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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: Aug. 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
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
Blanket permission forms for routine trips (such as walking to the park) versus parental permission for special one-time-only trips was discussed with the provider. The permission form for routine trips must indicate where the children will be going. Storage of personal hygiene products/cosmetics to be inaccessible to the children was discussed with the provider.

Comments:
An unannounced monitoring inspection was conducted today. The inspector arrived at 2:00 PM and 3:50 PM. Ten children, ages 9 months through 6 years, totaling twenty-three points, were in care with three caregivers. Nap time and transition to activities were observed. The provider reported that there have been no children's injuries and no medication has been administered to the children. Two household records, three caregiver records and eleven children's records were reviewed. An exit meeting to review the Acknowledgement Form was held with the Program Director prior to concluding the inspection. Upon receipt of the inspection notices, the facility 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 facility 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 facility. (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 facility 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 #: 22VAC40-111-110-B
Description: Based upon review of eleven children's records, the provider has not ensured that the documentation of physical examinations are signed by a licensed physician, the physician's designee or an official of a local health department. Evidence: The physical records provided for children numbers 7 and 8 were not signed by a licensed physician. The physicians' last names were hand printed on the forms, however there were no signatures.

Plan of Correction: The provider responded with the following: I never seen a physician signature from Boone Clinic on the well baby visits for kids under 1. I advised the paernts to take the page back to Boone's Clinic and have them stamped or signed.

Standard #: 22VAC40-111-120-A
Description: Based upon review of three caregiver records and provider interview, the provider has not ensured that for assistants and substitute providers who are not the spouse, parent, sibling, or child of the provider and are hired after June 30, 2010, there is documentation that two or more references as to character and reputation as well as competency were checked before employment. Evidence: 1. The record provided for caregiver 3, employed on 7/25/16, did not include documentation that two or more references were obtained prior to employment. 2. The provider was unable to provide documentation that references were obtained.

Plan of Correction: The provider responded with the following: References was obtained Caregiver 3 is a current Licensed provider in the military CDH program I have the references on paper now.

Standard #: 22VAC40-111-60-B
Description: Based upon review of eleven children's records and provider interview, the provider has not ensured that each child's record includes the name, address and telephone number of each custodial parent's place of employment, the name, office address and telephone number of the child's physician and the name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached. Evidence: The record provided for child 7 does not include each custodial parent's place of employment, the name, office address and telephone number of the child's physician and the street address for one of the designated persons to contact in case of an emergency if the parent cannot be reached. 2. The provider was unable to provide documentation of the above required information.

Plan of Correction: The provider responded with the following: I advised parent previously of the information needed on the emergency contact form. Since the inspection parent has updated that information.

Standard #: 22VAC40-111-70-A
Description: Based upon review of eleven children's records and provider interview, the provider has not ensured that before the child's first day of attendance, parents are provided in writing the provisions of the family day home's emergency preparedness and response plan and the medication administration decision form. Evidence: 1. The emergency preparedness and response plan provided to the parents of children numbers 9, 10 and 11indicated an evacuation location from the provider's previous Norfolk emergency preparedness and response plan, not the provider's current Virginia Beach emergency preparedness and response plan. 2. The medication administration decision form signed by the parent of child 10 indicated numerous decisions regarding medication administration, not the provider's stated decision that both over-the-counter and prescription medication will be administered to the children.

Plan of Correction: The provider responded with the following: I have put my new address and emergency location has updated. The form has been updated I had given that form to the parent in the registration packet and they checked all the boxes.

Standard #: 22VAC40-111-280
Description: Based upon observation, the provider has not ensured that potentially poisonous substances are stored in areas inaccessible to the children. Evidence: There was a container of Colgate Max Fresh toothpaste, labeled "warning, keep out of reach of children" in an unlocked drawer in the vanity under the sink in the bathroom used by the children.

Plan of Correction: The provider responded with the following: Colgate toothpaste has been placed in a lock container the children brush teeth twice therefore it was left out by mistake Item was put away while monitor was still here

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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