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Carla Seay
8045 Winding Way Court
Springfield, VA 22153
(703) 455-1205

Current Inspector: Kara Wright (703) 537-6241

Inspection Date: July 2, 2018

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Emergencies

Comments:
An unannounced renewal visit was conducted today between the hours of 8:24am through 11:30am with the provider on site. There were 9 children (16 points) with the provider and the assistant. A sample of 10 children's files and 3 staff/household member's files were reviewed. The children were engaged in the following: toy play, snack time, bathroom breaks, and hand washing. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Stacy.Doyle@dss.virginia.gov or 571-835-0386

Violations:
Standard #: 22VAC40-111-780-B
Description: Based on record review, the provider failed to review with the parent the emergency contact information required in 22 VAC 40-111-60 B 2 to ensure the information is correct, and obtain the parent's signed acknowledgement. Evidence: 1. Child B and Child C's parent signed the emergency contact information on 2/03/2016 and has not been reviewed and updated annually. 2. Child E's parent signed the emergency contact information on 11/27/2016 and has not been reviewed and updated annually.

Plan of Correction: I will have them review and update it and get their signature.

Standard #: 22VAC40-111-800-B
Description: Based on record review and interview, the provider did not review the emergency plan at least annually and update the plan as needed. Evidence: 1. The emergency plan had documentation that it had last been updated in 2015 and had a past assistant's name on the plan.

Plan of Correction: I will update the plan, sign and date it.

Standard #: 22VAC40-111-830-A
Description: Based on record review and interview, emergency evacuation procedures were not practiced monthly with all caregivers and children in care during all shifts that children are in care. Evidence: 1. The provider stated she did not do a fire drill in February 2018 or June 2018.

Plan of Correction: I will make sure they are done each month.

Standard #: 22VAC40-111-100-A
Description: Based on record 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 B and Child C began with the provider on 7/14/2014 and did not have results of a health exam for the children. 2. Child E began with the provider on 11/28/2016 and did not have results of a health exam for the child.

Plan of Correction: I will ask for a copy of their physical.

Standard #: 22VAC40-111-120-B
Description: Based on record review, the assistant's record was not complete. Evidence: 1. Assistant A was missing one reference and began employment on 6/21/2016.

Plan of Correction: I have emailed to get another copy of the one missing.

Standard #: 22VAC40-111-60-B
Description: Based on record review, 5 of 10 children's records were not complete. Evidence: 1. Child B and Child C's file were missing the parent's signed acknowledgment, immunization record, health exam, yearly parent review of emergency contact information and the providers policy for medication. 2. Child E was missing one parent's work phone number, results of a health exam, and yearly parent review of emergency contact information. 3. Child F was missing the provisions of emergency plan form. 4. Child G was missing documentation of the proof of identity.

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

Standard #: 22VAC40-111-70-B
Description: Based on record review, the provider did not obtain the parent's written acknowledgement of the receipt of the information required to be given before the child's first day of attendance. Evidence: 1. Child B and Child C began with the provider on 7/14/2014 and did not have a parent's signature for the policies for the administration of medications or the information for parent's form. 2. Child F began with the provider on 6/26/2017 and did not have a parent's signature for the provisions of the family day home's emergency preparedness and response plan.

Plan of Correction: I will obtain the parent's signature.

Standard #: 22VAC40-111-90-A
Description: Based on record review, the provider did not obtain documentation that the child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations before the child attended the family day home. Evidence: 1. Child B and Child C began with the provider on 7/14/2014 and did not have documentation of the children's immunization record.

Plan of Correction: I will ask the parent for their immunization record.

Standard #: 22VAC40-111-210-A
Description: Based on interview, caregivers did not obtain a minimum of 16 clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1. The provider stated she did not have a copy of certificates for the training that they had completed and had not completed 16 hours of training.

Plan of Correction: I have completed approximately 13 training hours and will get the certificates. I will get a copy of the Assistant's training hours that she has completed.

Standard #: 22VAC40-111-230-A
Description: Based on interview, the provider did not maintain written documentation of each caregiver's applicable first aid and CPR certification, and annual training. Evidence: 1. The provider stated she did not have a copy of the Assistant's first aid, CPR certification or annual training.

Plan of Correction: I will get a copy of them.

Standard #: 22VAC40-111-240-A
Description: Based on observation, furnishings of the family day home inside were not maintained in a safe and operable condition. Evidence: 1. A blue chair had large holes in the material and was worn, exposing the foam and padding. 2. A blue sofa arm had a large hole on the arm exposing the foam and padding.

Plan of Correction: I will sew up the sofa and cover up the chair with a chair cover.

Standard #: 22VAC40-111-500-D
Description: Based on observation, outdoor equipment did not meet all requirments. Evidence: 1. One children's little tikes blue swing had S hooks on the top of the swing that were open and not closed tightly. 1. Another children's swing next to the blue swing had S hooks that were open and not closed tightly.

Plan of Correction: I will remove the S hooks and replace them.

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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