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Tonya Mitchell
1501 Three Gait Trail
Virginia beach, VA 23453
(757) 309-6870

Current Inspector: Emily Walsh (757) 404-2575

Inspection Date: May 27, 2016

Complaint Related: Yes

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment

Technical Assistance:
Standard 22VAC 40-111-(2)-50.A requires that a written record of children in attendance is kept each day. The intent of the standard is to ensure that providers, emergency back-up caregivers and emergency responders are aware of and can account for children in care at any one time each day. This is important in case of an emergency in which the provider is separated or could be separated from the children.

Comments:
A complaint investigation was conducted at the family day home on May 27, 2016 in response to a complaint received on May 24, 2016. Three children, ages 16 months - 3 years, totaling seven points, were in care with a substitute provider. Five caregiver records and nine children's records were reviewed. The complainant alleged that children have been in the care of substitute caregivers for whom background checks had not been obtained. Virginia State Police criminal history searches and Child Protective Services central registry checks were available for all caregivers, thus this allegation was not valid. The complainant stated that substitute caregivers were not qualified or trained to care for the children. Evidence gathered determined the allegation to be valid. Also alleged was that parents were not given or required to sign policy agreements with the provider. Evidence revealed that the required policy agreements have been signed by the parents and the provider; therefore this allegation was found to be not valid. Additionally the complainant stated that the Family Day Home did not have enough available cribs for each infant in attendance at the same time. Evidence gathered determined that this is valid. Violations were cited in five of the fourteen areas of the Standards for Family Day Homes to include Administration, Personnel, Physical Health of Caregivers and Household Members, Caregiver Training and Physical Environment and Equipment. Violations cited that were not a part of the complaint can be found on the violation notice. An exit meeting was conducted with the substitute provider to review the Acknowledgment Form prior to concluding the inspection. Upon receipt of the inspection notices, the provider must develop a plan of correction for each violation cited. The plan of correction must include the following: - The steps taken to correct the noncompliance with the standards (violations); - Measures to prevent reoccurrence of noncompliance; - Person(s) responsible for implementation and monitoring of preventive measures(s); - Date by which noncompliance will be corrected. The provider has ten calendar days from receipt of the inspection notices to complete the sections titled Plan of Correction and Date to be Corrected, sign and date the pages where indicated and return the inspection notices to the Licensing Office. A copy is to be retained to be posted at the family day home. (NOTE: Supplemental Information is not to be posted due to confidentiality). Results of the inspection notices are subject to public disclosure and will be posted on the VDSS web site within 15 calendar days, regardless of whether the Plan of Correction section has been completed. If a provider disagrees with a violation(s), the facility has 15 calendar days from receipt of the inspection notices to initiate a written request for a First Step Review. Please contact the inspector if there are any questions.

Violations:
Standard #: 22VAC40-111-120-B
Complaint related: Yes
Description: Based upon review of five caregiver records and caregiver interview, the provider has not ensured that assistants' and substitute providers' records contain all required documentation. Evidence: 1. The record provided for caregiver 1 contained documentation of only 1 reference as to character and reputation as well as competency that was checked before employment. 2. The records provided for caregivers 2, 3, 4 and 5 did not contain any documentation that two or more references as to character and reputation as well as competency were checked before employment. 3. The records provided for caregivers 2, 4 and 5 did not have documentation of the date of employment or volunteering. 4. The records provided for caregivers 2, 3, 4 and 5 did not include the names, addresses and telephone numbers of persons to be contacted in an emergency. 5. The record provided for caregiver 2 did not contain a completed, signed and dated sworn disclosure or affirmation form. 6. The records provided for caregivers 1, 2, 3, 4 and 5 did not include documentation of the education, training or experience required by their positions. 7. Caregiver 1 was unable to provide any of the above listed documentation. Caregiver 1 confirmed that caregivers 2, 3, 4 and 5 have been on duty with the children. Caregiver 1 was on duty in the role of substitute provider during the inspection on May 27, 2016. 8. The substitute provider record had recorded that caregiver 2 was on duty with the children on April 14, 2016. 9. The substitute provider record had recorded that caregiver 3 was on duty with the children on May 23, 2016 and May 24, 2016.

