VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Henry Fork Service Center
71 Sandridge Road
Rocky mount, VA 24151
(540) 483-2819

VDSS Contact: Rebecca Forestier (540) 309-2835

Inspection Date: Aug. 2, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-191 Background Checks for Child Welfare Agencies 54.1-3408 Must be MAT Certified. 32.1 Report by person other than physician 63.2 Child Abuse & Neglect 63.2(17) License & Registration Procedures 63.2 Facilities & Programs.

Technical Assistance:

Licensing Inspector reviewed the following information with the Center Director: Document date of hire for each staff member Posting of Exemption Letter Adult-to-Child Ratio requirements 0 months up to 16 months ? 1 adult for every 4 children 16 months up to 2 years ? 1 adult for every 5 children 2 years up to 3 years ? 1 adult for every 8 children 3 years up to 5 years ? 1 adult for every 10 children 5 years up to 9 years ? 1 adult for every 20 children 9 years through 12 years ? 1 adult for every 25 children New car/booster seat laws effective July 1, 2019

Comments:

The Licensing Inspector for Henry Fork Service Center conducted an unannounced RECDC Monitor Inspection on Friday, August 2, 2019. Licensing Inspector arrived & started inspection at 11:10 am and concluded at 2:15 pm. Upon arrival, there were a total of thirty-six (36) children age 3-13 years old, eight (8) staff members and the Center Director present. Information for 7 enrolled children was requested but unavailable. Licensing Inspector reviewed information for 9 staff members during today?s inspection. The Licensing Inspector conducted an exit interview along with reviewing the Risk Assessment and the areas of non-compliance with the Center Director on August 2, 2019. If you have any questions, the Licensing Inspector for this facility can be reached at (540) 309-2397.

Violations:

Standard #:	22VAC40-191-40-C-2
Description:	Based on review of staff information, the Center failed to ensure each employee, volunteer or any other person who is expected to be alone with one or more children enrolled in a religious exempt child day center has completed Sworn Disclosure Background Check before employment/commencement of service and Central Registry Background Check within 30 days of employment/commencement of service. EVIDENCE: Licensing Inspector information for nine (9) staff members. Information for Staff #1, #3, #4, #5, #6, #7 and Staff #8, did not include evidence of completed Central Registry (CPS) Background Check. Information for Staff #9 did not include evidence of a completed Sworn Disclosure.
Plan of Correction:	The provider must send documentation to the Licensing Inspector that the background checks have been requested no later than 10 days following this notification date 8-02-2019
Standard #:	63.2(17)-1716-A-4
Description:	Based on review of staff information, the Center failed to ensure each employee has been certified by a practicing physician to be free from any disability which would prevent him from caring for children under his supervision. EVIDENCE: Licensing Inspector reviewed health information for nine (9) staff members. Evidence of Staff Health Report was unavailable for Staff #4, #5 and #9.
Plan of Correction:	Staff will complete health exam. Documentation of the results will be kept at the center.
Standard #:	63.2(17)-1716-B-5
Description:	Based on inspection & discussion with the Center Director, the Center failed to ensure all children in the center are in compliance with the regulations regarding the immunization of children against certain diseases. EVIDENCE: Licensing Inspector requested immunization information for seven (7) enrolled children. 7 out of the 7 children did not have information regarding immunizations against certain diseases.
Plan of Correction:	Director will request immunization information from each parent.
Standard #:	63.2(17)-1720.1-A
Description:	Based on review of staff information, the Center failed to ensure each employee, volunteer or any other person who is expected to be alone with one or more children enrolled in a religious exempt child day center undergo Background Checks (Sworn Disclosure, Fingerprint and Child Protective Services) prior to employment and every five years thereafter. EVIDENCE: Licensing Inspector information for nine (9) staff members. Child Protective Services Background Check has not been updated for Staff #1 and Staff #9. Staff #1 last completed cps on 4/22/2008; Staff #9 last completed cps on 7/22/2009.
Plan of Correction:	The provider must send documentation to the Licensing Inspector that the background checks have been requested no later than 10 days following this notification date 8-02-2019
Standard #:	63.2(17)-1720.1-B-2
Description:	Based on record review, the Center failed to ensure each employee, volunteer or any other person who is expected to be alone with one or more children enrolled has submitted documentation of completed Fingerprint Background Check before employment/commencement of service. EVIDENCE: Licensing Inspector reviewed information for nine (9) staff records. Information for 9 out of 9 staff members did not include evidence of a completed fingerprinting Background Check.
Plan of Correction:	The provider must send documentation to the Licensing Inspector that the background checks have been requested no later than 10 days following this notification date 8-02-2019