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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: Sept. 4, 2018

Complaint Related: No

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

Technical Assistance:
Discussed training available.

Comments:
An unannounced focused visit was conducted today between the hours of 9:06am through 11:00am with the provider and assistant on site. There were 5 children (11 points) with the provider and assistant. A sample of 5 children's files and 2 staff/household member's files were reviewed. The children were engaged in the following: toy play, puzzle time and other organized activities. 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 signatures.

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 physicals.

Standard #: 22VAC40-111-60-B
Description: Based on record review, 5 of 10 children's records were not complete. Evidence: 1. Chil A was missing the parent's work address and one emergency contact address. 2. Child D was missing one parents work address, work phone number, one emergency contact address, parent's signed acknowledgement, authorization for emergency medical care, policy for administration of medication, provisions of the emergency plan. 3. Child B and Child C's file were missing health exam and yearly parent review of emergency contact information. 4. Child E was missing one parent's work phone number, results of a health exam, and yearly parent review of emergency contact information.

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

Standard #: 22VAC40-111-70-A
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 A began with the provider on 8/27/2018 and did not have a parent's signature for the policies for the administration of medications, provisions of the emergency plan or the information for parent's form.

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

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 completed 8 hours of training and had certificates for the 8 hour training completed. 2. The Assistant stated she completed 5 hours of training, but did not have certificates for the training.

Plan of Correction: We will work on getting the 16 hours completed.

Standard #: 22VAC40-111-500-D
Description: Based on observation, outdoor equipment did not meet all requirements. 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 removed them today until I can find something better to replace it.

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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