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Maria Soto Martinez
118 North French Street
Alexandria, VA 22304
(571) 257-5392

Current Inspector: Stephanie Salvatori (571) 389-0980

Inspection Date: Dec. 12, 2018

Complaint Related: No

Comments:
An unannounced inspection was conducted today between 7:30am and 9:30am in response to a self reported incident. 7 children (26 points) were present with 2 caregivers. Policies, children's records and caregiver records were reviewed. Areas of non-compliance are identified in the Violation Notice. For questions regarding this inspection, please contact Stephanie.salvatori@dss.virginia.gov.

Violations:
Standard #: 22VAC40-111-120-A
Description: Based on interview and review of records, the Provider did not maintain a record for each caregiver.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: Caregiver #4 doesn't complete document on time, she doesn't longer work with us. In the future I will obtain required information immediately. [sic]

Standard #: 22VAC40-111-170-A
Description: Based on interview and review of records, the provider did not obtain, from each caregiver at the time of hire, prior to coming into contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: Caregiver #1 doesn't complete her TB on time, but she doesn't longer work with us. In the future no employee will be hired if they doesn't obtain a TB test, as per standard guidelines DSS. [sic]

Standard #: 22VAC40-111-200-A
Description: Based on interview and review of records, the Provider did not maintain a record for each caregiver.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: In the future, no person will be hired if they don't obtain the mandatory requirements indicated by the standard of DSS.

Standard #: 22VAC40-111-230-A
Description: Based on interview and review of records, the provider did not maintain written documentation of each caregiver's applicable education and programmatic experience, applicable first aid and CPR certification, orientation, annual training, and applicable medication administration training.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: The caregiver #1 doesn't complete her CPR certifications on time and other training the reason it was separated from our family home. in the future, the personnel will be completely training with the requirements of the standard of the DSS it is mandatory. [sic]

Standard #: 22VAC40-191-60-B
Description: Based on interview and review of records, a caregiver employed with the FDH did not have a completed sworn disclosure statement or affirmation.

Evidence: No records were on file for Caregiver #1, who was present on 12/ 5/2018.

Plan of Correction: Caregiver #1 doesn't complete her documents on time, she doesn't longer work with us. An sworn disclosure statement or affirmation will be completed by the provider prior to employment. [sic]

Standard #: 22VAC40-191-60-C-2
Description: Based on interview and review of records, a caregiver employed with the FDH did not
have a central registry finding within 30 days of employment.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: Caregiver 31 doesn't complete her document on time, she doesn't longer work with us. In the future, all new hires needing out-of-state background checks will be completed by date of hire moving forward. [sic]

Standard #: 63.2-1720.1-B-2
Description: Based on interview and review of records, a caregiver did not submit to fingerprinting and provide personal descriptive information.

Evidence: No records were on file for Caregiver #1, who was present on 12/05/18.

Plan of Correction: In the future, the fingerprint will be submitted before hiring a new person and will not be in until receiving the results. (elegible). [sic]

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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