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Fabiola Salinas
8471 Summer Breeze Lane
Springfield, VA 22153
(571) 223-6721

Current Inspector: Maria Robles-Lopez (703) 397-3827

Inspection Date: Nov. 9, 2016

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
1. Items should not be stored on the diaper chaning pad. 2. Changes to the menu should be noted promptly. 3. Discussed serving options for lunch, to ensure the caregivers are aware of what all children are doing. 4. A chimney/fireplace inspection is required in the first year. 5. Inspector agreed to seek possibility of infant/toddler training program.

Comments:
Conducted an unannounced monitoring inspection. Observed 9 children = 26 points with the Provider + Assistant. Ratios and supervision were not maintained consistently today. Children were having indoor free-play, eating lunch, and taking naps during the inspection. Transition between activities was chaotic and at times the caregivers were not aware of misbehaviors occurring. The daycare areas of the home were clean and sufficiently supplied with toys and equipment for the children. Medication management was not in compliance. Required documents were posted. Record keeping violations found. Advised the Provider that significant improvements in compliance need to occur before the expiration of the license. Questions about this inspection may be directed to: pamela.sneed@dss.virginia.gov

Violations:
Standard #: 22VAC40-111-700-A
Description: Based on records reviewed, it was determined that there was no written parent authorization for two medications on-site for Child #8.

Plan of Correction: I will make sure to get the authorization of any parent when it comes to medication for any child.

Standard #: 22VAC40-111-720-A
Description: Based on observations made, an over-the-counter medication was not labeled properly. Evidence: Two medications belonging to Child #8 were not labeled with the child's name,

Plan of Correction: I will make sure to label any medication belonging to any child to assure that is is in fact for that child. [sic]

Standard #: 22VAC40-111-730-D
Description: Based on observations made, it was determined that two medications were not stored in a locked place. Evidence: Two over the counter medications belonging to Child #8 were found to be stored in a grocery bag hanging on a door hook in the hallway of the daycare.

Plan of Correction: When having medication of any sort I will make sure it is secured in a place where a lock is provided where no child can get access to it.

Standard #: 22VAC40-111-800-A
Description: Based on records reviewed, it was determined that the emergency preparedness plan did not include a consistent relocation site. Some plans stated the Provider's address, while other plans stated the address of another Provider.

Plan of Correction: I will make sure to include the same address on the emergency preparedness plan for one provider.

Standard #: 22VAC40-111-120-A
Description: Based on records reviewed and interview conducted, it was determined that a caregiver does not have a record of employment. Evidence: The Assistant, who has been working for 6 months, does not have a record to include: name, address, verification of age, date of employment, emergency contact, reference checks, documentation of TB screening, education and training, and background checks.

Plan of Correction: This assistant who has been helping me for 6 months will no longer be present and I will not have an assistant unless they fit those requirements.

Standard #: 22VAC40-111-60-B
Description: Based on records reviewed, it was determined that 10 of 10 children's records did not include documentation of required information. Evidence: 1. Child #1 - 1 of 2 parents information was left blank, no medical insurance policy number, no completed/signed Information for Parents Form, no signed Emergency Preparedness Plan, and no signed Liability Insurance form. 2. Child #2 - No day documented in the enrollment date, 1 of 2 emergency contacts left blank, no medical insurance policy number, and no emergency medical authorization. 3. Child #3 - No day documented in the enrollment date, 1 of 2 emergency contacts left blank, no medical insurance policy number, and no emergency medical authorization. 4. Child #4 - No date of enrollment, and no fees specified on the Information for Parents Form. 5. Child #5 - No day documented in the enrollment date, and no fees specified on the Information for Parents Form. 6. Child #6 - No date of enrollment, no address for 1 of 2 emergency contacts. 7. Child #7 - No day documented in the enrollment date, and no medical insurance policy number. 8. Child #8 - No verification of proof of identity, 1 of 2 parents information left blank, no address for 1 of 2 emergency contacts, no medical insurance policy number, and no fees specified on the Information for Parents Form. 9. Child #9 - No verification of proof of identity, no date of enrollment, and no page 2 of the Information for Parents Form. 10. Child #10 - No date of enrollment, no emergency medical authorization, the Information for Parents Form was not signed by the parent, and the Emergency Preparedness Form was not signed by the parent.

Plan of Correction: I will carefully review each child's documentation and make sure they are all filled correctly. [sic]

Standard #: 22VAC40-111-70-A
Description: Based on records reviewed, it was determined that the following information was not consistent in children's records, or with posted information. Evidence: 1. The back-up caregiver was not identified on the enrollment paperwork, but was posted on the bulletin board. 2. The written medication policies varied to include the Provider giving only prescription medications, to applying only topical ointments, to giving both prescription and non-prescription medications.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-111-130
Description: Based on observations made and interview conducted, it was determined that the Assistant caregiver did not speak English. Evidence: The Assistant, who has been working in this role for 6 months, was not able to tell the inspector her name, as she did not understand the question. The Provider stated that the Assistant does not speak English.

Plan of Correction: If I have an assistant I will make sure she fits the requirement of speaking English.

Standard #: 22VAC40-111-170-A
Description: Based on interview conducted, it was determined that a caregiver did not obtain a TB screening prior to coming into contact with children. Evidence: The Provider stated that the Assistant has been working in this role for 6 months, and has not obtained a TB screening.

Plan of Correction: If I have an assistant I will make sure she fits the requirement of having had the TB screening.

Standard #: 22VAC40-111-290
Description: Based on observations made, it was determined that sharp objects were accessible to children. Evidence: A total of 11 razors were in an unlocked cabinet located in the daycare bathroom. Children were observed using the bathroom independently.

