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Ms. Cynthia Holmes
26070 Old Office Road
Culpeper, VA 22701
(540) 854-8939

Current Inspector: Michelle W. Argenbright (540) 848-4123

Inspection Date: Aug. 11, 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
22VAC40-111 Transportation
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
63.2 General Provisions.
63.2 Child Abuse and Neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
We discussed the requirements for caregiver's records and the staffing requirements. The risk assessments for violations were provided. We talked about the out-of-reach storage for toxic items. Also, you were reminded about storage of children's linens in separate locations and away from the diapering mat. The C.P.R. certificate will expire in February 2016.

Comments:
Thank you for your assistance during today's unannounced monitoring inspection conducted from 12:02 PM to 3:50 PM. Today, there were seven children in care and one resident child under age eight years of age (seventeen points) with the provider. I viewed daily routines, staffing, supervision, interactions with children, lunch, infant feeding, diapering procedures, activities, equipment, nap, two records for caregivers, caregiver training, three children's records, emergency supplies and drill records, posted information, indoor and outdoor areas. The children had access to toys for play activities. We talked about the use of the front yard for outdoor experiences. The new screened porch is not used for child care. We talked about limited television viewing.

Violations:
Standard #: 22VAC40-111-230-A
Description: Based on a review of two records for caregivers, and an interview with the provider, there was not documentation of the orientation training for caregiver 2. Evidence: The provider has indicated that caregiver 2 started work with children by March 12, 2015. There was not any written information about orientation training in the record.

Plan of Correction: The provider will print and use the orientation model form to document the initial training. The provider will use the staff record checklist to make sure all required information was added to the record of assisting staff.

Standard #: 22VAC40-111-570-B
Description: Based on a review of the staffing needs for the children in care, and an interview with the provider, there was a resident child under eight years of age who was present, counting in the point maximum, and there was not an assistant caregiver present during times there were more than sixteen points according to the ages of a total of eight children present on August 11, 2015. Evidence: There were seven children in care, ages infancy through twelve years of age, and the points assigned totaled sixteen. The school age resident child added one point. The provider indicated that the regular assistant was ill this date. The provider was not aware of the total points until the inspector discussed the points determined during the visit. The provider indicated that the last two children arrived around 11:45 AM. Parent pick-up of children started at 3:30 PM.

Plan of Correction: The provider will determine the number of points assigned to children in care for each date and arrange to have an assistant caregiver present during the hours that there are more than sixteen points according to the ages and number of children present. If the regular caregiver is ill, a resident adult will be asked to assist or to take the resident child for the day. The provider will review the licensing standards and requirements for staffing.

Standard #: 22VAC40-191-40-D-1-b
Description: Based on a review of two records for caregivers, and an interview with the provider, there were not background checks in the record of caregiver 2. Evidence: The provider indicated that the request forms were sent at the time of initial employment in March and a request form that was returned and required a signature was sent to Richmond. Only copies of the unprocessed request forms for the criminal history check and the central registry check were in the record.

Plan of Correction: The provider will contact the agencies in Richmond to inquire about the processing of the requested background checks. The provider will make sure the required requests have been made and the background checks are obtained for the record. In the future, both background checks will be obtained within the first month of employment.

Disclaimer:

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.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.

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