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(Under the authority of Executive Order 51, the Commissioner of Department of Social Services is waiving regulation 22VAC40-665-40.N which references the period of time for a redetermination of eligibility for the subsidy program. )

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Mrs. Nancy Beight
5400 Beckner Street
Norfolk, VA 23509
(757) 855-8210

Current Inspector: Rene Old (757) 404-1784

Inspection Date: Aug. 9, 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
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure

Technical Assistance:
The following FDH standards were reviewed and discussed with the provider: -Standard 240.A - Home maintenance. Discussed ensuring that the kitchen is completely inaccessible to children in care while the remodeling/renovation project is under way. -Standard 560.A and 560.C - Supervision of children. -Standard 690.D - Sanitizing and cleaning procedures for the diapering surface. -The new sworn statement or affirmation was reviewed. -New CPS check requirements discussed. Anyone who has lived in another state in the past five years is required to request a check of the child abuse and neglect registry for each state they have lived in the past five years. The Eastern Licensing Office has moved to a new location. Our new address: Eastern Regional Office 420 N. Center Drive, Building 11, Suite 100 Norfolk, Virginia 23502 Phone: (757) 985-4700 Eastern Regional Office Fax Number ? 757-455-0840 Licensing Fax Number ? 757-455-0836 *My phone number and e-mail address will remain the same.

An unannounced monitoring inspection was conducted on 08/09/2017 from 9:35am - 12:00pm. At the time of entrance there were five children in care with the provider. The ages of the children counted for a total of 11 points. Children were observed playing outside in the backyard. Morning snack was served outside. Children were additionally observed playing with toys in the playroom. Records were reviewed for six children. Training was reviewed for the provider. The provider stated that no medication is being administered at this time. The violations are listed on the violation notice and were reviewed with the provider at the conclusion of the inspection.

Standard #: 22VAC40-111-830-C
Description: Based on record review and interview, the provider failed to ensure that documentation shall be maintained of emergency evacuation and shelter-in-place drills. Evidence: 1. The emergency practice log for the family day homes indicates the most recent emergency practice drill was conducted on 05/09/2017. 2. The provider stated emergency drills had been conducted however, documentation had not been maintained for June and July of 2017.

Plan of Correction: Have updated drill sheet and will continue so.

Standard #: 22VAC40-111-880
Description: Based on observation and menu review, the provider failed to ensure that meals and snacks provided by the family day home shall follow the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (USDA). Evidence: 1. The morning snack served to children at 10:11am consisted of prepackaged cheese crackers and HI- C fruit juice. HI - C fruit juice contains only 10% fruit juice according to the product label. a. USDA requires fruit juice to consist of 100% fruit juice. 2. The menu provided for review listed chips as a food component five times during the week beginning 08/07/2017. a. Chips are considered a snack food and do not count as a food component under USDA requirements.

Plan of Correction: Replace Hi-C with 100% apple juice. Chips taken off menu - replace with veg.

Standard #: 22VAC40-111-900-B
Description: Based on observation, the provider failed to ensure that children shall not be allowed to eat or drink while walking, running or playing. Evidence: A two-year old child was observed running across the outdoor play area with a cracker in his hand at 10:21am.

Plan of Correction: All children will be seated in chairs or at table while eating.

Standard #: 22VAC40-111-920
Description: Based on observation, the provider failed to ensure that when meals or snacks are provided by the family day home, the menu for the current one-week period shall be given to parents or posted or placed in an area accessible to parents; Evidence: 1. The current menu was not posted in an area visible or accessible to parents. a. The provider stated that the menu was posted on the refrigerator in the kitchen however, the kitchen is being remodeled and is not visible or accessible to parents due to the floor to ceiling plastic sheeting that has been placed around the opening to the kitchen.

Plan of Correction: Menus and attendance sheets etc. have been replaced to different area visible to parents in dining area. Plastic sheeting removed. Menu posted in dining area.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the provider failed to ensure that children's records shall contain the following information: *Name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached. Evidence: 1. The enrollment record for child #1 lacked a telephone number for the first designated emergency contact. 2. The enrollment record for child #1 lacked an address and telephone number for the second designated emergency contact. 3. Child #1 was in care during the inspection and the provider verified that complete emergency contact information was not on file.

Plan of Correction: Child 1 files all updated.

Standard #: 22VAC40-111-70-A
Description: Based on record review and interview, the provider failed to ensure that before a child's first day of attendance, parents shall be provided in writing the following information: a. Operating information including the hours and days of operation, holidays or other times closed, and the telephone number where a message can be left for a caregiver; b. Schedule of fees and payment plans; c. Check in and check out procedures; d. Requirement for the family day home to notify the parent when the child becomes ill and for the parent to arrange to have the child picked up as soon as possible if so requested by the home; e. Requirement for the parent to inform the family day home within 24 hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life-threatening diseases, which must be reported immediately; f. Requirement for paid caregivers to report suspected child abuse or neglect according to ? 63.2-1509 of the Code of Virginia; g. Custodial parent's right to be admitted to the family day home any time the child is in care as required by ? 63.2-1813 of the Code of Virginia; h. General daily schedule that is appropriate for the age of the enrolling child; i. Policies for the provision of food; j. Presence of a pet or animal in the home; k. Discipline policies including acceptable and unacceptable discipline measures; l. Policies for termination of care; and m. Address of the web site of the department, with a note that a copy of this regulation and additional information about the family day home may be obtained from the web site, including compliance history. Evidence: 1. The enrollment record for child #1 lacked a written parent agreement with all required elements. a. Child #1 has been enrolled in the family day home since 2010 and was in care during the inspection. 2. The enrollment record for child #2 lacked a written parent agreement with all required elements. a. Child #2 has an enrollment date of 12/10/2016. 3. The provider verified that the parent agreement was not on file for child #1 and child #2.

