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Maria Monzon
9106 Andromeda Drive
Burke, VA 22015
(703) 989-1011

Current Inspector: Nancy Radcliffe

Inspection Date: Jan. 8, 2018

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.

Comments:
An unannounced monitoring visit was conducted today between the hours of 9:00am through 12:00pm with the provider on site. There was 1 child (3 points) with the provider and assistant. A sample of 4 children's files and 6 staff/household member's files were reviewed. The children were engaged in the following: toy play, games, listening to music, snack, diaper changing, hand washing, and other organized activities. The home is clean and organized. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Stacy.Doyle@dss.virginia.gov 571-835-0386.

Violations:
Standard #: 22VAC40-111-700-C
Description: Based on observation, when an authorization for medication expired and the parent did not renew the authorization or pick the medication up within 14 days, the provider did not take to a pharmacy for proper disposal. Evidence: 1. The provider had a medication in a locked case for child D, but did not have an authorization from the parent to give the medication. The provider stated she has had the medication for more than 14 days and will return the medication to the parent.

Plan of Correction: I will return the medication.

Standard #: 22VAC40-111-70-A
Description: Based on review, two of four children's records did not have documentation that the parents were provided in writing the required information before the child's first day of attendance. Evidence: 1. Child A and Child B did not have a signed copy from the parent of the Policy for the administration of medications.

Plan of Correction: I will provide the parents the forms to review and sign.

Standard #: 22VAC40-111-180-A
Description: Based on review, the provider did not obtain for each caregiver and adult household member a current Report of Tuberculosis Screening form, in accordance with the requirements in 22 VAC 40-111-170, every two years from the date of the first screening or more frequently as recommended by a physician. Evidence: 1. Household Member A and Household Member B have tuberculosis screening forms dated 07/12/2015 and are both more than two years from the date of the first screening.

Plan of Correction: I will schedule them both an appointment.

Standard #: 22VAC40-111-200-C
Description: Based on interview, the provider did not have documentation of the orientation signed and dated by the provider and substitute provider or by the provider and assistant. Evidence: 1. The provider stated an orientation was provided to the Assistant the first week of employment, but did not have documentation of the orientation.

Plan of Correction: I will find the documentation and have her sign it.

Standard #: 22VAC40-191-40-D-4-a
Description: Based on review, one household member did not have a criminal history record check within 30 days of the person becoming 18 years of age. Evidence: 1. Household Member D was required to have a criminal history record check (CRC) 30 days after 06/09/2017 and the provider did not have documentation of sending the CRC.

Plan of Correction: I will find out how to get her fingerprinting scheduled and send off.

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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