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Tonya Mitchell
1501 Three Gait Trail
Virginia beach, VA 23453
(757) 309-6870

Current Inspector: Emily Walsh (757) 404-2575

Inspection Date: Aug. 14, 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

Technical Assistance:
Changes to the background check regulations effective 7/1/2017 were discussed with the provider and a sample Sworn Affirmation and Disclosure statement was given. Required background checks for household members was discussed. Those standards regarding overnight care were discussed with the provider as the provider is licensed to provide overnight care. The provider stated that overnight care has not been provided to date.

Comments:
An unannounced, mandated renewal inspection was conducted today. The inspector arrived at 11:00 AM and departed at 1:40 PM. Activities, lunch service and preparation for nap were observed. The provider stated that the back yard is not being used by the children and that the children played outside in the front yard this morning. The provider reported that there have been no children's injuries since the inspection conducted on 7/24/2017. The provider reported that no medication has been administered to children in care and no medication is currently stored for emergency administration to the children. Two caregiver records and a sample size of six children's records were reviewed. An exit meeting was conducted with the provider to review the Acknowledgement Form and violations found prior to closure of the inspection. Please contact the inspector if there are any questions.

Violations:
Standard #: 22VAC40-111-900-A
Description: Based upon observation, the provider has not ensured that to assist in preventing choking, food that is hard, round, small, thick and sticky and slippery such as whole hot dogs sliced into rounds are not served to children under four years of age. Evidence: Hot dogs cut into rounds were served to child 7 whose date of birth is 3/5/2014.

Plan of Correction: The provider responded with the following: I cut up all the hot dogs in tiny sections on "child 7" I had them in a circle shape. All kids under four will be cut nito triangular slant like shapes to prevent choking.

Standard #: 22VAC40-111-940-A
Description: Based upon observation of the provider's thermometer in the freezer, the provider has not ensured that the temperature in the freezer compartment is maintained below 0 degrees F. Evidence: 1. The temperature on the thermometer in the freezer compartment at 11:45 AM registered 6 degrees F. 2. The temperature on the thermometer in the freezer compartment at 1:00 PM registered 5 degrees F.

Plan of Correction: The provider responded with the following:
O turned my Freezer lower while monitor was here. It is aready reading zero. I had it turned. down because it was having my food so frozen like freezer burn

Standard #: 22VAC40-111-60-B
Description: Based upon review of six children's records and provider interview, the provider has not ensured that each child's record includes the parent's signed acknowledgement of the receipt of the information required by 22 VAC 40-111-70, written information for parents. Evidence: 1. The record provided for child 2 did not include the parent's signed acknowledgement of receipt of the required written information for parents. 2. The provider was unable to locate the signed parent acknowledgement for child 2.

Plan of Correction: The provider responded with the following: The parent has signed the Child Information Page when she came this evening.

Standard #: 22VAC40-111-150-D-1
Description: Based upon review of caregiver records, the provider has not ensured that assistants have current certification in cardiopulmonary resuscitation (CPR) from the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department. Evidence: 1. The record provided for caregiver 2 did not have documentation of current CPR from the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department. There was a certificate from the American Life and Health Foundation for CPR. 2. The provider verified that the CPR certification from the American Life and Health Foundation is an on-line course that does not include a practical demonstration of techniques.

Plan of Correction: The provider responded with the following: My Assistant First Aid CPR ran out about a week ago I thought she just need a refresher being she had been certified the past six years. She has signed up for A handson First Aid CPR Trainning

Standard #: 22VAC40-111-150-D-2
Description: Based upon review of caregiver records, the provider has not ensured that assistants have current certification in first aid from the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department. Evidence: 1. The record provided for caregiver 2 did not have documentation of current first aid from the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department. There was a certificate from the American Life and Health Foundation for first aid. 2. The provider verified that the certification from the American Life and Health Foundation is an on-line course that does not include a practical demonstration of techniques.

Plan of Correction: The provider responded with the following: My Assistant First Aid CPR ran out about a week ago I thought she just need a refresher being she had been certified the past six years. She has signed up for A handson First Aid CPR Trainning

Standard #: 22VAC40-111-240-A
Description: Based upon observation, the provider has not ensured that areas and furnishings of the family day home are maintained to be safe. Evidence: 1. There was a five foot electrical cord hanging from a laptop computer on a high counter. The cord was pooled on the floor, creating a potential tripping hazard. 2. The same cord described in #1 was within reach of the children who were observed eating lunch at a table beneath the high counter. The laptop computer could potentially be pulled off onto a child below the counter.

Plan of Correction: The provider responded with the following:
I took my cord off my laptop corrected on site while monitor was still there. I will make sure when I am not using my laptop to remove my cord.

Standard #: 22VAC40-111-560-A
Description: Based upon observation, the provider has not ensured that the direct care and supervision of each child includes caregiver awareness of and responsibility for each child in care, including being near enough to intervene if needed. Evidence: 1. Between 12:45 and 12:50 AM, as children were at the low table in the kitchen waiting for lunch to be served, child 6, age two years, 11 months, was observed standing on a chair,hanging onto the edge of the high kitchen counter at three different times. Child 3 then copied the actions of child 6 and stood on a chair. Caregiver 1 was on the opposite side of the high counter, preparing lunches. Caregiver 2 was setting down cots in the family room. 2. Child 2, age thirteen months, was placed into a high chair with straps that did not tightly secure the child in the high chair. At 12:58 PM child 2 slipped her arms out of the safety straps and attempted to get out of the chair. Caregiver 2 was not in the kitchen with the children and caregiver 1 was on the opposite side of the tall counter from where the high chair was located. Caregiver 1 did not notice that the child had slipped the safety straps until prompted by the inspector. 3. Child 2, age thirteen months was given a whole round cracker while waiting for lunch to be served. Child 2 was observed putting the entire cracker in her mouth. Caregiver 2 was not in the kitchen and caregiver 1 was on the opposite end of the tall counter from child 2 in the high chair. Caregiver 1 did not notice that child 2 had the entire cracker in her mouth until prompted by the inspector. Caregiver 1 stated that child 2 often put a whole cracker into her mouth, however child 2 gagged as caregiver 1 attempted to remove the cracker from the child's mouth. 4. Child 2, age thirteen months,was left unattended eatng her lunch in a high chair while caregiver 1 was changing diapers at the bathroom and caregiver 2 was getting children onto their cots in the family room. Child 2 was observed stuffing hand fulls of cut up hotdogs, fruit and corn into her mouth.

Plan of Correction: The provider responded with the following: I will be sure the kids engage in other reading or fun activity until lunch is on the table. I will move the table back some more from the counter as well. I will also have a second assistant therefore it will be three of us daily The straps were tighten and corrected while monitor was on site I broke the cracker up while monitor was on site. Child is 13 months she does really well eating Food on her own but I do understand how the cracker can be dry and become a choking hazard all future round Food such as bread or crackers will be broken up.

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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