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Lucia Martinez
5646 Kathryn Street
Alexandria, VA 22303
(703) 960-6438

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: April 17, 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
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
Consultation was provided regarding required timeframes for central registry findings.

Comments:
An unannounced monitoring inspection was conducted between the hours of 10:15am through 1:00pm. There were a total of 5 children present (12 points) with the Provider and 1 assistant. A total of 4 children?s files, 2 staff files, and 1 household member?s files were reviewed. The children were engaged in the following: playing with play dough and making shapes, listening to music, reading books, and eating lunch which consisted of chicken noodle soup, broccoli, watermelon and milk. Positive interactions between caregivers and children were observed during this inspection. A complete inspection of the programming space, children and staff records, evacuation drills, menu, attendance, and emergency procedures were completed today. The provider advised there was no medication on site today. There was an abundant supply of age appropriate materials and toys. Please contact me with any questions or concerns at morgan.bryson1@dss.virginia.gov.

Violations:
Standard #: 22VAC40-111-50-A
Description: Based on record review, the family day home did not keep a written record of children in attendance each day. Evidence: 1. Child #4 is present at the family day home today. 2. Daily attendance record was reviewed and Child #4 was not signed in as being present Monday, 4/15/2019 and Tuesday, 4/15/2019. 3. The provider stated Child #4 was present at the family day home on 4/15/2019 and 4/16/2019.

Plan of Correction: I will sign the child in on the attendance sheet. I will make sure everyone signs in.

Standard #: 22VAC40-111-60-B
Description: Based on record review, 4 of 4 children's records reviewed are incomplete. Evidence: 1. Child #1's record is missing 1 of 2 emergency contacts. 2. Child #2's record is missing 2 complete addresses for the emergency contacts. Child #2's record is also missing the father's work phone number. 3. Child #3's record is missing 1 of 2 addresses for emergency contacts. Child #3's record is also missing mother's place of employment, work address, and work phone number. 4. Child #4's record is missing the parents' names and contact information, parents employment name, address and work phone number, 2 of 2 emergency contacts, medical insurance provider and policy number, written authorization for emergency medical care and results of a health examination for the child

Plan of Correction: I will get the information from the parents for the files.

Standard #: 22VAC40-111-70-A
Description: Based on record review, parents were not provided with required information before the child's first day of attendance: Evidence: 1. Child #1 (Start date: 3/5/18)'s record is missing the family day home's policies for the administration of medications signed by the child's parents. 2. Child #2 (Start date: 6/13/16)'s record is missing the provisions of the family day home's emergency preparedness and response plan signed by the child's parents. 3. Child #3 (Start date: 6/24/18) and Child #4 (Start date: 12/12/2016)'s records are missing both the signed policy for administration of medication and the provisions of the family day home's emergency preparedness and response plan. 4. Child #1, Child #2, Child #3, and Child #4's records are missing the parent's signed acknowledgement of the receipt of the family day home's policies and procedures.

Plan of Correction: I will have the parents sign these forms.

Standard #: 22VAC40-111-90-C
Description: Based on record review, updated immunizations were not updated for a child under two years of age. Evidence: 1. Child #1 is under age 2 and the last immunizations on file are dated 2/27/2018.

Plan of Correction: I will ask the parents to bring the immunizations by next week.

Standard #: 22VAC40-111-170-A
Description: Based on record review, an adult household member does not have documentation that a Tuberculosis screening or test has been completed to document the absence of Tuberculosis in a communicable form. Evidence: 1. Adult Household Member #1 does not have documentation a Tuberculosis screening or test has been completed.

Plan of Correction: The household member will get a TB test this week.

Standard #: 22VAC40-191-40-D-1-a
Description: Based on record review, an adult household member does not have a completed Sworn Disclosure Statement on file at the family day home. Evidence: 1. Adult Household Member #1 has an unsigned Sworn Disclosure Statement in the file.

Plan of Correction: The form is completed and I will have the adult household member sign today.

Standard #: 22VAC40-191-60-C-2
Description: Based on record review and staff interview, the family day home did not obtain a central registry finding within 30 days of employment for a staff member. Evidence: 1. Staff #2's (Date of Hire: 12/6/2018) record did not contain the findings of a Virginia central registry search. 1. Staff #2 stated she has not completed a Virginia central registry search since beginning employment at the family day home.

Plan of Correction: This staff will complete the form today and we will send it out tomorrow.

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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