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Ms. Rohee Mendoza
82 Tavern Road
Stafford, VA 22554
(540) 720-7103

Current Inspector: Cathy E. Aylor (540) 222-6352

Inspection Date: Jan. 30, 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
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
Information regarding fingerprinting through Fieldprint is available on our website at dss.virginia.gov. I will forward the link to you. All household members over the age of 18 and assistants over the age of 16 will need to do mandatory national fingerprinting. You will need to register online to make an appointment.

Comments:
An unannounced monitoring inspection was conducted with provider. There were eight children present totalling 18 points with one caregiver and one 14 year old household member. The younger children were having rest time and the school age children were watching age appropriate TV shows. Four new children's files were reviewed - please see Supplemental Summary for missing items. Time of today's inspection: 2:15 p.m. to 4:15 p.m. Please call me if you have any questions 540-219-4122 or e-mail tara.barton@dss.virginia.gov.

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on review of eight children's files, the provider failed to have documentation of a physical examination within the first 30 days of each child's attendance. Evidence: Child C did not have documentation of a physical examination on file within the first 30 days of attendance.

Plan of Correction: Provider will ask the parent for the physical again.

Standard #: 22VAC40-111-50-A
Description: Based on observation, the provider failed to have a written record of children in attendance each day. Evidence: the attendance record was completed by the provider during today's inspection: (approximately 2:15 p.m.)

Plan of Correction: Provider completed the attendance record during today's inspection.

Standard #: 22VAC40-111-60-A
Description: Based on review of eight children's records, the provider failed to have all required information in each file. Evidence: Child H did not have documentation of the name, address, and phone number of the child's physician. Child H did not have the address and phone number of two emergency contacts.

Plan of Correction: Provider will request the information from the parents again.

Standard #: 22VAC40-111-70-A
Description: Based on review of eight children's records, the provider failed to provide all required information in writing to the parents before the child's first day of attendance. Evidence: Child B did not have documentation of a completed VDSS form "Policy on the Administration of Medication" or an equivalent. Child A, B, C, D, E, F, G, and H did not have documentation of a completed and signed VDSS form "Provisions of the Emergency Preparedness plan" or an equivalent.

Plan of Correction: Provider will complete the forms for parents signature.

Standard #: 22VAC40-111-150-A
Description: Based on observation, the provider failed to have an assistant 16 years of age or older. Evidence: Household member 3 was acting as an assistant (counted in points), but is 14 years old.

Plan of Correction: Provider will use only assistants over the age of 16.

Standard #: 22VAC40-111-180-A
Description: Based on provider interview, the provider failed to have documentation of repeat tuberculosis tests. Evidence: Household member 1 and Household member 2 did not repeat tuberculosis tests due to be renewed 10/2/2017.

Plan of Correction: Household members 1 and 2 will get an updated tuberculosis test on Friday.

Standard #: 22VAC40-111-340-C
Description: Based on observation, the provider failed to keep all necessary items in the bathroom. Evidence: there was no toilet paper in the rest room used by the children downstairs.

Plan of Correction: Provider placed toilet paper in the rest room downstairs during today's inspection.

Standard #: 22VAC40-111-520-A
Description: Based on observation and provider interview, the provider failed to have a crib for each child from birth through 12 months of age. Evidence: the provider has two infants in care today but only one crib.

Plan of Correction: Provider will purchase a second crib this evening.

Standard #: 22VAC40-111-570-A
Description: Based on observation, the provider failed to ensure that a caregiver does not exceed 16 points. Evidence: there was one provider and one assistant under the age of 16 alone with 18 points.

Plan of Correction: Provider will not exceed 16 points. The school agers were home from school today.

Standard #: 22VAC40-191-40-D-5-a
Description: Based on provider interview, the provider failed to have a child protective services central registry check within 30 days of a person in the home becoming 14 years old. Evidence: Household member 3 turned 14 in May 2017 and does not have a completed child protective services central registry check on file.

Plan of Correction: Provider will send the Child Protective Services central registry check this week.

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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