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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: March 2, 2015

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
63.2 Facilities and Programs..
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
We discussed the requirements for caregiver's records. The risk assessment for a violation was provided. Also, we talked about model forms available for writing the annual emergency response plan training. As a reminder, two shelter-in-place drills, such as for a tornado warning, are required each year. Sixteen hours of annual training are required for caregivers.

Thank you for your assistance during today's unannounced focused inspection conducted from 11:25 AM to 1:25 PM. There were eleven children, ages infancy to two years (38 points) with three caregivers. Today, I determined the corrective action taken regarding the violations from the November 19, 2014 inspection findings. I viewed five records for caregivers/residents, posted information, emergency drill records, indoor safety, daily routines, lunch, staffing, supervision, and interactions with children. The caregivers were seen responding to individual needs of the children. The were seen conducting cleaning routines in the child care areas. Let me know if you have any questions. 540/332-9173

Standard #: 22VAC40-111-120-A
Description: Based on a review of five records for caregivers/residents, and an interview with the provider, there was required information missing from the records of caregiver 2, 4 and 5. (Repeat Violation) Evidence: There was not any documented orientation training, dates of employment and position titles, background information regarding education and programmatic experience with the caregiver's records.

Plan of Correction: The provider immediately copied the model forms for employment information of assistant and substitute caregivers and the orientation training checklist. The provider will make sure these forms are completed and the needed information is placed with the caregiver's records. Whenever new employees are hired, the required information regarding employment, background information, and orientation training will be documented using the model forms.

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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