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Ejigayehu Ayalew
9607 Sloway Coast Drive
Lorton, VA 22079
(703) 967-3386

Current Inspector: Mahrukh Aziz (571) 835-4718

Inspection Date: April 20, 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 Medication Administration
22VAC40-111 Emergencies
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

Technical Assistance:
Consultation was given on the new background requirements for finger printing, a revised Sworn Statement (SDS) for new staff hired after 7/1/2017 and requesting out-of-state Central Registry checks for staff who have lived outside of Virginia within the last five years. The model SDS form is online at VA DSS as well as a link to the Adam Walsh site to assist with out-of-state central registry forms. VA DSS will be paying for initial child care finger print checks until 9/30/2018. Each facility must establish a point of contact with VA DSS. All questions regarding facility codes should be directed to OBI at 804-726-7884. Eligibility letters will be sent out by e-mail and staff may not be hired until the completed letter is received. Please read, review, and respond to all correspondences regarding the fingerprint roll out. Discussed with provider the new license renewal application and the timely submission of the application, discussed obtaining the required background checks for household member as they turn 18 years of age, children's records and the practice of required emergency drills.

An unannounced monitoring inspection was conducted from 12:40pm through 1:50pm. There was 1 child (4 points) in direct care of 1 caregiver. 1 child's/4 staff and household member files were reviewed. The child was observed playing with large blocks and looking at children's books. Emergency drill records were reviewed. There were no medications on site. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at or 571-835-4718.

Standard #: 22VAC40-111-830-B
Description: Based on record review and staff interview family day home did not practice shelter in place twice per year. Evidence: 1. The emergency drill record did not have prior documentation to show that a shelter in place drill was conducted twice per year. 2. Staff #1 stated that she has not done a shelter in place drill.

Plan of Correction: I will do a shelter in place drill today.

Standard #: 22VAC40-111-60-B
Description: Based on record review, provider did not obtain complete information for a child's record. Evidence: 1. Child # 1's record did not have a complete liability insurance form in file. 2. Child # 1's record did not have the medical insurance policy number listed.

Plan of Correction: I will have the parent complete the form and place in her file.

Standard #: 22VAC40-111-180-A
Description: Based on record review, provider did not obtain subsequent Tuberculosis (TB) screenings from each caregiver and household member. Evidence: 1. Staff # 1's most recent TB screening was obtained on 1/7/2016. The TB screening expired on 1/7/2018. 2. Household member # 1's most recent TB screening was obtained on 1/6/2016. The TB screening expired on 1/6/2018.

Plan of Correction: We will get the TB screening done.

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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