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Clotilde Espinoza
4602 15th Street, N
Arlington, VA 22207
(703) 525-8862

Current Inspector: Tanya Johnson (571) 423-6392

Inspection Date: Oct. 8, 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 Emergencies
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies
63.2 Child abuse and neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs

Technical Assistance:
Reminder:All caregivers need to complete 16 hours of training annually.

Comments:
An unannounced renewal inspection was conducted today between 10:00 am and 1:00 pm. There wee 6 children (21 points) with 3 caregivers. The children were observed hand washing, during diaper change, playing with floor toys and eating Lunch. Infants were observed sleeping in cribs. Lunch consisted of chicken, rice, mixed vegetables, fruit and milk. The physical plant, attendance logs, evacuation logs, emergency plans, menu's, cribs, bottles, children's records, caregiver records, household member's records and emergency supplies were inspected. There were no medications on site. Areas of non compliance were cited on the Violation Notice. If you have any questions, please contact me at Tanya.Johnson1@dss.virginia.gov or call me at 571.423.6392.

Violations:
Standard #: 22VAC40-111-830-B
Description: Based on a review of evacuation logs,the provider failed to ensure that shelter in place procedures will be practiced a minimum of twice per year.

Evidence:
The provider did not have documentation of practicing the shelter in place procedures two times per year.

Plan of Correction: We will practice the shelter i place procedure two times

Standard #: 22VAC40-111-960-E
Description: Based on observation, the provider failed to ensure that bottles are labeled with the child's full name and the date.

Plan of Correction: If parents forget to label bottles, we will label them

Standard #: 22VAC40-111-60-A
Description: Based on a review of 5 children's records, in 1 of 5 records, the provider failed to maintain up to date records for each child enrolled.

Evidence:
Child #5's record does not have documentation that the record was updated annually. The last update was 1/22/2018.

Plan of Correction: .I will have parents review/update record and sign forms and then I will place in child's file.

Standard #: 22VAC40-111-70-A
Description: Based on a review of 5 children's records, 1 or 5 records did not have completed documentation before the first day.

Evidence:
Child # 3's record did not have documentation of the Information For Parent's form or the Parent Agreement form.

Plan of Correction: I will have parents fill out forms and sign them and then I will forms in child's file.

Standard #: 22VAC40-111-180-A
Description: Based on a review of caregiver's records, the provider failed to obtain for each caregiver a current Report of Tuberculosis Screening every two years for the date of the first screening or more frequently by a physician or the local health department.,

Evidence:
Caregiver #2's record does not have documentation of a current Tuberculosis Screening form.

Plan of Correction: Caregiver # 2 has had a TB screening and submitted it to the provider; however, the form could not be located during the time of the inspection. She will get a copy and give it to the provider,

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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