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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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Masomeh Azadi
10249 Leesburg Pike
Vienna, VA 22182
(703) 430-0222

Current Inspector: Cynthia Ford (703) 479-4679

Inspection Date: Jan. 31, 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
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.

An unannounced monitoring visit was conducted today between the hours of 10:05am through 11:45am with the provider on site. There were 5 children (14 points) with the provider. A sample of 5 children's files and 2 staff/household member's files were reviewed. The children were engaged in the following: infant care, toy play and other organized activities. The home was clean and organized. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at 571-835-0386

Standard #: 22VAC40-111-100-A
Description: Based on review, the provider did not obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child A did not have documentation of a physical exam prior to the child's attendance or within 30 days after the first day. The child's first day of attendance is 07/13/2015.

Plan of Correction: I will ask the parent for a copy of it.

Standard #: 22VAC40-111-60-B
Description: Based on review, 4 of 5 children's records are incomplete. Evidence: 1. Child B's record is missing both parent's home address and work address. 2. Child D's record is missing one parent's address and both parent's work address and work phone number. 3. Child E's record is missing one parents work address and work phone number.

Plan of Correction: I will ask the parent's for the information.

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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