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Ms. Pauline Henley
801 Ebenezer Road
Amherst, VA 24521
(434) 363-5522

Current Inspector: Victoria E Dawson (540) 309-2674

Inspection Date: Nov. 1, 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 Emergencies
22VAC40-111 Nutrition
22VAC40-111 Transportation
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies

Comments:
An unannounced renewal inspection was completed on 11/1/17. There was one child in care with the provider. The point total was two. Two, possibly three, children were expected to be picked up for after school care and return to the family day home at approximately 4:15 pm. One child's record was reviewed to check for correction of a previous violation. All other records were up-to-date and there were no newly enrolled children since the last inspection. The provider's record was reviewed to view the annual training; three additional hours are needed by 12/31/17. The provider has registered for a four hour training on 11/18/17. The provider does not administer medications. The inspector arrived at the provider's home at 11:45 am and departed at 2:15 pm. The child was observed during play time and during nap. The provider had taken a field trip to the library in the morning and lunch was provided during this outing. There was discussion with the provider about the following: change in phone numbers (both land line and cell phone), the new Sworn Statement form. The provider completed the renewal application at the inspection as Part II (FDH Addendum) of the renewal application was submitted to the inspector. This was missing from the renewal application when Par I and the fee were received in the licensing office on 10/10/17.

Violations:
Standard #: 22VAC40-191-40-D-4-a
Description: REPEAT VIOLATION Based on record review and interview with the provider, the provider failed to ensure that when a person in the home becomes 18 years old that a Criminal Record Check (CRC) was completed. Evidence: 1. The inspector noticed through review of records that a household member became 18 years old on April 12, 2017. The household member did not have a completed CRC. The provider stated that she had sent a CRC in August after the violation was cited 5/30/17 to the VA State Police. The provider stated that the form was returned to the provider by the VA State Police to be completed on a different form. The household member, according to the provider, left for college on August 27.

Plan of Correction: The provider told the inspector that the form was resent (mailed) on October 27, 2017.

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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