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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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Lucia Martinez
5646 Kathryn Street
Alexandria, VA 22303
(703) 960-6438

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: Dec. 6, 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 Facilities and Programs..
63.2 Liability Insurance Disclosure

Technical Assistance:
Discussed email for finger print registry.

An unannounced inspection was conducted from 3- 415 today. The Provider and an assistant were present with 2 children for a total of 8 points. The Provider has attended over 30 hours in training, has MAT certification, and both caregivers are CPR/First Aid Certified. The Provider stated no one is currently in need of medication and her evacuation drills are being conducted monthly. Records for household and children present were reviewed. Please call with questions 703-479-4679

Standard #: 22VAC40-111-60-B
Description: Based on record review of two children's files, it was determined the Provider does not maintain the Parent's Signed Acknowledgement of written information. Evidence: 1. Two children present today and both records reviewed. The two files were missing the Acknowledgement form that contains operating info, schedule of fees, check in/out procedures, medication administration procedures, food policies, discipline policies, amount of time a substitute may be needed, and termination policies.

Plan of Correction: I found the form during the inspection. I will make copies, fill out, and give to the parents to sign.

Standard #: 22VAC40-111-200-C
Description: Based on interviews of staff and review of assistant #1's file, it was determined that the Provider did not document orientation given to the assistant when she started. Evidence: 1. Assistant #1 started to work in the home in September, 2017. The file does not have Documentation of Orientation but does have Preservice training documentation. Provider and assistant said Orientation was covered .

Plan of Correction: We will sign the documents.

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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