VIRGINIA DEPARTMENT OF SOCIAL SERVICES

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

Current Inspector: Trisha Brown (757) 404-2601

Inspection Date: Nov. 7, 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 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-191 Background Checks for Child Welfare Agencies 54.1-3408 Provider must be MAT certified to administer prescription medication. 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 11/7/19 from 11:45am - 1:35pm. At the time of the inspection there were seven children in care, ages four months old to four years old (18 points), with two caregivers present. Records were reviewed for five children and five caregivers. Children were observed eating lunch and during rest period. 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 #:	22VAC40-111-100-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 #2 (date of enrollment 8/12/19) 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 records for child #2 and child #4 did not contain documentation of a physical examination.
Plan of Correction:	The provider responded: The parents of child #2 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 number for the child's doctor, and any documentation of whether or not child #1 had previously attended child care. 2. The record for child #2, present during the inspection, did not contain the medical insurance policy number, the phone number for the child's doctor, and any documentation of whether or not child #1 had previously attended child care. 3.,The record for child #3, present during the inspection, did not contain the medical insurance policy number, the phone number for the child's doctor, and any documentation of whether or not child #1 had previously attended child care. 4. The record for child #4, present during the inspection, did not contain the name, the phone number, and the address for the second emergency contact. 5. The record for child #5, present during the inspection, did not contain a complete address for both emergency contacts, and the medical insurance policy number 6. Caregiver #1 reviewed the records for child #1, child #2, 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 #2, 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 #2 (date of enrollment 8/12/19), present during the inspection, did not contain an immunization record. 2. Caregiver #1 acknowledged that the record for child #2 did not contain documentation of an immunization record.
Plan of Correction:	The provider responded: The parents of child #2 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 three 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. The record for caregiver #2, contained documentation of TB screening that was dated 11/6/17. 3. Caregiver #1 confirmed that an updated TB screening had not been received for caregiver #1, and for caregiver #2.
Plan of Correction:	The provider responded: Caregiver #1 and caregiver #2 will complete an updated TB screening.
Standard #:	22VAC40-191-60-B
Description:	Based on a review of three caregiver records, it was determined that the facility did not ensure that the facility did not ensure that an employee must not be employed until a sworn statement or affirmation has been completed. Evidence: 1. The record for caregiver #3 (date of hire June 2019), working during the inspection did not contain a sworn statement or affirmation. 2. Caregiver #1 confirmed that there was not a sworn statement or affirmation for caregiver #3 available for viewing during the inspection..
Plan of Correction:	The provide responded: Caregiver #3 previously filled out the sworn statement, but I could not find it during the inspection. Staff #3 will complete a new sworn statement. all new caregivers will complete a sworn statement prior to beginning employment.