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Ms. Jessica Richardson
102 Barbados Place
Stephens city, VA 22655
(540) 877-6954

Current Inspector: Maureen Gallagher-McLeod (540) 430-9259

Inspection Date: May 30, 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
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
63.2 General Provisions.
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.

Comments:
Thank you for your time and assistance during the unannounced monitoring inspection conducted on May 30, 2017 between the hours of approximately 10:24 a.m. and 2:10 p.m. Nine children were enrolled and in the care of two caregivers (total of 26 points). One residential child was also present, on this date. Eight children's records were reviewed and/or updated and one caregiver's record was reviewed. No medication was administered during this inspection, as is the policy of this family day home. Facility documents, posted information and safety equipment were observed/reviewed. Breakfast/snacks were provided by the caregiver and lunches were provided by the children's parents. Program observation was completed. Activities observed on this date included: indoor play (toys); outdoor play; stories; dancing/music; restroom, diapering and handwashing procedures; lunch; naptime and infant care. Adult/child interactions, behavior guidance and daily routines/transitions were also observed. The daily activities were consistent with the posted schedule and the children knew and followed the daily routine and transitions well. Exceptions to compliance were noted on the Violation Notice. Please contact me if you have questions concerning this inspection, the licensing standards and/or if I may be of assistance to you (540) 430-9262.

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on review and/or update of eight children's records and discussion with caregiver #1 on May 30, 2017, the program failed to obtain documentation of a physical exam report for one child within 30 days of initial attendance. Evidence: 1. Update of child B's record, on this date, revealed that documentation of a physical exam report was not on file (initial date of attendance was prior to date of license issuance - 4/10/2017). 2. Caregiver #1 confirmed the lack of a physical exam report. Two reports were provided by the physician's office for the child's sibling instead of a report for each child.

Plan of Correction: The child's parent will be contacted and documentation of a physical exam report will be obtained.

Standard #: 22VAC40-111-60-B
Description: Based on review and/or update of eight children's records and discussion with caregiver #1 on May 30, 2017, the program failed to ensure two children's records contained complete information. Evidence: 1. Update of child A's and child B's records, on this date, determined that the policy number(s) of the children's medical insurance was not included in the records. 2. Caregiver #1 verified the lack of information in the children's records.

Plan of Correction: The children's parent will be contacted and the information will be obtained.

Standard #: 22VAC40-111-170-A
Description: Based on review of one caregiver's record and discussion with caregiver #1 on May 30, 2017, the program failed to obtain a current report of tuberculosis (TB) screening/exam at the time of hire. Evidence: 1. Review of caregiver #2's record, on this date, established that documentation of a current TB screening was not obtained at the time of hire (hire date - 3/20/2017 and date of the TB screening - 5/19/2017). 2. Caregiver #1 confirmed the dates of hire and the TB screening.

Plan of Correction: In the future, TB screenings/exam reports will be obtained at the time of hire of all caregivers.

Standard #: 22VAC40-111-500-C
Description: Based on observation and estimation of equipment spacing on May 30, 2017, the program failed to ensure the play structure/swing set measured at least six feet from obstacles. Evidence: 1. Estimation of space, on this date, between the rear of the swingset support and the fence revealed that there was approximately five feet of clearance. 2. Estimation of space between the right side support structure of the swingset and the tree revealed that there was approximately four to five feet of clearance. 3. The caregiver and one household member confirmed the lack of six feet of clearance in the rear and on the right side of the play structure/swingset.

Plan of Correction: An allowable variance request will be submitted for approval.

Standard #: 22VAC40-191-40-D-1-b
Description: Based on review of one caregiver's record and discussion with caregiver #1 on May 30, 2017, the program failed to obtain a search of the central registry before 30 days of employment for the caregiver. Evidence: 1. Review of caregiver #2's record, on this date, determined that a search of the central registry was not on file (date of hire - 3/20/2017). 2. Discussion with caregiver #1 revealed the clearance was returned for additional information.

Plan of Correction: The search of the central registry has been re-submitted for processing and will be obtained.

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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