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Feriha Ibrahim
7233 Barry Road
Alexandria, VA 22315
(571) 218-0930

Current Inspector: Karen Dickens (571) 423-6978

Inspection Date: Aug. 28, 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 Nutrition
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
The provider has expressed interest in becoming a subsidy vendor.

Comments:
Today an unannounced Monitoring inspection took place between 10:45am and 1:45pm. There were 9 children present with the provider and 2 assistant for a total of 28 points within the supervision guidelines. The children were observed finishing their lunches, playing freely, coloring with crayons and taking naps. Diaper changing procedures were observed. A complete inspection of the physical plant, children and staff records, fire drill log, menu, attendance and emergency procedures were observed during this inspection. The provider states that there are not medications currently on site. Thank you for your cooperation. If you have any questions, please email me at whitney.mcgrath@dss.virginia.gov.

Violations:
Standard #: 22VAC40-111-870-G
Description: Based on observation, high chair trays were not cleaned after each use. Evidence: At the start of the inspection, 6 children were observed sitting in high chairs finishing their lunches. One child who had finished eating was removed from their chair and sent to the floor area to play. A separate child was picked up from a bouncy chair on the floor and placed into the same high chair as the previous child to begin eating their lunch. The high chair tray was not cleaned in between each use.

Plan of Correction: They know that they should be doing that. I will tell them to do it again.

Standard #: 22VAC40-111-100-A
Description: Based on record review, the provider did not obtain documentation of a physical exam prior to a child's attendance or within 30 days after their first date of attendance. Evidence: Child #2 (first date of attendance: 2/5/18) and Child #4 (first date of attendance: first week of July) files did not contain documentation of a physical exam.

Plan of Correction: I have already asked the parents, I will ask the parents again to bring it as soon as possible.

Standard #: 22VAC40-111-120-A
Description: Based on record review, the provider did not maintain a record for each caregiver. Evidence: Caregiver #3 does not currently have a staff record.

Plan of Correction: I have the papers and I will need to look for it.

Standard #: 22VAC40-111-50-A
Description: Based on record review, the caregivers did not keep an accurate written record of children in attendance each day. Evidence: At the start of the inspection there were 9 children in attendance. The attendance record for today's don't only reflected 7 children in attendance.

Plan of Correction: We always do that but sometimes we get distracted. We will make a habit to do it right away.

Standard #: 22VAC40-111-60-B
Description: Based on record review, children's records did not contain all required information. Evidence: Child #2 file did not contain a street address for their second emergency contact. Child #3 file did not contain documentation of the child's first date of attendance, the child's family medical insurance carrier or insurance policy number, Child #4 file did not contain documentation of the child's first date of attendance, the child's physician or physician's contact information, two emergency contacts, the child's family medical insurance carrier or insurance policy number, or documentation that the child's age and identity had been verified by the provider. Child #5 file did not contain a second emergency contact, the child's family medical insurance carrier or insurance policy number, or parents acknowledgement of the provider's medication administration policy.

Plan of Correction: I will need to be more careful with my filing. I will notify parents of missing information asap and I will get it.

Standard #: 22VAC40-111-90-A
Description: Based on record review, the provider did not obtain updated immunizations every six months for children under the age of two. Evidence: Child #2 (8 months old) most recent immunizations are from when the child was 2 months old. Child #3 (15 months old) most recent immunizations are from when the child was 6 months old. Child #5 (18 months old) most recent immunizations are from when the child was 6 months old.

Plan of Correction: I will be more firm with the parents about bringing a copy of immunizations after they get immunizations done.

Standard #: 22VAC40-111-180-A
Description: Based on record review and interview, the provider did not obtain a subsequent Tuberculosis (TB) screening every two years for one adult household member. Evidence: Household member #1 most recent TB screening is dated 6/1/2009.

Plan of Correction: I know that he did it because I know that it's required but I don't know where the record is.

Standard #: 22VAC40-111-210-A
Description: Based on record review, caregivers did not obtain a minimum of 16 hours of training annually in areas relevant to their job responsibilities. Evidence: The provider has obtained 8 hours of training since 10/21/2017. Caregiver #2 has not obtained any training since 5/16/2015.

Plan of Correction: [Caregiver #2] has done 7 hours with me but I don't have the certificate. We will finish it by the end of the year.

Standard #: 22VAC40-111-560-A
Description: Based on observation, caregivers were not providing direct care and supervision for each child at all times. Evidence: Several children (between the age of 1 and 2 years) were observed standing on top of the providers toddler table and in the chairs. While the caregivers observed this repetitive behavior, the children were not actively redirected away from the behavior. The caregivers were observed sitting on the floor with younger children in their laps and verbally telling the children to get off the table and chairs, however the children that were standing on the tables and chairs were not old enough to process the caregivers verbal directions.

Plan of Correction: We will pick them up and tell them because we are their teachers.

Standard #: 22VAC40-111-680-B
Description: Based on observation, caregivers did not ensure that children's hands were washed. Evidence: All children were observed having their diapers changed. None of the children's hands were washed after the caregivers were finished changing their diapers.

Plan of Correction: That caregiver is still learning. I will have to press more on that.

Standard #: 22VAC40-111-690-D
Description: Based on observation, the diaper changing surface was not cleaned and sanitized after each use. Evidence: All children were observed having their diapers changed. The diaper changing surface was not sanitized until after all diaper changes were completed.

Plan of Correction: She is a new assistant and she is still learning. We will reminder her asap.

Standard #: 22VAC40-191-60-B
Description: Based on record review, the provider has not obtained a sworn disclosure statement for one caregiver. Evidence: Caregiver #3 does not have a sworn disclosure statement on file.

Plan of Correction: I will do it this week.

Standard #: 22VAC40-191-60-C-2
Description: Based on record review, the provider has not obtained a central registry (CPS) background check within 30 days of employment for one caregiver. Evidence: Caregiver #3 (date of hire: 7/9/2018) does not have the results of a CPS background check on file.

Plan of Correction: I will do it 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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