Plan of Correction: The provider responded with the following: Caregivers 3, 4, 5 do not need references that is my mom, sister and daughter. Provider 2 file is not complete because I do not need her yet. I just ran a bunch of background checks just in case something was to come up and I needed someone, Therefore, caregiver 2 will not have a file as she will not be with the kids until needed and then she will have completed file. Caregiver 3 and 5 files are complete and if needed will be the only substitute.

Standard #: 22VAC40-111-60-B
Complaint related: No
Description: Based on review of nine children's records, the provider has not ensured that each child's record contains the last dates of attendance. Evidence: 1. The record provided for child 9 did not include the last date of attendance. 2. child 9 was not in attendance during the inspection. 3. Caregiver 1 stated that child 9 is no longer attending.

Plan of Correction: The provider responded with the following: I apologize the child had just recently left and I forgot to put the termination date but it has since been updated.

Standard #: 22VAC40-111-140-B-3
Complaint related: Yes
Description: Based upon review of five caregiver records and caregiver interview, the provider has not ensured that providers and substitute providers have current certification in cardiopulmonary resuscitation (CPR). Evidence: 1. Caregiver 1 stated that caregiver 4 and caregiver 5 were the only caregivers on duty with the children while the provider and caregiver 1 were on vacation May 4, 5, 6, and 9. 2. Documentation of CPR certification was not in the records provided for caregivers 4 and 5. 3. Caregiver 2 signed in on the substitute provider record as the substitute provider on April 14, 2016 from 7:00 AM to 10:02 AM. 4. Documentation of CPR certification was not in the record provided for caregiver 2. 5. Caregiver 3 signed in on the substitute provider record as the substitute provider on May 23, 2016 from 7:00 AM to 4:50 PM and on May 24, 2016 from 7:00 AM until an undocumented time. 6. Caregiver 1 was unable to provide documentation of CPR certification for caregivers 2, 3, 4 and 5.

Plan of Correction: The provider responded with the following: I have proof of all the substitutes CPR cards in there folders. I know now everything needs a paper trail instead of me just knowing that it exist. I made copies of first aid, CPR, and TB screenings and put it in the files.

Standard #: 22VAC40-111-140-B-4
Complaint related: Yes
Description: Based upon review of five caregiver records and caregiver interview, the provider has not ensured that providers and substitute providers have current certification in first aid. Evidence: 1. Caregiver 1 stated that caregiver 4 and caregiver 5 were the only caregivers on duty with the children while the provider and caregiver 1 were on vacation May 4, 5, 6, and 9. 2. Documentation of first aid certification was not in the records provided for caregivers 4 and 5. 3. Caregiver 2 signed in on the substitute provider record as the substitute provider on April 14, 2016 from 7:00 AM to 10:02 AM. 4. Documentation of first aid certification was not in the record provided for caregiver 2. 5. Caregiver 3 signed in on the substitute provider record as the substitute provider on May 23, 2016 from 7:00 AM to 4:50 PM and on May 24, 2016 from 7:00 AM until an undocumented time. 6. Caregiver 1 was unable to provide documentation of first aid certification for caregivers 2, 3, 4 and 5.

Plan of Correction: The provider responded with the following: I have proof of all the substitutes that will substitute if needed. First aid card copies in there folders.

