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(Under the authority of Executive Order 51, the Commissioner of Department of Social Services is waiving regulation 22VAC40-665-40.N which references the period of time for a redetermination of eligibility for the subsidy program. )

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NOVA KinderCare Learning Center
1227 North Ivy Street
Arlington, VA 22201
(703) 527-2288

Current Inspector: Ann Dramstad (703) 314-0860

Inspection Date: April 28, 2016

Complaint Related: No

Areas Reviewed:
22VAC40-191 Background Checks (22VAC40-191)

Technical Assistance:
Consultation was given on submitting background searches in a timely manner, the new DSS web site, model medication authorization forms, tummy time with infant teachers and maintaining staff records.

An unannounced visit was conducted to follow up on a self reported allegation concerning care of children. Based on the preponderance of evidence, the allegation is not founded. An unannounced monitoring visit was conducted. All rooms were in operation with direct care staff meeting supervision ratios. Children were observed in infant care, diapering and feeding, circle time for older children, room arrangements and supplies as well as transitions. The playground was not observed today due to rain. Emergency drills, records for staff and children as well as medication procedures were reviewed. Areas of non-compliance are identified in this report. Please sign and date the report and return it to me within 10 calendar days from date of receipt. If you have any questions regarding the inspection, please feel free to contact me. Thank you Ann Dramstad Licensing Inspector 703-314-0860

Standard #: 22VAC40-185-160-A
Description: Based on record review, 2 of 4 staff records did not contain documentation within 21 days of hire date of a TB screening. Evidence: 1. Staff #2 was hired 12/2/2015 and her TB record was dated 4/21/2016. 2. Staff #5 was hired 3/28/2016 and did not have a TB screening record in her file.

Plan of Correction: Staff #5 TB test was read the following day.

Standard #: 22VAC40-185-60-A
Description: Based on record review, 1 of 4 children's records was missing verification that proof of ID was reviewed. Evidence: Child #4's record did not contain the required information (birth certificate #, date viewed or staff signature).

Plan of Correction: Corrected

Standard #: 22VAC40-185-70-A
Description: Based on record review, 1 of 4 staff records is incomplete. Evidence: Staff #2 was missing reference documentation in her personnel record. Staff was hired 12/03/2015.

Plan of Correction: References were provided to inspector before she left the building.

Standard #: 22VAC40-185-270-A
Description: Based on observation, areas of the center are not being maintained in a clean manner. Evidence: 1. The kitchen door from the infant side of the building is peeling paint. 2. The blue and red wedge cushions in the Toddler area are torn on the corners. 3. The bookcase in the toddler room with the Math label has sticky glue like substance peeling from the sides.

Plan of Correction: 1. Work order submitted. 2. Cushions removed 3. Corrected.

Standard #: 22VAC40-185-500-A
Description: Based on observation, a staff member did not wash their hands after assisting a child with blowing their nose. Evidence: The Licensing Inspector observed a staff ember in the Toddler class wipe a child's nose and hand a second staff the used kleenix. The staff member did not wash her hands afterwards. When asked by the Inspector she acknowledged that she had not washed her hands as required.

Plan of Correction: Staff retrained.

Standard #: 22VAC40-185-510-C
Description: Based on medication review, the center did not follow the procedure for long term medication. Evidence: 1. Medication for child #3 had an expired authorization for both the parent and physician signatures as both were older than one year. The parent signed the authorization 3/31/2015 and the physician signed the authorization 4/12/2015. 2. Medication for child #1 was completed on an Arlington DHS form which only authorizes Arlington County employees to administer the medication. It does not give KinderCare staff authorization to administer the medication.

Plan of Correction: Corrected

Standard #: 22VAC40-185-510-L
Description: Based on medication review, a record of medication administration was incomplete. Evidence: The medication log did not contain the signature or name of the staff member who admiistered medication for child #1 on 3 occasions.

Plan of Correction: Error by staff no longer at the cetner. HAve retrained staff presently at the center.

Standard #: 22VAC40-191-40-D-1-B
Description: Based on record review, 1 of 5 staff is missing a Central Registry form within 30 days of employment (CPS) Evidence: Staff #4 was hired 3/7/2016 and does not have a search of the Central Registry (CPS form) in her file.

Plan of Correction: Anither form was notarized and sent for investigation.

Standard #: 22VAC40-191-60-C-2
Description: Based on record review, a staff member was not denied employment when 30 days has passed since her hire date and no CPS record is on file at the center. Evidence: Staff #4 started working on 3/7/2016. The facility continued to employ even though no completed CPS record was on file.

Plan of Correction: Staff will not be allowed to work until form is returned with satisfactory results.

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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