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Loudoun P&R - Countryside CASA and Camps
20624 Countryside Bolevard
Sterling, VA 20165
(703) 777-0357

Current Inspector: Stacy Doyle (571) 835-0386

Inspection Date: July 23, 2015

Complaint Related: No

Areas Reviewed:
22VAC40-185 ADMINISTRATION.
22VAC40-185 STAFF QUALIFICATIONS AND TRAINING.
22VAC40-185 PHYSICAL PLANT.
22VAC40-185 STAFFING AND SUPERVISION.
22VAC40-185 PROGRAMS.
22VAC40-185 SPECIAL CARE PROVISIONS AND EMERGENCIES.
22VAC40-185 SPECIAL SERVICES.
22VAC40-80 THE LICENSE.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..

Technical Assistance:
1. The findings of the most recent inspection report are to be posted on-site in a manner that is readily viewable by the public. Placing this report on the back of the bulletin board does not make the document viewable.

Comments:
Conducted an unannounced monitoring inspection. Observed 67 children + 5 direct-care staff in the summer camp program. Ratios and supervision were in compliance. Children were drawing, playing indoor games, participating in a dinosaur egg hunt outside, washing hands, and eating lunch. Staff were leading activities and assisting children as needed, for example helping them apply sunscreen. The indoor areas were found to be clean, safeguarded appropriately, and sufficiently supplied with equipment for the children. Medication management and record keeping violations found. Inspection completed 10:50am-12:20pm. Questions about this inspection may be directed to pamela.sneed@dss.virginia.gov

Violations:
Standard #: 22VAC40-185-240-D-5
Description: Based on records reviewed, it was determined that there was no documentation on-site of which staff working the afternoon shift was trained to give medications (MAT).

Plan of Correction: MAT certificate for PM staff posted at site immediately

Standard #: 22VAC40-185-510-G
Description: Based on records reviewed, it was determined that 2 of 5 medications did not have the required written authorizations. Evidence: 1. Child 2 - According to the registration form, the child was enrolled in summer camp 6/22/15-8/14/15. There was no physician authorization for the long-term emergency medication on-site. 2. Child #3 - The form on-file authorized Loudoun County Public School personnel to give the medication, not the CASA staff.

Plan of Correction: Forms have been reviewed and parents asked for correct authorization paperwork immediately

Standard #: 22VAC40-185-510-L
Description: Based on records reviewed, it was determined that 1 of 4 medication administration logs did not accurately document when medication was/was not given per the written authorization. Evidence: 1. Child #1 - According to registration forms, was enrolled in summer camp 6/22/15-8/15/15. 2. According to the medication authorization signed by parent and physician, medications #1 and #2 were to be given daily while at summer camp. 3. According to medication administration record for medication #1, it was given on 6/29/15, 7/7/15, and 7/8/15. There was no documentation as to why the medication was not given as authorized. 4. According to medication administration record for medication #1, it was given on 6/26/15, and 7/6/15. There was no documentation as to why the medication was not given as authorized.

Plan of Correction: Staff have been reminded the importance of immediately and succinctly documenting medication administration immediately

Standard #: 22VAC40-185-550-M
Description: Based on records reviewed, it was determined that 2 of 4 written injury reports did not include required information. Evidence: 1. 1 of 4 reports did not include 2 signatures. 2. 1 of 4 reports did not include the time the parent was notified.

Plan of Correction: Staff reminded correct procedures to complete forms immediately

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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