Standard #: 22VAC40-111-140-D
Complaint related: Yes
Description: Based upon review of caregiver records and caregiver interview, the provider has not ensured that substitute providers record and sign the time of arrivals and departures on each day that the substitute provider works. Evidence: 1. The substitute provider record sheet was provided to the inspector by caregiver 1. 2. Caregiver 1 stated that caregiver 4 and caregiver 5 were on duty together with the children while the provider and caregiver 1 were on vacation May 4, 5, 6, and 9. No record of arrivals and departures for a substitute provider was recorded for May 4, 5, 6, and 9. 3. The inspector conducted an unannounced inspection at the family day home today, May 27, 2016. Caregiver 1 stated that the provider was attending a training session today, May 27, 2016. Caregiver 1 was on duty alone and said she was serving as the substitute provider for the day. Caregiver 1 had not entered her time of arrival on the substitute provider record for today.

Plan of Correction: The provider responded with the following: We now have the staff sheet available and are aware that my assistant is there every has to sign, we will do so being that she was the original one that was on my application from the start we did not know she needed to but is fixed and we have a system put in place for the future of signing in and out.

Standard #: 22VAC40-111-170-A
Complaint related: Yes
Description: Based upon review of caregiver records and caregiver interview, the provider has not ensured that a current Report of Tuberculosis Screening form documenting the absence of tuberculosis in a communicable form is obtained from each caregiver at the time of hire. Evidence: 1. The records provided for caregivers 2, 3, 4 and 5 did not include documentation indicating the absence of tuberculosis in a communicable form. 2. Caregiver 1 was unable to provide tuberculosis screening documentation for caregivers 2, 3, 4 or 5 all of whom caregiver 1 indicated had been on duty with the children. 3. The substitute provider record had recorded that caregiver 2 was on duty with the children on April 14, 2016. 4. The substitute provider record had recorded that caregiver 3 was on duty with the children on May 23, 2016 and May 24, 2016.

Plan of Correction: The provider responded with the following: With the previous program the backups bought their own files with them when they came to work I did not know to keep the files with me. I now have the TB screenings in a folder for all participating substitute candidates.

Standard #: 22VAC40-111-230-A
Complaint related: Yes
Description: Based upon review of five caregiver records and caregiver interview, the provide has not maintained written documentation of each caregiver's applicable orientation training. Evidence: 1. The records provided for caregivers 2, 3, 4 and 5 did not include documentation of the caregiver's orientation training. 2. Caregiver 1 was unable to provide documentation of orientation training for caregivers 2, 3, 4 and 5. Caregiver 5 stated that caregivers 2, 3, 4 and 5 have been on duty with the children. 3. The substitute provider record had recorded that caregiver 2 was on duty with the children on April 14, 2016. 4. The substitute provider record had recorded that caregiver 3 was on duty with the children on May 23, 2016 and May 24, 2016.

Plan of Correction: The provider responded with the following: I advise the substitute and went over the training with them of the emergency evacuations, emergency numbers. first aid kit, emergency supplies reporting child abuse and when the parents must be notified and they knew because it is my mom, sister and daughter I been doing this 9 years but forgot to document. I it now documented that they know.

Standard #: 22VAC40-111-520-A
Complaint related: Yes
Description: Based upon observation, attendance records and caregiver interview, the provider has not ensured that cribs are provided for children from birth through 12 months of age. Evidence: 1. There is only 1 crib set up for use at the family day home. 2. According to the sign-in sheets completed by the parents, child 1, born 8/6/15, attended care on 5/16/16 (6:25 - 14:02), 5/17/16 (7:12 - 16:28), 5/18/16 (6:54 - 12:06) and 5/19/16 (8:30 - 15:15). Child 2, born 8/16/15, also attended care on 5/16/16 (6:00 - 16:00), 5/17/16 (6:00 - 15:00), 5/18/16 (9:30 - 15:11) and 5/19/16 (5:41 - 16:00). 3. Caregiver 1 stated that the one crib that was set up on 5/27/2016 is the only crib at the family day home.

Plan of Correction: The provider responded with the following: Child 2 was contracted 4 hours a day so the schedules were opposite so instead of taking up space in the infant play area we observed they sleep opposite times when here a full schedule ad we would sanitize and change sheets for each child. We now have purchased another crib.

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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