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Ms. Cynthia Holmes
26070 Old Office Road
Culpeper, VA 22701
(540) 854-8939

Current Inspector: Michelle W. Argenbright (540) 848-4123

Inspection Date: Jan. 31, 2017

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
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
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.
VENDHOM-000 Caregiver Qualifications and Training

Technical Assistance:
We discussed the requirements for physical examination reports, written information for updating the emergency procedures and response plan and conducting monthly evacuation drills. The risk assessments for violations were provided. We talked about the posting requirements for menu changes and the emergency procedures map. Television time needs to be limited as required. Also, we discussed your plans for the Virginia Preservice Training.

Comments:
Thank you for your cooperation during today's unannounced monitoring inspection conducted from 10:50 AM to 3:55 PM. Today, there was one child present for care (two points). An additional child, age two, attended for part of the morning. I viewed activities, daily routines, equipment, lunch/menu, staffing, supervision, interactions with the child in care, posted information, emergency supplies and drill records, emergency plan and posted procedures, five records for children, two records for caregivers/residents, caregiver training, indoor and outdoor areas. All outdoor equipment in the wooded area is not used with children in care. The children have been playing in the front yard adjacent to the house. We talked about the procedures during transportation and outings. There was a selection of toys and materials for children's play and activities. Let me know if you need any assistance. 540/430-9259

Violations:
Standard #: 22VAC40-111-800-B
Description: Based on a review of the emergency preparedness and response plan, and an interview with the provider, there has not been an annual review of the plan with any needed updates and documentation. Evidence: The provider indicated that she looked over the plan during the last three months and did not add information needed for the earthquake plan. Also, the review date was not written.

Plan of Correction: The provider will add the missing procedures for a response to an earthquake and place the written information with the original plan. The provider will write the date of the updated information. The provider will make sure the annual review and any updated plans are written on the emergency plan each year.

Standard #: 22VAC40-111-830-A
Description: Based on a review of the documentation of emergency procedures practiced with children, and an interview with the provider, there were not monthly evacuation practices for four months at the end of 2016. Evidence: There was not any information written on the drill log for September, October, November and December 2016. The last monthly drill for 2016 was documented on August 10, 2016. There was an evacuation practice documented for January 10, 2017.

Plan of Correction: The provider will make sure the evacuation practices are done in the middle of each month and the information is written on the emergency drill form.

Standard #: 22VAC40-111-100-A
Description: Based on a review of five records for children, and an interview with the provider, a physical examination record that was due within thirty days of attendance could not be located in the file for child 2. Evidence: There were only copies of seven immunization reports in the file. Child 2 has attended since March 22, 2012.

Plan of Correction: The provider will ask the parent to provide a copy of the latest physical examination report since the information is missing. The provider will make sure all records contain required 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.

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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