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Ms. Mozhdeh Monjezi
1658 Old Brook Road
Charlottesville, VA 22901
(434) 409-6465

Current Inspector: Diann S. Reed (540) 280-0742

Inspection Date: Nov. 19, 2014

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 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-111 Transportation
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
We discussed the requirements for caregiver's records, background checks, indoor safety, emergency drill records, first aid/CPR, and posted information. The risk assessments for violations were provided. As a reminder, it is important to keep track of the dates for caregiver's records and training. Substitute provider's work hours must be documented when the provider is absent for more than two hours during the day.

Thank you for your assistance during today's unannounced monitoring inspection conducted from 11:10 AM to 3:50 PM. Today, there were eleven children, infants and toddlers (thirty-eight points), with three caregivers. I viewed daily routines, activities, staffing, supervision, interactions with children, diapering procedures, meals/snacks, four records for children, four records for caregivers/residents, emergency supplies and drill record maintenance, posted information, indoor and outdoor areas. The children enjoyed dance and music activities. The older children had opportunities for gluing shapes. A variety of age appropriate toys were accessible. The caregivers were seen providing the children with frequent interactions and needed comfort and affection. Let me know if you have any questions. 540/332-9173

Standard #: 22VAC40-111-790
Description: Based on a review of posted information, and an interview with the provider, the telephone numbers for the regional poison control center and emergency phone number "911" were not posted near a phone. Evidence: After looking for the posted emergency numbers and not viewing them where they were previously available, the provider indicated that after the room was recently painted the phone numbers were not posted again.

Plan of Correction: The provider will make sure the emergency phone numbers "911" and poison control are posted in the entrance day care room near the phone.

Standard #: 22VAC40-111-830-C
Description: Based on a review of the emergency drills, and an interview with the provider, the record of drills for evacuations and shelter-in-place were not maintained for 2014. Evidence: The drill records were no longer posted near the door. The provider indicated that the posted records were removed when the room was painted this autumn and the drill records were searched for in a storage area and not found.

Plan of Correction: The provider will resume documenting monthly evacuation practices with the children and all shelter-in-place drills. If records are removed from the day care area, they will be placed in a designated area and easily accessed when needed.

Standard #: 22VAC40-111-120-A
Description: Based on a review of four records for caregivers/residents, and an interview with the provider, there was not required information in a record for caregiver 2. Evidence: The provider indicated that caregiver 2 was employed in October 2014. There was not documented education/experience, references, hire date, position title, and orientation training in the file. There was only a signed sworn statement and a TB statement in the record for caregiver 2.

Plan of Correction: The provider will use model forms for documented information about employment dates, position titles, background information, reference checks, and orientation training. The caregiver will add all missing information to the record of caregiver 2. The provider will check all records to make sure they contain all required information.

Standard #: 22VAC40-111-140-B-4
Description: Based on a review of records for four records for caregivers/residents, and an interview with the provider, there have been times when there are not any caregivers with current certification in first aid and CPR. Evidence: The first aid/CPR certification for the provider expired in July 2014. There was an assistant who works most of the day to meet staffing requirements and has certification until November 24, 2015.

Plan of Correction: The provider will register for a first aid and CPR course and renew the certifications. In the future, the provider will register for the needed courses before the certification expires so that there is always a caregiver present who has the current training for first aid and CPR.

Standard #: 22VAC40-111-180-A
Description: Based upon a review of four records for caregivers and residents, and an interview with the provider, the updated TB screenings and statements for caregiver/resident 1 and 3 were not obtained by two years from the date of the last TB statement. Evidence: The most recent TB statements were obtained June 29, 2012 for caregiver/resident 1 and June 28, 2012 for caregiver/resident 2.

Plan of Correction: The provider will arrange appointments for the two TB screenings and obtain updated statements for the staff files. The provider will review record dates on a periodic basis to make sure any updated information is obtained before it is due. Arrangements will be made to obtain updated records before planned vacation days.

Standard #: 22VAC40-111-280
Description: Based on observation of the bathroom area, and an interview with caregivers, the bathroom cabinet under the sink contained accessible cleaning supplies and diaper rash lotion. Evidence: The child proof latch for the cabinet was open. There was a half-gallon container of bleach, spray sanitizer container, and diaper rash lotion treatment in the cabinet.

Plan of Correction: The caregiver immediately latched the cabinet when the unlocked cabinet was brought to her attention. All caregivers who use the supplies in the cabinet will use the child-proof latch immediately after use. The provider will make sure the cabinets are latched and the caregivers are reminded to keep potentially poisonous substances out of reach of children.

Standard #: 22VAC40-111-320-B
Description: Based on observation of all child care areas of the home, and an interview with caregivers, there was an electric outlet without a child-resistant protective cover. Evidence: The electric outlet was uncovered in a child care activity area and accessible to children under age five.

Plan of Correction: The provider placed a cover on the outlet. The provider and caregivers will replace the protective covers immediately after using outlets such as for cleaning. The provider will check the outlets daily to make sure they are covered.

Standard #: 22VAC40-191-40-C-1-b
Description: Based on a review of four records for caregivers/residents, and an interview with the provider, the background checks for caregiver 4 were not obtained as required. (Repeat Violation.) Evidence: A sworn statement or affirmation was signed March 10, 2014 on the first date of employment. There was not a criminal history record check and central registry clearance obtained for the records.

Plan of Correction: The provider will make sure both background checks are requested and obtained for caregiver 4. The provider will request background checks at the time of hire and when sworn statements are signed in preparation for employment. Caregivers without background checks will not be alone with children until the criminal history records are received. The provider will review all records and have a system for keeping track of the dates of each background check.

Standard #: 22VAC40-80-120-E-1
Description: Based on a review of posted information, and an interview with the provider, there were required documents not posted in a prominent place. Evidence: The current license and the violation notice for the previous inspection were not posted in the locations where they were seen during past inspections. The provider indicated that the documents were removed this autumn when the walls were painted and the documents were not located after the work was finished.

Plan of Correction: The provider will obtain a copy of the license from the Valley Licensing Office and post it near the entrance. In the future, the provider will contact the licensing office and request copies of missing documents when they are not found. The provider will have a designated storage area for documents and records whenever work is done in the child care space so the information can be easily found.

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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