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Hilda Bustamante
1531 Coat Ridge Rd.
Herndon, VA 20170
(703) 409-8222

Current Inspector: Maria Soto (571) 835-5058

Inspection Date: Sept. 14, 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 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:
Discussed with provider schedule for resilient surfacing outside under fall zones.

An unannounced renewal inspection was conducted today from 10:15 am- 11:00 am. Observed 12 children with the provider, caregiver #1 and caregiver #2. Ratios and supervision were in compliance. The children were observed engaged in various activities: playing outside, personal hygiene routines, hand washing, waking up from nap, and being comforted after being upset because there was a strange face in the play area. The interior of the family day home was found to be clean, organized and well supplied with toys and equipment for the children. No medications were reported to be on site. A sample of children/caregiver and household member records were reviewed. Emergency supplies and procedures, emergency drill records and posted documents were also reviewed. Areas of non-compliance are identified in this report. If you have any questions regarding today's inspection, please contact Kelly Savittiere at (703) 479-4746 or

Standard #: 22VAC40-111-100-A
Description: Based upon record review a child in care did not have required physical on file. Evidence: Child C does not have a physical on file with in 30 days after first day of attendance ( 03/09/2015)

Plan of Correction: Parent will be reminded again at pick up that physical is due. Child's 1 year check up is next month.

Standard #: 22VAC40-111-60-B
Description: Based upon review of records, required information was found to be incomplete. Evidence: Child B's record is missing: a complete address for emergency contact #2, the actual location written on the emergency procedures form ( this was signed by the parent) and a parent's signature on the first page of the child's physical form.

Plan of Correction: Will have parent provide missing information.

Standard #: 22VAC40-111-90-C
Description: Based upon record review, required documentation was not on file. Evidence: Child A (Date of birth 03/24/2013) does not have a current immunization report on file. The last immunization report on file is 03/26/2014. Children under age 2 are required to have immunizations updated every six months and once annually between ages 4-6.

Plan of Correction: Will ask parent again for record at pick up.

Standard #: 22VAC40-111-240-A
Description: Based upon observation, equipment was found not maintained in safe condition. Evidence:A ride on toy and a plastic opening to a playhouse in the backyard were found to have pieces of sharp plastic accessible to children.

Plan of Correction: The provider removed broken equipment during inspection.

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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