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Ms. Pauline Henley
801 Ebenezer Road
Amherst, VA 24521
(434) 363-5522

Current Inspector: Victoria E Dawson (540) 309-2674

Inspection Date: Nov. 13, 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 Emergencies
22VAC40-111 Nutrition
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks for Child Welfare Agencies

Comments:
An unannounced monitoring inspection was completed on 11/13/18. There were two children present with the provider supervising. The point total was six. Five children's records were reviewed along with updates in the provider's record and two household member's records. The provider does not administer medications. The inspector arrived at the provider's home at 12:30 pm and departed at 2:45 pm.

Violations:
Standard #: 22VAC40-111-830-C
Description: Based on record review, the provider failed to ensure that documentation was maintained of monthly emergency evacuation drills. Evidence: 1. There was no documentation of an emergency evacuation (fire) drill for October 2018.

Plan of Correction: The provider will make sure that drills are documented as they occur for future.

Standard #: 22VAC40-111-920
Description: Based on observation, the menu for the current one-week period was not posted. Evidence: 1. The menu was not posted. 2. The provider was asked about the menu and had it in a stack of papers. The provider stated that she had been working on the menu.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the provider failed to ensure that all required information was documented in each child's record. Evidence: 1. There was no address documented for the emergency contact for child #1. Two emergency contacts including name, address, and phone number are required for each child's record. 2. The following required information was not documented in the record for child #5: first date of attendance, the child's medical insurance name and policy number.

Plan of Correction: The provider will have the parents complete the information on the forms.

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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