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Ms. Crystal Payne
9724 Louisa Road
Gordonsville, VA 22942
(540) 832-5364

Current Inspector: Beth Orebaugh (540) 847-9173

Inspection Date: Aug. 8, 2016

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
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 General Provisions.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
54.1-3408 Provider must be MAT certified to administer prescription medication.

Comments:
Thank you for your time and assistance during the unannounced monitoring inspection conducted on August 8, 2016 between the hours of approximately 11:08 a.m. and 1:45 p.m. Twelve (12) children were enrolled and eleven (11) children were in the care of two caregivers on this date (23 points). One household member was also present in the home. Seven children's records were reviewed and/or updated. The caregivers' and household members' records were up-to-date and, therefore, not reviewed/updated. No medications were administered, as is the policy of this family day home. Facility documents, posted information and safety equipment (first aid kit, flashlight and fire extinguisher) were observed/reviewed. The lunch served on this date included spaghetti, corn, mandarin oranges, cheese slices and milk. Program observation was completed. Activities observed included: indoor play with toys; television; music time; restroom, diapering and handwashing procedures; lunch; infant care and naptime. Adult/child interactions, behavior guidance and daily routines/transitions were observed. The outdoor play area was viewed but not inspected due to the rainy weather conditions. Substantial compliance with the licensing standards continues to be maintained; refer to the Violation Notice indicating the exception to compliance (children's records). Please contact me if you have questions concerning this inspection, the licensing standards and/or if I may be of assistance to you (540) 430-9262.

Violations:
Standard #: 22VAC40-111-60-B
Description: Based on review and/or update of seven children's records and discussion with caregiver #1 on August 8, 2016, complete information was not included in four of the records. Evidence: 1. Review of records for children A, B, D and G determined that the medical insurance policy number was not included in the records. 2. Review of child G's record revealed that the emergency contact information did not include the addresses of the two persons listed. 3. Caregiver #1 confirmed that the information listed above was not included in the children's records.

Plan of Correction: The children's parents will be contacted and the information will be obtained and added to the children's records. In the future, children's records will be carefully reviewed at the time of enrollment, to ensure complete information is obtained.

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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