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Ms. Mary Almy
1315 Coltrane Dr
Portsmouth, VA 23701
(757) 541-3144

Current Inspector: Chris Robinson (757) 404-2322

Inspection Date: April 5, 2019

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
22VAC40-111 Transportation
22VAC40-111 Nighttime Care
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.
63.2 Child abuse and neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs

Technical Assistance:
Technical assistance was provided in the following areas of the standards: 22VAC40-191 (Background checks); 22VAC40-111-60-B (Children's records); 22VAC40-185-(2)-120 (Caregiver records)

Comments:
An unannounced monitoring inspection was conducted on 4/5/19 from 9:25am - 11:35am. At the time of the inspection there were10 children in care, ages two months old to five years old (26 points), with two caregivers present. Records were reviewed for five children and five caregivers. Children were observed during learning activities. There was no medication at the family day home currently. Emergency plan and emergency supplies were reviewed. Areas of non-compliance are identified on the violation notice and were discussed with the provider during the exit interview.

Violations:
Standard #: 22VAC40-111-830-A
Description: Based on a review of the emergency drill log and interview, it was determined that the provider did not ensure that the emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care. Evidence: 1. The Licensing Inspector reviewed the emergency drill log and did not find evidence that an emergency evacuation practice drill was completed during the month of March 2019, as the last documented drill was for February 2019. 2. Caregiver #1 reviewed the emergency drill log and confirmed that an emergency evacuation practice drill was not completed for the month of March 2019.

Plan of Correction: The provider responded: Going forward, we will complete an emergency evacuation practice drill each month.

Standard #: 22VAC40-111-100-A
Description: Based on a review of five children's records, it was determined that the provider did not ensure that 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 is obtained. Evidence: 1. The record for child #3 (date of enrollment 1/14/19) did not contain documentation of a physical examination. 2. The record for child #4 (date of enrollment 1/3/18) did not contain documentation of a physical examination. 3. Caregiver #1 acknowledged that the record for child #3 and child #4 did not contain documentation of a physical examination.

Plan of Correction: The provider responded: The parents of child #3 and child #4 will be asked to provide a copy of the child's physical examination. All newly enrolled children will have documentation of a physical examination within 30 days.

Standard #: 22VAC40-111-60-B
Description: Based on a review of five children's records, it was determined that the provider did not ensure they maintain and keep at the family day home a complete record for each child enrolled that contains all required information. Evidence: 1. The record for child #1, present during the inspection, did not contain the medical insurance policy number, the phone numbers for both emergency contacts, and any documentation of whether or not child #1 had previously attended child care. 2. The record for child #3, present during the inspection, did not contain the street address for either emergency contact, the medical insurance policy number, and documentation for review if the family day home's emergency preparedness plan. 3. The record for child #4, present during the inspection, did not contain a complete address for the second emergency contact, and documentation to show the annual review of the record was completed. 4. The record for child #5, present during the inspection, did not contain a complete address for the second emergency contact. 5. Caregiver #1 reviewed the records for child #1, child #3, child #4, and child #5, and confirmed the records were not complete.

Plan of Correction: The provider responded: The parents of child #1, child #3, child #4, and child #5 will be contacted to complete all missing information. All children's files will be reviewed to ensure they contain all of the required information. New children to the family day home will have their records reviewed to ensure they contain all of the required information prior to enrollment enrollment.

Standard #: 22VAC40-111-90-A
Description: Based on a review of five children's files, it was determined that the provider did not ensure that documentation was obtained to show that each child has been adequately immunized according to the requirements of the Code of Virginia and applicable State Board of health regulations prior to attendance in the family day home. Evidence: 1. The record for child #3 (date of enrollment 1/14/19), present during the inspection, did not contain an immunization record. 2. Caregiver #1 acknowledged that the record for child #3 did not contain documentation of an immunization record.

Plan of Correction: The provider responded: The parents of child #3 will be contacted to provide a copy of an immunization record. All children's files will be reviewed to ensure they contain an immunization record. New children to the family day home will have documentation of an immunization record on file prior to enrollment enrollment.

Standard #: 22VAC40-111-180-A
Description: Based on a review of two caregiver records, it was determined that the provider did not ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The record for caregiver #1, contained documentation of TB screening that was dated 3/26/17. 2. Caregiver #1 confirmed that an updated TB screening had not been received for caregiver/household member #1, and for caregiver/household member #4.

Plan of Correction: The provider responded: Caregiver #1 and caregiver/household member will complete an updated TB screening.

Standard #: 22VAC40-111-210-A
Description: Based on a review of two caregiver records, it was determined that the provider did not ensure that caregivers shall obtain a minimum of 16 clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1. The record for caregiver #1 only contained documentation for 10 hours of training being completed in the previous year. 2. The record for caregiver #2 only contained documentation for 10 hours of training being completed in the previous year. 3. Caregiver #1 acknowledged that caregiver #1 and caregiver #2 had not completed the required 16 hours of annual training.

Plan of Correction: The provider responded; Going forward all caregivers will complete 16 hours of training annually.

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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