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Constance Basoah
4201 Sonia Court
Alexandria, VA 22309
(571) 314-7737

Current Inspector: Mahrukh Aziz (571) 835-4718

Inspection Date: Oct. 28, 2016

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Household Members
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
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

Comments:
An announced Initial inspection was conducted today. There are no children present during the inspection. 3 adult and 4 children's files were reviewed. See violation notice from missing information. There is one crib assembled for use (not needed currently) with an acceptable manufacture date of 7/2014. Due to case load adjustments, your next inspection will be with different inspector. All inspectors carry ID badges for security purposes. If you have any questions regarding this inspection, please contact me at 703-479-4678. LI was present today from 10:00 AM - 11:30 AM

Violations:
Standard #: 22VAC40-111-760-A
Description: Based upon a review of first aid supplies, the first aid kit is incomplete. Evidence: There is no digital thermometer available.

Plan of Correction: I will buy a thermometer.

Standard #: 22VAC40-111-770
Description: The radio available for inspection is not a weather band radio.

Plan of Correction: I will purchase a weather band radio

Standard #: 22VAC40-111-800-A
Description: Based upon a review of documents, the emergency preparedness plan is incomplete.

Plan of Correction: I will complete the template emergency preparedness plan.

Standard #: 22VAC40-111-60-B
Description: Based upon a review of files, children's files are incomplete. Evidence: 4 of 4 files reviewed were missing required information. Missing information includes but is not limited to: *Father's information (Children 1,2,3,4) *Mothers work address (Children 1,2,3,4) *Insurance information (Children 1,2,3,4) *Emergency authorization (Children 1,2,3,4)

Plan of Correction: I will ask the aprents to complete new forms with all the information.

Standard #: 22VAC40-111-70-A
Description: Based upon a review of files, parents have not acknowledge receipt of all required policies and procedures. Evidence: 4 of 4 files reviewed were missing required policies/procedures. Missing information includes but is not limited to: Check in and out procedures, decision to administer medication, relocation address, liability insurance declaration, the DSS web site address, custodial rights statement.

Plan of Correction: I will use the model forms and have the parent sign the new forms.

Standard #: 22VAC40-191-40-C-1-b
Description: Based upon a review of files, one adult file is incomplete. Evidence: Adult A does not have a completed Sworn Disclosure Statement (SDS) on file.

Plan of Correction: I will have the form completed.

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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