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Masomeh Azadi
10249 Leesburg Pike
Vienna, VA 22182
(703) 430-0222

Current Inspector: Cynthia Ford (703) 479-4679

Inspection Date: June 13, 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 Emergencies
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies

Comments:
An unannounced renewal visit was conducted today between the hours of 9:25am through 11:30am with the provider on site. There were 12 children (39 points) with the provider and two assistants. A sample of 5 children's files and 4 staff/household member's files were reviewed. The children were engaged in the following: toy play, coloring and dancing. Interactions between the children and staff were positive. The site was clean, organized and contained an abundant supply of developmentally appropriate materials. The physical space, emergency supplies, evacuation drills, attendance records and the Emergency Preparedness Plan were reviewed. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Stacy.Doyle@dss.virginia.gov or 571-835-0386.

Violations:
Standard #: 22VAC40-111-120-B
Description: Based on record review, the assistant's records were not complete. Evidence: 1. Assistant A and Assistant B had one reference in each of the files, but did not have documentation of a 2nd reference.

Plan of Correction: I will call today if I can't locate them.

Standard #: 22VAC40-111-60-B
Description: Based on review, the five children's records reviewed were incomplete. Evidence: 1. Child #1 (start date 1/25/2019) and Child #3 (start date 3/11/2019) did not have written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately. 2. Child #2 (start date 11/05/2018) did not have one emergency contact address and did not have written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately. 3. Child #4 (start date 09/06/2018) did not have the parent;s home address, one parents place of employment, both parents work phone numbers and did not have written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately. 4. Child #5 (start date 1/21/2019) did not have both parents work phone number, one emergency contact name, address and phone number and did not have written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately.

Plan of Correction: I will ask the parents for the information and signatures today.

Standard #: 22VAC40-191-60-C-2
Description: Based on record review, the provider did not have the central registry findings within 30 days of employment for an assistant. Evidence: 1. Assistant #2 began employment with the provider on 4/01/2019 and the provider did not have the central registry findings for the assistant within 30 days. The provider stated it was sent and she recently called to follow up on the results.

Plan of Correction: It should be coming next week as I called them yesterday.

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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