VIRGINIA DEPARTMENT OF SOCIAL SERVICES

YMCA Programs at 13th Street Branch
3422 North 13th Street
Arlington, VA 22201
(703) 525-5420

Current Inspector: Mark Davis (804) 629-7103

Inspection Date: Dec. 16, 2019

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. 22VAC40-191 Background Checks (22VAC40-191) 63.2(17) License & Registration Procedures

Technical Assistance:

Consultation was given on third party references. As long as the name and a date of the individual conducting the reference check is available then a third party can be used to obtain the references.

Comments:

An unannounced monitoring visit was conducted today during the after school program. Six children were present with two staff. An additional bus will bring two more groups to the program at approximately 4:00. Reviewed physical space, emergency preparation, records, medications and care of children. Snack provided today was popcorn and applesauce. Areas of non-compliance are identified in the violation notice. If you have any questions regarding the inspection, please feel free to contact me. Thank you Ann Dramstad Licensing Inspector 703-314-0860 ann.dramstad@dss.virginia.gov

Violations:

Standard #:	22VAC40-185-160-A
Description:	Based on record review, 1 of 3 staff did not have documentation of a negative TB screening no later than 21 days after employment. Evidence: Staff #3 was missing a TB screening in her personnel file within 21 days of hire (date of hire 6/2019)
Plan of Correction:	Staff will obtain new TB screening.
Standard #:	22VAC40-185-60-A
Description:	Based on record review, 1 of 4 children's records did not contain all required information. Evidence: Child #2 was missing a second emergency contact.
Plan of Correction:	Second emergency contact will be obtained from family.
Standard #:	22VAC40-185-240-A
Description:	Based on record review, 1 of 3 staff files did not contain documentation that the staff received orientation by the end of the first day of assuming job responsibilities. Evidence: Staff #1 (date of hire 12/2/2019) was missing documentation of orientation.
Plan of Correction:	New orientation form has been signed by staff and added to file.
Standard #:	22VAC40-185-510-C
Description:	1. Based on medication review, the center did not follow procedures to administer medication. Evidence: Child #2's two long term medications did not have a signed authorization by the parent or physician. 2. The center did not prevent the use of an outdated medication. Evidence: Child #2's medication expired 11/2019.
Plan of Correction:	Old medication will be returned to family and new medication will be provided.
Standard #:	22VAC40-185-540-C
Description:	Based on observation, the first aid kit in the loft was missing items. Evidence: The first aid kit did not contain triangular bandages, thermometer, tweezers, tape or antiseptic pads.
Plan of Correction:	First aid kit restocked and placed in new location in the loft.
Standard #:	22VAC40-191-40-D-1-B
Description:	Based on record review, 1 of 3 staff did not have a completed VA Central Registry Search (CPS) within 30 days of employment. Evidence: Staff #3's personnel file did not contain documentation of a completed VA CPS search within 30 days of employment-date of hire 6/2019.
Plan of Correction:	CPS check was sent vefore hire date but no response. Will follow up with VA CPS for update.
Standard #:	63.2(17)-1721.1-B-3
Description:	Based on record review, 1 of 3 staff did not have documentation that a request for an out of state search of the Central Registry has been sent within 45 days of employment. Evidence: Staff #3 documented on a Sworn Disclosure Statement that they had lived outside the State of VA within the last 5 years. No documentation was available to verify that a search of the State's Central Registry had been requested within 45 days of employment (date of hire 6/2019.
Plan of Correction:	MD registry check was sent before hire date, application returned due to clerical error. Will resend to MD agency.