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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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Kim Kristine
3612 West Ox Road
Fairfax, VA 22033
(703) 508-4965

Current Inspector: Brenda Kuhlman (703) 304-9609

Inspection Date: Dec. 7, 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
22VAC40-80 THE LICENSE.
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:
Technical assistance today included record keeping; new background check forms; sanitizer for cleaning surfaces. Check your e-mail for updated information concerning fingerprinting locations and new background check information. For more information and to obtain the updated Sworn Disclosure Statement, look at the website at dss.virginia.gov

Comments:
An unannounced monitoring inspection was conducted today from 2 - 3:30 pm. There were 7 children in care with the provider and assistant for 18 points. I arrived at naptime to see children sleeping to peaceful holiday music. Children woke up to quiet play and snack. If you have any questions, please contact me at brenda.kuhlman@dss.virginia.gov

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on a review of children's records today, some children did not have documentation of physical exams. Evidence: There were no physical exams available for Child # 4 and Child # 6. Both have been in care over 30 days.

Plan of Correction: I will talk to the parents today.

Standard #: 22VAC40-111-60-A
Description: Based on a review of children's records today, some information was missing. Evidence: There was only one emergency contact for Child # 7 and Child # 5 did not have the addresses of emergency contacts as required. There was no policy number listed for health insurance as required for Child # 1. There was no signed liability form for Child # 5 and no signature for authorization for emergency treatment for Child # 5. There was no annual review of information as required for Child # 2 (due 9/17) and Child # 4 (2/17). There was incomplete physician information for Child # 7.

Plan of Correction: I will talk to the parents today and tomorrow.

Standard #: 22VAC40-111-80-A
Description: Based on review of records today, there was no proof of identity verified for one child in care. Evidence: There was no proof of identity documented for Child # 6, who began care over seven days ago.

Plan of Correction: I will talk to the parent today.

Standard #: 22VAC40-111-90-A
Description: Based on a review of records today, one child did not have documentation of immunizations before beginning care. Evidence: Child # 6, who began care 9/17, did not have a shot record available for review.

Plan of Correction: I will talk to the mother today.

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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