VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Malka Jawaid
505 Jefferson Street
Winchester, VA 22601
(540) 539-5148

Current Inspector: Amy Tomblin (804) 629-3923

Inspection Date: Dec. 3, 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 22VAC40-80 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

Technical Assistance:

We discussed the requirements for children's records, diapering procedures, hand washing, nap equipment, and emergency supplies. The risk assessments for violations were provided. We reviewed requirements for caregiver/resident records, shelter-in-place drills, emergency plans, diaper disposal, caregiver hand washing, and cleaning supply storage.

Comments:

Thank you for your assistance during today's unannounced monitoring inspection conducted from 1:01 PM to 5:25 PM. Today, there were three children in care during the day, ages sixteen months through three years (7 points) with the provider. Two school age children attended after school. I viewed daily routines, staffing, supervision, interactions with children, activities, equipment, diapering procedures, posted information, emergency supplies and drill records, menu, nutrition, five records for children three records for caregivers/residents, caregiver training, chimney inspection, and indoor areas. The children were provided a child-centered daily routine and access to a variety of toys and materials. There were positive, nurturing interactions with individual children. Let me know if you need any assistance. 540/430-9259

Violations:

Standard #:	22VAC40-111-770
Description:	Based on a review of the emergency supplies, and an interview with the provider, the battery-operated radio was not operable. Evidence: The radio was not turning on to tune into a station. The provider changed the batteries and the radio was still not working.
Plan of Correction:	The provider will purchase new batteries to try with the radio. If the radio does not work with new batteries, a new weather-band radio will be purchased.
Standard #:	22VAC40-111-780-B
Description:	Based on a review of five records for children, and an interview with the provider, the provider did completed an annual review of the emergency contact information with the parents of all children to ensure the information is correct. Evidence: The annual review section at the bottom of the registration forms for child 1, 2, 3, 4, and 5 did not have parent signatures and dates. The last parent signature for child 1 was from July 2018, child 2 was from February 2018, child 3 was from February 2016, child 4 was from September 2014 and child 5 was from August 2015.
Plan of Correction:	The provider will have the parents review the emergency contact information in the record and sign the review with a current date. The provider will make sure this is done annually.
Standard #:	22VAC40-111-100-A
Description:	Based on a review of five records for children, and an interview with the provider, the provider failed to obtain 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. Evidence: Child 1 began attending on July 23, 2018 and there were only immunization reports in the file. Child 2 began attending February 26, 2018 and there were only immunization reports in the file. Child 3 began attending February 13, 2016 and there were only immunization reports in the file. There was only an immunization record in the file of child 4 enrolled September 24, 2014. There was only an immunization record in the file for child 5 who began attending August 4, 2015.
Plan of Correction:	The provider will request and obtain physical examination records for all five children. The provider will make sure physical examination records are obtained no later than thirty days when children begin attending. The checklist on the registration form will be used to keep track of information obtained from parents for records.
Standard #:	22VAC40-111-70-A
Description:	Based on a review of five records for children, and an interview with the provider, the provider failed to provide all required written information, and an parent signature to acknowledge receipt, for four children. Evidence: The "Information for Parent" form was not used to provide information such as fees/payment, hours of operation, food provisions, and discipline policies for child 1, 2, 3 and 4. There was only a blank model form in the record of child 4. The parent signed an incomplete form for child 3.
Plan of Correction:	The provider will complete the "Information for Parents" form for parents to sign and give a copy to parents while keeping one in the children's records. The provider will use the checklist on the registration form to keep track of required records.
Standard #:	22VAC40-111-90-C
Description:	Based on a review of five records for children, and an interview with the provider, the provider failed to obtain all required updated immunization records. Evidence: The only immunization record in the file for child 5 was completed on July 29, 2015. Child 5 became six years old in August 2019. The immunization report for child 5 was not obtained at least once between age four and six years.
Plan of Correction:	The provider will arrange for the parent of child 5 to provide a copy of the most recent immunization record signed by the health care provider. The provider will make sure updated immunization records are obtained before children turn age six.
Standard #:	22VAC40-111-510-A
Description:	Based on observation of the sleep arrangements for children, and an interview with the provider, a child was not provided a with an individual crib, cot, rest mat or bed for resting or napping. Evidence: Child 1, age sixteen months, slept on a blanket placed on the carpeted floor. There was an extra crib, bed and an available cot was stored and not in use.
Plan of Correction:	The provider will have child 1 sleep on a cot with the required linens.
Standard #:	22VAC40-111-680-B
Description:	Based on observation of the afternoon snack time, and an interview with the provider, the provider did not ensure that children's hands were washed with soap and running water before they ate snack food. Evidence: A couple of children were seen eating snack including dry cereal from a bowl. When asked, the provider indicated that the children have only washed hands before eating lunch.
Plan of Correction:	The provider will make sure the children's hands are washed each time before they eat.
Standard #:	22VAC40-111-690-C
Description:	Based on observation of a diaper change, and an interview with the provider, the provider did not ensure that the diaper mat was cleaned and sanitized after each diaper change. Evidence: After changing the diaper of child 2 before rest time, the provider was seen placing the diaper mat where it is stored under a crib. When asked about the process of cleaning and sanitizing, the provider indicated that it is done at the end of the day and not after each diaper change.
Plan of Correction:	The provider will start using both a cleaning and sanitizing solution on diaper changing mats after each individual diaper change.