Care Food Program, does not provide transportation and does not administer medication. Children were observed during outdoor activities, meals/snacks served, handwashing/diapering/bathroom procedures, independent/group activities, active/quiet activities, structured/unstructured activities & rest time. Areas of non-compliance & risk assessment were reviewed with the Provider on 4/26/2015.

Violations:
Standard #: 22VAC40-111-780-A
Description: Based on record review, the Licensee failed to ensure each child's record contains all required documentation. EVIDENCE: Record for Child #4 did not include emergency contact information & the parent's written authorization for emergency medical care in the event of a child's illness or injury.

Plan of Correction: Will take care of

Standard #: 22VAC40-111-780-B
Description: Based on record review, the Licensee failed to annually update emergency contact information for each child to ensure the information is correct and obtain the parent's signed acknowledgment of the review. EVIDENCE: LI Anderson reviewed five (5) children records. Record for Child #3 did not include documentation of annual review of to ensure emergency information is up-to-date.

Plan of Correction: Will take care of

Standard #: 22VAC40-111-920
Description: Based on inspection, the Licensee failed to have a meal/snack menu for the current one-week period . EVIDENCE: Meal/snack menu was not posted not available.

Plan of Correction: Take care of today

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. EVIDENCE: 1. Record for Child #1 did not include documentation of the the child's physical examination. Date of enrollment was not documented in the record, however enrollment documents were signed by the child's parents on 9/04/2015

Plan of Correction: Will take care of

Standard #: 22VAC40-111-60-B
Description: Based on record review, the Licensee failed to document required information in children's records. EVIDENCE: LI Anderson reviewed five (5) children records. 1. Record for Child #1 did not include the completed address of place of employment for each parent. 2. Record for Child #1 did not include the date of enrollment (1st day of attendance) 3. Record for Child #3 did not include documentation of the review of the child's emergency contact information as required by 22 VAC 40-111-780 B. 3. Record for Child #4 did not include documentation of the review of the child's emergency contact information as required by 22VAC40-111-780-B. 4. Record for Child #4 did not include the insurance name & policy number in case of an emergency.

Plan of Correction: Will take care of

Standard #: 22VAC40-111-70-B
Description: Based on record review, the Licensee failed to obtain the parent's written acknowledgement of the receipt of required information. EVIDENCE: LI Anderson reviewed five (5) children records. 1. Record for Child #1 did not include the parent's written acknowledgment of receipt of the policies for the administration of medication 2. Record for Child #2 did not include the parent's written acknowledgment of receipt of the policies for the administration of medication, operating information including the hours & days, schedule of fees & payment plans, check in/out procedures & required notifications. 3. Record for Child #5 did not include the parent's written acknowledgment of receipt of the policies for the administration of medication

Plan of Correction: Will take care of

Standard #: 22VAC40-111-90-C
Description: Based on record review, the Licensee failed to obtain documentation of additional immunizations for each child once every six months for children under the age of two years. EVIDENCE: LI Anderson reviewed five (5) children records. 1. Record for Child #1 did not include documentation of updated immunizations every 6 months. Child #1 date of birth 11/14/2014.

Plan of Correction: Will take care of

Standard #: 22VAC40-111-210-A
Description: Based on record review & discussion with the Provider, the Licensee failed to ensure caregivers obtain a minimum of 16 clock hours of annual training in areas relevant to their job responsibilities. EVIDENCE: Staff Members #1, #3 and #4 did not complete 16 hours of annual training for year 2015.

Plan of Correction: Will take care of

Standard #: 22VAC40-111-680-B
Description: Based on observations, the Licensee failed to ensure children's hands are washed with liquid soap and warm running water after toileting/diapering. EVIDENCE: LI Anderson observed children's hands were not washed with water and liquid soap after diapering.

Plan of Correction: Will take care of today

Standard #: 22VAC40-191-40-D-4-a
Description: Based on record review & discussion with the Provider, the Licensee failed to ensure each person living in the home completes a Sworn Statement/Affirmation, search of Central Registry Check & Criminal History Record check within 30 days of a person 18 years of age and older beginning to reside in the home. EVIDENCE: Household Member #5 does not have completed Background Checks

Plan of Correction: Will take care of

Standard #: 22VAC40-191-60-C-1
Description: Based on record review, the Licensee failed to ensure Background Checks are completed within 30 days of employment. EVIDENCE: Record for Staff #4 did not include documentation of a Background Check (Criminal Record) completed within the first 30 days of hire.

Plan of Correction: Staff member is scheduled for vacation & will return once background checks have been completed.

Standard #: 22VAC40-191-60-C-2
Description: Based on record review, the Licensee failed to ensure Background Checks are completed within 30 days of employment. EVIDENCE: Record for Staff #4 did not include documentation of a Background Check (Child Protective Services) completed within the first 30 days of hire.

Plan of Correction: Staff member is scheduled for vacation & will return once background checks have been completed.

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.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.

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