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Hiromi Waite
715 Fall Place
Herndon, VA 20170
(703) 371-4529

Current Inspector: Karen Dickens (571) 423-6978

Inspection Date: Oct. 24, 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 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.

Technical Assistance:
LI discussed with the provider the maximum amount of points allowed per caregiver.

Comments:
An unannounced monitoring inspection was conducted today from 10:15am-11:45am. There were 8 children (16 points) directly supervised by the provider. The home, 1 staff records, 5 children?s records, 3 household member?s records, evacuation drills, emergency supplies, and policies were inspected. There were no medications on site today. Children were observed playing freely singing, working on an art project with watercolors, and they engaged in dance while listening to interactive music. There was an abundant supply of books, toys, and materials for the children. The home was clean and organized. Areas of non-compliance are identified on the Violation Notice. If you have any questions regarding this inspection, please contact Maria Soto at 571-835-5058 or maria.soto@dss.virginia.gov

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on record review, it was determined that 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: The record of Child#1 contains documentation of physical examination form that was signed by the child's parent, but the document was not signed by the child's pediatrician. The child's first day of enrollment was documented as 9/5/2018.

Plan of Correction: I will ask the parents to get the form completed by their doctor by next week.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the provider did not maintain complete records for each child. Evidence: Child#2's record does not contain the child's medical insurance policy number.

Plan of Correction: I will ask the parents to give me the number.

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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