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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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Champa Kumar
22778 Oak Grove Road
Sterling, VA 20166
(703) 689-0049

Current Inspector: Mary J. Wizbicki (703) 479-4707

Inspection Date: Sept. 19, 2017

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
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 Emergencies
22VAC40-111 Nutrition
63.2 Liability Insurance Disclosure

Technical Assistance:
Reviewed all current and upcoming changes to the background check procedures. All information regarding background check procedures will only be communicated via email moving forward.

An unannounced monitoring inspection was conducted today. The provider and two assistant caregivers were caring for 8 children, totaling 21 points. The Inspector reviewed new caregiver records, children's records, emergency preparedness documents and items, administrative documents, and the physical plant today. The children were observed finishing lunch and taking their nap during this inspection. The children had been served chick peas, rice, mixed vegetables, apples, and milk for lunch today. This inspection was completed between approximately 11:30am and 12:45 pm. Thank you for meeting with me today. If you have any questions regarding this inspection please email me at

Standard #: 22VAC40-111-120-B
Description: Based on a review of new caregiver records, it was determined that one record is not complete. Evidence: The file for assistant caregiver #2 does not include: emergency contact information; two completed reference checks.

Plan of Correction: I will make sure the information is completed today.

Standard #: 22VAC40-111-60-B
Description: Based on a review of children's records, it was determined that three records were not complete. Evidence: 1. Child record #1 does not include the physician's signature on the shot record, indicating that the child is adequately immunized for his age. 2. Child record #2 does not include: the physician's signature on the shot record, indicating that the child is adequately immunized for his age; documentation showing that the parent has reviewed the child's contact information within the past year. 3. Child record #4 does not include a signed "Information for Parents" document.

Plan of Correction: All missing items will be completed today.

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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