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Ms. Deanna Southern
41 Winding Way Road
Boones mill, VA 24065
(540) 334-5437

Current Inspector: Jensen Mellnick (540) 309-2051

Inspection Date: Sept. 28, 2016

Complaint Related: No

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
22VAC40-111 Care of Children
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
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.

Comments:
An unannounced monitoring inspection was conducted in the Family Day Home on September 28, 2016. Upon arrival, the LI observed 10 children under the care and supervision of two caregivers. Based on the ages of the children, six months to three years, the point total was 24. As reported by the Provider, 15 children are on roll to include ages from infancy to school-age, full time/part-time enrollment. The children were observed during the lunch meal. The children participated in a variety of activities including outdoor play, story time and self-selected activities. The FDH was supplied with age appropriate toys and materials for the children. A sample of 4 children's records was reviewed. The records for 2 caregivers were reviewed. A medication and written authorization to administer was reviewed for a child. Documentation of the practiced emergency drills was reviewed. Clarification was given to the Provider regarding confidentiality of the supplemental page. This information is not to be posted but maintained for your information. A discussion was also held regarding Standard 250.B. Toys or objects less than 1 1/4 inches in diameter and less than 2 inches in length shall be kept out of the reach of children under the age of three years. Findings of the inspection were reviewed with the Provider at the time of exit. The inspection was conducted from noon to 4:00pm. If you have any questions, please e-mail elaine.moore@dss.virginia.gov Thank you.

Violations:
Standard #: 22VAC40-111-800-C
Description: Based on reviewed documentation, a caregiver had not received annual training regarding the FDH's emergency evacuation, emergency relocation, and shelter-in-place procedures on an annual basis. Evidence: The training log for caregiver 2 did not support that she had received training regarding the Family Day Home's emergency evacuation, emergency relocation, and shelter-in-place procedures on an annual basis.

Plan of Correction: The Provider will review the emergency procedures with the caregiver, the date of the review and the time required will be documented on the caregiver's training log.

Standard #: 22VAC40-111-960-B
Description: Based on direct observations, an infant was not picked up and held during bottle feedings. Evidence: The LI observed an infant (six months old) seated in an infant seat on the floor while being fed a bottle. The child was not picked up during the feeding. The LI observed the infant seated in a carrier seat, a caregiver held the infant's bottle with one hand and rubbed another child's back at nap time. On another observation, the infant was seated in a carrier outdoors on the ground while the other children played. The caregiver positioned the bottle in the infant's hands on several occasions and walked away from the infant to attend to other children and or other tasks. The bottle dropped from the infant's hands and the infant could not manage the bottle unassisted.

Plan of Correction: The caregivers will ensure infants are held during bottle feedings if they are not able to hold the bottle on their own.

Standard #: 22VAC40-111-60-B
Description: Based on a sample review of children's records, the caregivers failed to follow dietary restrictions when a food allergy was listed by the parent in the child's record. Evidence: The record of child #2 noted a milk allergy. The child was served dairy milk with the lunch meal.

Plan of Correction: The caregivers will ensure all noted allergies are monitored to ensure identified foods are not served to the child per parental instructions. The specific dietary needs will be addressed in the child's record to include who is responsible to provide the alternate food choice.

Standard #: 22VAC40-111-70-B
Description: Based on a sample review of children's records, the Provider did not obtain the parent's written acknowledgement of the receipt of the information required in this section (270.A. 1 - 19). Evidence: The assistants and substitute providers listed as care givers changed after children were enrolled and the information was no longer applicable. The Provider had marked through the names of the individuals who are no longer working in the FDH and initialed with her initials. Documentation did not support that the Provider had given the updated information in writing to the parents.

Plan of Correction: Parents will be provided with updated written documentation to include the amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider.

Standard #: 22VAC40-111-180-A
Description: Based on reviewed documentation and verification from the Provider, documentation of a current report of tuberculosis screening was not available, the screening shall be at least every two years from the date of the first screening. Evidence: Documentation of the TB screening for caregiver 1 was not was current, documentation was dated 07/29/14.

Plan of Correction: An appointment will be scheduled with the Health Department to obtain an updated TB screening.

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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