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Ms. Serena Mann
3924 Galleon Drive
Chesapeake, VA 23321
(757) 254-8156

Current Inspector: Heather Harrell (757) 334-4329

Inspection Date: Aug. 21, 0215 and Aug. 24, 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
22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:
Today we discussed the use of pack-n-play's, mesh sided port-a-cribs and play yards/pens.

Comments:
An unannounced monitoring inspection of the family day home and records was conducted on 8/21/15 from 1:15pm - 3:45pm and on 8/24/15 from 11:15 ? 1:30pm. There were 7 children in care, both days, ages six months to 8 years. There was one resident school age present both days. Additionally, the provider and one assistant were present on both days. Interviews were conducted with children and adults present. Eight children?s records and one assistant record were reviewed. Children were observed in side and out side play activities, nap, lunch, transitions, hand washing, rest room routines adult and self-directed activities. Transportation was reviewed with the provider. The inspector reviewed the family day home first aid kit, emergency radio and flashlight, medication as well as emergency evacuation drills. Violations were found in the following areas and appear as violations on the violation notice: home maintenance, background checks, diaper changing, medication administration, and documentation of emergency escape drills. Upon receipt of the inspection documentation, the licensee must develop a plan of correction for each violation. The plan of correction must include the following: ? The steps to correct noncompliance with the standard(s); ? Measures to prevent reoccurrence of noncompliance; ? Person(s) responsible for implementation and monitoring of preventive measure(s); ? Date by which noncompliance will be corrected. The licensee will have ten calendar days from receipt of the inspection documentation to complete the section titled Plan of Correction, sign each page of the documentation and return it to the Licensing Office by 9/5/15. The licensee should retain a copy to be posted at the facility (Supplemental Information is not to be posted due to confidentiality). Results of the inspection documentation are subject to public disclosure and will be posted on the VDSS web site within 15 calendar days, regardless of whether the Plan of Correction section is completed.

Violations:
Standard #: 22VAC40-111-700-A
Description: Based on observation, record review and interview the provider failed to ensure that when administering over the counter skin products all requirements are followed.
Evidence:
1. The child's name did not appear on the tube of diaper cream used.
2. There was not written authorization available for review in the child's record.
3. The provider reviewed the child's record and confirmed that there was not written authorization for administering diaper cream, in the child's record.
4. The assistant was observed administering the diaper cream during the inspection on 8/24/15.

Plan of Correction: The provider had a signed permission form to administer medication however it did not refer to diaper cream exclusively. The provider will make a new form that will name the specific topical skin cream that may be administered to the child and have it signed and dated by the parent. The parent will also label the product with the child name and leave it at the day home so it may be stored in a place inaccessible to the children in care

Standard #: 22VAC40-111-830-C
Description: Based on record review and interview the provider failed to ensure that documentation of emergency evacuations drills is maintained as required.
Evidence:
1. The documentation for emergency evacuations maintained by the provider include the month and the year. The information documented does not include the date (day) the drill was completed on. The document lists 0126 without any slash marks or divider between the numbers, the continues as 02/14, 03/15, 04/15, 05/15, 06/15, 07/15 and 08/ /15.
2. The provider confirmed that the complete date was not documented as had been previously documented on the sheet from 2014.

Plan of Correction: The provider states that she overlooked writing the day on the form because she mis-wrote the January entry and each month that followed was in the same format. The provider will make sure that the exact day is included when entering the month and year by prewriting the month and year on each entry leaving only the exact day to be added.

Standard #: 22VAC40-111-240-A
Description: Based on observation and interview the provider failed to ensure that areas inside are maintained in safe condition.
Evidence: On 8/21/15
1 - There is a room in the home that contains a crib and the following is a list of piles, stacks, boxes, and bags of items observed in this room.
- There are three stacked boxes that are labeled 12" Liberty Tax Trike which pose a toppling hazard
- An open box of soaps and other cosmetics some of which are not labeled. These items may be hazardous to young children.
- Five large plastic bags containing toys. These bags pose a suffocation hazard.
- There is a discarded paper cup and spoon on the floor in this room.
- There is an infant bouncer seat turned upside down on top of some of the items stacked in this room. This poses a topple hazard.
- The closet is standing open and there are cots leaning against the back of closet and placed in upright position. These cots pose a topple hazard.
2. The provider reports that room is used as a sleep space for one infant in care. However, there are items placed outside the crib that are within reach of a child once placed in the crib. These items include folded boxes, poster board, and two plastic play tents.
3. A four year old child was observed playing on a stationary ride on toy in this room.
4. When asked if the provider knew there was child playing in the room the provider stated that she did not realize he was in the room.
5. There was a six month in care during the inspection on 8/21/15 and 8/24/15.
6. The provider stated that the infant present for care on 8/21 & 8/24 sleeps in this room.
7. There is a closet in the hallway where household items including putty compound and small hooks are stored in the bottom. The closet was unlocked during the inspection on 8/21/15.
8. When the unlocked closet was pointed out the provider she then put the combination lock back in place.

Plan of Correction: The items stated as cosmetics were natural skin creams and soaps made by one of the parents and were left in the nursery so the children could pick out what they wanted for their parents after they got up from nap. None of these items contained anything toxic. The provider will make sure future items are stored in another location so they will not be mistaken for hazardous materials. The play tents by the crib were cloth and will be removed immediately along with the folded boxes and posters. The rest of the piles were toys that were in disarray and will be immediately reorganized. The provider will make sure that the room is kept neat to avoid toppling hazard. The closet was opened to obtain blankets for nap. The provider will make sure the closet will be re locked immediately after getting nap items. The provider will make sure no children occupy the room when it is in disarray.

Standard #: 22VAC40-111-690-D
Description: Based on observation and interview the provider failed to ensure that the diaper changing surface is cleaned after each diaper change.
Evidence:
1. After completing a diaper change the assistant was asked what was in the blue spray bottle. The assistant responded that it was a bleach/water solution.
2. When told that the diaper changing surface must be cleaned with soap and water then sanitized the caregiver left the diapering area, went into the kitchen and returned with additional supplies to clean the diaper.

Plan of Correction: The provider will make sure that she and all assistants use the proper cleaning procedure for changing pads by making a visual checklist that will be posted in the area where the children are changed to aid in remembering each step is done correctly.

Standard #: 22VAC40-111-690-E
Description: Based on observation the provider failed to ensure that foot operated trash can or a trash can is used in such a way that neither the caregiver's hand nor the soiled diaper touches the exterior surface of the trash can.
Evidence:
After changing the infant's diaper the assistant used her hand to lift the lid of the step diaper pail to through away the soiled diaper.

Plan of Correction: The provider will make sure foot pedal trash cans are used properly to avoid contamination.

Standard #: 22VAC40-191-60-B
Description: Based on record review and interview the provider failed to maintain adult records as required.
Evidence: On 8/21/15
1. The record for the assistant does not contain a sworn statement or affirmation.
2. When asked the provider reviewed the assistant record and confirmed that the sworn statement was not present.

Plan of Correction: The sworn letter of affirmation was obtained upon employment and had been reviewed previously by the inspector. A new form was completed and put into the assistants file. Un sure of how the document went missing the provider will check assistants records weekly to insure all needed documents are in place.

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.

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