Plan of Correction: All information has been file in each child's folder. *All information put in file - both child 1 & child 2 have parent agreement on file.

Standard #: 22VAC40-111-240-A
Description: Based on observation, the provider failed to ensure that areas of the family day home shall be maintained in a safe condition. Evidence: The following safety hazards were observed in the backyard play area where children, ranging in age from 13 months - seven years, were observed playing during the inspection. 1. A uncovered trash container contained discarded cigarette butts and broken dry wall. a The trash container, which measured approximately 30 inches in height with an approximate circumference of 60 inches, was filled not quire half - full with mostly broken dry wall and approximately ten cigarette butts. b. The cigarette butts and dry wall are hazardous if ingested or inhaled. Additional risk of injury could result from sharp/broken areas of drywall. 2. There were two areas of rust on the support poles for the backyard metal swing set. These areas are sharp which pose a hazard if touched. 3. Two of the plastic wheels on the push cart were broken and cracked. Cracked plastic is a pinch point for children's fingers. a. Children were observed playing with this push cart. 4. The kitchen area of the home is being renovated. Plastic sheeting was observed hung from the ceiling to the floor as a containment method. However, no barrier was placed at the entry to the kitchen in order to prevent children access to the plastic sheeting and kitchen. a. During the inspection, an infant was observed attempting to walk through the sheeting in order to enter the kitchen.

Plan of Correction: *Trash can emptied, snap lock lid in place. *Swing set disposed of during the inspection on 08/09/2017. *Broken chip toys disposed of. *Gate up at entrance of kitchen.

Standard #: 22VAC40-111-430-A
Description: Based on observation, the provider failed to ensure that children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision shall not have access to stairs. Evidence: 1. A 13-month old child was observed climbing up the stairs to the outdoor deck at 10:32am. a. The deck has three steps and the child made it to the top step before the provider could intervene. 2. There had been a gate placed at the bottom of the stairs when the inspector arrived at 9:35am however, the provider had removed the gate when morning snack was served at 10:10am.

Plan of Correction: Gate will be permanently kept on bottom of steps when outside.

Standard #: 22VAC40-111-500-C
Description: Based on observation, the provider failed to ensure that stationary outdoor playground equipment shall be firmly anchored with ground supports that are covered with materials to protect children from injury. Evidence: 1. The metal swing set, with three swings, was not firmly anchored into the ground. a. This resulted in the four support poles being lifted up and down as the children swung back and forth on the swings.

Plan of Correction: Swing set thrown away.

Standard #: 22VAC40-111-540-A
Description: Based on observation, the provider failed to ensure that infant carrier seats shall be used according to the manufacturer's instructions and when occupied by a child, a safety strap shall be used and securely fastened. Evidence: 1. A 13-month old infant was placed in an infant feeding chair, with tray, for snack at 10:15am. The safety strap was not engaged. 2. A 13 - month old infant was placed in an infant chair at 11:30 am. The safety strap was engaged however, the bottom front support bar was not engaged. The provider briefly left the living room to check on three children in the playroom. During this time, the child thrust himself forward causing the child to fall forward, toward the floor, as the support bar was not properly engaged. a. Had the inspector not intervened, the child would have fallen face forward onto the floor. Injury could have resulted as the child was strapped into the chair and would have fallen onto the floor with the chair attached to him.

Plan of Correction: *Replaced with chair with straps. *Front support bar always in use at all times. Support bar used at all times.

Standard #: 22VAC40-111-680-B
Description: Based on observation, the provider failed to ensure that children's hands are washed with liquid soap and warm running water before eating. Evidence: 1. Children did not wash their hands prior to morning snack which was served at 10:10am. a. Snack was served outside after children had been playing in the backyard play area.

Plan of Correction: Snacks, meals etc. will be no longer served outside to have access to washing hands.

Standard #: 63.2-1701-G
Description: Based on observation and interview, the provider failed to ensure the the findings of the most recent inspection of the facility shall be posted. Evidence: 1. The findings of the most recent licensing inspection, which was conducted on 05/09/2017, were not posted anywhere that could be viewed by the inspector. 2. The provider stated the inspection reports were posted in the kitchen on the refrigerator however, the kitchen is inaccessible due to current renovations. a. The kitchen has been closed off using a plastic floor to ceiling curtain thereby making the entire kitchen area inaccessible to the families of the children in care.

Plan of Correction: Inspection sheet was replaced to dining area as well. Plastic sheeting taken down.

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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