Plan of Correction: Sharp objects such as the razors found in the cabinet will be locked or placed in a higher stand where it is not in arms reach for the kids.

Standard #: 22VAC40-111-320-B
Description: Based on observations made, it was determined that electrical outlets did not have protective covers. Evidence: An outlet in the entry way foyer and another outlet in the daycare bathroom did not have covers.

Plan of Correction: I will make sure that all outlets have covers to protect each child from possible danger.

Standard #: 22VAC40-111-350-E
Description: Based on observations made, it was determined that the hot water temperature did not fall within a range of 105-120 degrees. Evidence: The hot water temperature was measured in the daycare bathroom to be 147.8 degrees.

Plan of Correction: The temperature of the water in the bathroom has been changed to fit within the range of 105-120 degrees.

Standard #: 22VAC40-111-520-A
Description: Based on observations made, it was determined that one child was not provided a crib to sleep in today. Evidence: Child #4 was buckled into a rocking chair for nap time today. The Provider stated that the 2 year-old child was not developmentally ready to sleep on a cot, and he has been sleeping in a mesh-sided portable crib.

Plan of Correction: I will provide the child with a crib that fits the requirements or teach him to sleep in a cot during nap time.

Standard #: 22VAC40-111-520-C
Description: Based on interview conducted, it was determined that a child has been sleeping in a crib that does not meet the current CPSC safety standards. Evidence: The Provider stated that Child #4 has been sleeping in a mesh-sided portable crib, which was present in the home today.

Plan of Correction: I will provide the child with a crib that fits that standards of safety in the current CPSC or teach the child to sleep in a cot. [sic]

Standard #: 22VAC40-111-530-A
Description: Based on observations made, it was determined that required linens were not provided to children sleeping on cots. Evidence: A total of 4 children were observed sleeping directly on the mesh cot surface and were not given bottom sheets/linens.

Plan of Correction: I will provide each child that sleeps on a cot with a sheet or linen to sleep on.

Standard #: 22VAC40-111-540-A
Description: Based on observations made, safety straps were not securely fastened when children were placed in high chairs. Evidence: A total of 6 children were fed lunch while they were seated in high chairs. Each child was placed to sit on top of the safety strap.

Plan of Correction: When placing a child in a high chair I will make sure they have a safety belt securely fastened on them before beginning to feed them.

Standard #: 22VAC40-111-560-A
Description: Based on observations made, it was determined that the caregivers were not aware of children's behaviors and did not intervene as needed. Evidence: Children were observed throwing toys at one another, hitting one another, throwing toys at the wall, climbing and standing on chairs and table while the caregivers were around the corner feeding other children lunch. This behavior went unnoticed for a period of at least 10 minutes.

Plan of Correction: I will be more aware of the behaviors and actions made by the children that are not eating lunch by making it clear that they shall not move from the table until everyone is finished. I will also manage the schedule better so that everyone is eating lunch at the same time.

Standard #: 22VAC40-111-570-A
Description: Based on observations made, it was determined that ratios were not maintained and a maximum of 16 points per caregiver was exceeded at times today. Evidence: Based on the ages of the children in care, there was a total of 26 points. The Assistant caregiver on multiple occasions was observed leaving the lower level of the home, where children were in care, and going to the upper level of the home to get food and lunch supplies. This left the Provider alone with 9 children = 26 points.

Plan of Correction: I will be more cautious and prevent this situation from occurring by avoiding leaving the lower level and instead placing what I need from the upper level downstairs ahead of time.

Standard #: 22VAC40-111-600-B
Description: Based on observations made, it was determined that a child spent more than 30 consecutive minutes confined to equipment. Evidence: Upon arrival the inspector observed Child #4 sitting in a high chair. He was not eating, nor did he have toys to play with. The child was moved sporadically from one chair to another where he was confined to each, and eventually to a rocking chair where he was buckled for nap time and was observed kicking and rocking the chair so hard that it was moving around the room. During the duration of the inspection, just over 2 hours, the child did not have more than a few minutes of play time on the floor.

Plan of Correction: I will be extra careful when placing a child in time out as well as placing them in a high chair due to a long period in an enclosed area. [sic]

Standard #: 22VAC40-191-60-B
Description: Based on interview conducted, it was determined that the Assistant caregiver did not complete a Sworn Disclosure Statement (SDS) prior to working with the children. Evidence: The Provider stated that she has not completed a SDS, though she has been working in a direct-care role for 6 months.

Plan of Correction: If I do have an assistant again I will make sure they complete a SDS prior to working with children and becoming an assistant.

Standard #: 22VAC40-191-60-C-1
Description: Based on interview conducted, it was determined that the Assistant caregiver did not complete a Criminal Record Check (CRC) within the first 30-days of employment. Evidence: The Provider stated that she has not completed a CRC, though she has been working in a direct-care role for 6 months. Employment has not been denied.

Plan of Correction: If I do have an assistant again I will make sure they complete a CRC prior to working with children and becoming an assistant.

Standard #: 22VAC40-191-60-C-2
Description: Based on interview conducted, it was determined that the Assistant caregiver did not complete a Central Registry Check (CPS) within the first 30-days of employment. Evidence: The Provider stated that she has not completed a CPS, though she has been working in a direct-care role for 6 months. Employment has not been denied.

Plan of Correction: If I do have an assistant again I will make sure they complete a CPS prior to working with children and becoming an assistant.

Standard #: 22VAC40-80-120-A-4
Description: Based on observations made, it was determined that the Provider was not operating within the terms of the license today. Evidence: The maximum capacity of 7 children was exceeded, as there were 9 children present.

Plan of Correction: Not available online. Contact Inspector for more information.

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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