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Roina Mustafa
7702 Tanner Robert Court
Springfield, VA 22153
(703) 569-4084

Current Inspector: Anansa Archer-Hicks (703) 268-3295

Inspection Date: Dec. 19, 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.
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 renewal inspection was conducted today. Observed 9 children (20 points) directly supervised by 3 caregivers. Ratio and supervision were in compliance. A sample of 2 caregiver records, 2 children's records, and 1 household member record were reviewed. The physical plant, emergency supplies and procedures were also reviewed. No medications were reported to be on site. The children were engaged in various activities, to include: free play, infant care, and feeding. Areas of non-compliance are identified in this report. The exit interview was conducted with the licensee. If you have any questions regarding today's inspection, please contact Ana Dally at (703) 577-0270 or anailim.dally@dss.virginia.gov

Violations:
Standard #: 22VAC40-111-100-A
Description: Based upon documentation reviewed, the provider did not obtain documentation of a physical examination prior to a child's attendance or within 30 days after the first day of attendance. Evidence: One of the two children's records did not contain a physical examination (Child B; DOE 10/29/2016).

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

Standard #: 22VAC40-111-60-B
Description: Based upon documentation reviewed, a child's record was incomplete. Evidence: One of the two children's records reviewed did not contain the address and telephone number of each parent's place of employment, documentation verifying the child's age and identity, and parent's signed acknowledgement of the receipt of required information such as, but not limited too: sign in/out procedures, fees, and schedules (Child A; Date of enrollment (DOE) 08/29/2016).

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

Standard #: 22VAC40-111-210-A
Description: Based upon documentation reviewed, a caregiver did not obtain a minimum of sixteen clock hours of training annually. Evidence: Caregiver #1 did not complete the minimum requirement of sixteen clock hours between May, 2015 to May, 2016.

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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