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Mrs. Deborah Bell
1536 Andrew Road N.W.
Roanoke, VA 24017
(540) 400-8240

Current Inspector: Julia Kimbrough (276) 608-4267

Inspection Date: Sept. 20, 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 separating staff/household member's files LI Anderson discussed completion of 16 hours annual training for 2015 should be completed by Oct 31, 2016 to allow sufficient time to also complete 16 hours annual training for 2016 for all staff.

Comments:
LI Anderson conducted an unannounced renewal inspection on Tuesday, September 20, 2016. Upon arrival at 10:20 AM, there were four (4) children in care under the direct care & supervision of two (2) caregivers. Children in care were ages 22 months through 4 years old totaling nine (9) points; adult to child ratios were in compliance. Children & staff records were reviewed during today?s inspection including records for recently enrolled children & recently terminated children. Records that were found out of compliance during the previous inspection were reviewed; there were several repeat violations found with the children & staff records. There have been some reductions 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 prescribed nor over-the-counter medication. Children were observed during meals/snacks served, handwashing/diapering/bathroom procedures, independent/group activities, active/quiet activities, structured/unstructured activities & rest time. An exit interview including review of the Risk Assessment & areas of non-compliance was conducted with the Licensee on September 20, 2016. Inspection concluded at 12:50 PM

Violations:
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. REPEAT VIOLATION 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: Provider will review children records & have parents to review & update emergency information.

Standard #: 22VAC40-111-830-A
Description: Based on inspection & discussion with the Provider, the Licensee failed to practice monthly emergency evacuation drills. EVIDENCE: Emergency evacuation drills were not conducted for July 2016 & August 2016

Plan of Correction: Provider will conduct monthly evacuation drills & at least 2 shelter-in-place drills each year. Documentation will be kept on file for at least 1 year

Standard #: 22VAC40-111-830-D
Description: Based on inspection, the Licensee failed to keep records of emergency evacuation & shelter-in-place drills for one year. EVIDENCE: Evacuation & shelter-in-place drills for 2015 were unavailable.

Plan of Correction: Provider will keep documentation of completed evacuation drills & shelter-in-place drills for at least 1 year.

Standard #: 22VAC40-111-920
Description: Based on inspection, the Licensee failed to provide a menu for the current one-week period. REPEAT VIOLATION EVIDENCE: Menu for the current week (9/19-9/23) was not available.

Plan of Correction: Provider will complete weekly menu & post.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the Licensee failed to document required information in children's records. REPEAT VIOLATION EVIDENCE: LI Anderson reviewed six (6) children records. 1. Record for Child #1 did not include the date of enrollment (1st day of attendance) 2. 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. 5. Record for Child #5 did not include the date of termination 6. Record for Child #6 did not include documentation of the review of the child's emergency contact information as required by 22VAC40-111-780-B.

Plan of Correction: Provider will review records & have parents update/correct information.

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. REPEAT VIOLATION EVIDENCE: LI Anderson reviewed six (6) 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 #4 did not include the parent's written acknowledgment of receipt of the policies for the administration of medication

Plan of Correction: Provider will review children records & request information/documents from parents.

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. REPEAT VIOLATION EVIDENCE: Staff Members #1 & #3 did not complete 16 hours of annual training for year 2015.

Plan of Correction: Provider will seek training opportunities to complete 16 hours of training for year 2015.

Standard #: 22VAC40-111-430-A
Description: Based on observations, the Licensee failed to ensure children under 2 years of age does not have access to stairs. EVIDENCE: Stairwell gate was not closed & securely fastened. There were 2 children under the age of 2 in care; having direct access to the stairwell. LI Anderson observed children playing in a room located directly beside the stairs.

Plan of Correction: Provider will keep gate closed & locked. Corrected during inspection

Standard #: 22VAC40-111-580-C
Description: Based on inspection & discussion with the Provider, the Licensee failed to have the daily age-appropriate activity schedule. EVIDENCE: Daily activity schedule was unavailable.

Plan of Correction: Provider will document & post daily schedule.

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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