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Hanna Vaitovich
43299 Stonegarden Terrace
Ashburn, VA 20148
(757) 839-7136

Current Inspector: Charles Perkins (703) 309-3963

Inspection Date: Sept. 29, 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 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.

Technical Assistance:
Discussion was held on the topics of current enrollment, current staffing, changes to background checks with regards to expiration dates, new sworn disclosure statements, and (if needed) to obtain CPS checks from other states as listed from the past five years. Discussion of obtaining the updated immunization page for Child #7 which is due very soon. A clarification of the signed annual review of emergency information for Child #8 (the form and child are both new). MAT certification was obtained on 09/22/2017 for the Provider.

Comments:
The following inspection took place between the hours of 10 am through 1 pm. Today, I met with the Provider on site at the Family Day Home (FDH) located in Broadlands, Virginia. At the start of this unannounced renewal inspection there were a total of 8 children (18 points) (one child in residence) with 2 caregivers. A total of 9 children?s files and 5 staff/household member?s files were reviewed. The children were engaged in the following: toy play, games, learning, large motor skills outside, the FDH went on a walk, bathroom breaks, hand washing, lunch, and other organized activities. If you should have any future questions, please call. Thank you. Charlie Perkins, Licensing Inspector (703) 309-3963

Violations:
Standard #: 22VAC40-111-120-B
Description: Based on review, 1 of 5 staff/household member's files reviewed indicated that not all of the required information was obtained for each caregiver. Evidence - 1. On the date of inspection (09/29/2017), the following information was not available for Member #2: Date of employment; Name address and telephone number of a person to be notified in an emergency; and that two or more references as to character and reputation as well as competency were checked before employment. 2. The file for Member #2 did contain all required background checks and TB test information.

Plan of Correction: ASSISTANT/SUBSTITUTE PROVIDER RECORD form and at least 2 references shall be completed and placed on file.

Standard #: 22VAC40-111-60-B
Description: Based on review, 3 of 9 files reviewed indicated that not all of the required information was contained within each child's record. Evidence - 1. On the date of inspection (09/29/2017), the address for the child's doctor was not available for: Child #9, and Child #10. 2. On the date of inspection, the addresses for the 2 emergency contacts listed were not available for: Child #5 (1 of 2 addresses was not available), Child #9 (2 of 2 addresses were not available), and Child #10 (2 of 2 addresses were not available).

Plan of Correction: All missing information shall be obtained and placed on file.

Standard #: 22VAC40-111-70-A
Description: Based on review, 1 of 9 children's files reviewed indicated that the Policies for the Administration of Medications form was not on file. Evidence - 1. On the date of inspection (09/29/2017), the Policies for the Administration of Medications form was not available for Child #9, and Child #10. 2. Both children were on site today during this inspection.

Plan of Correction: This documentation shall be completed for both children and placed in each file.

Standard #: 22VAC40-111-200-A
Description: Based on review, documentation of an orientation training was not available for review. Evidence - 1. On the date of inspection (09/29/2017), documentation of the orientation training for Member #2 was not available for review. 2. Member #2 had already assumed her job responsibilities by the date of inspection.

Plan of Correction: A completed orientation training form shall be placed on file for Member #2

Standard #: 63.2-1809.1-B
Description: Based on review, 2 of 9 children's files reviewed indicated that the signed acknowledgement of the notice of liability for the Family Day Home (FDH) was not available. Evidence - 1. On the date of inspection (09/29/2017), a signed acknowledgement form of the notice of liability held by the FDH was not available for the following children: Child #5, and Child #8. 2. This same violation was cited previously for Child #5 during an inspection held on 06/14/2017.

Plan of Correction: The documentation shall be completed and placed in each applicable child's file.

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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