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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: March 16, 2016

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 and children's records. The risk assessments for violations were provided. As a reminder, sixteen hours of annual training are required for each caregiver. An annual review of the emergency response plans is due with an assistant caregiver. Background checks are due every three years. TB statements are due every two years. We discussed your email and the need to access it outside of the home and make room for new email notices. Let me know if you are able to add satellite internet for home.

Comments:
Thank you for your assistance during today's unannounced monitoring inspection conducted from 12:03 PM to 4:00 PM. Today, there were seven children in care (19 points) with two caregivers. I viewed daily routines, lunch/menu, staffing, supervision, interactions with children, diapering procedures, equipment, activities, posted information, emergency supplies and drill records, caregiver training, three records for caregivers and residents, four records for children, indoor and outdoor areas. The children are playing in the immediate front yard and are not using the equipment in the area of the trees. Also, they are kept away from all parked vehicles. The children enjoyed having a book read to them. Age appropriate toys were accessible. Nap mats have been cleaned/sanitized daily. Let me know if you have any questions. 540/430-9259

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on a review of four records for children, and an interview with the provider, a physical examination record for child 3 was not obtained within thirty days after the first day of attendance. Evidence: The first date of attendance was on April 14, 2015. There were only copies of immunization reports in the file folder.

Plan of Correction: The provider will request and obtain a copy of the physical examination record for child 3. In the future, the provider will make sure the parents of new children provide a copy of a physical examination report within the first month of attendance.

Standard #: 22VAC40-111-60-B
Description: Based on a review of four records for children, and an interview with the provider, there was some required information and all of the written agreements and parent authorizations missing from the records of child 1 and 2. Page 1 of the information record for child 3 was missing. Evidence: The provider indicated that child 1 and 2 started today on a trial basis. The immunization reports, birth records, and parent's work contact numbers were obtained for today. The information and agreement forms, liability insurance acknowledgement, parent information forms, emergency response forms and medication policy were not completed by the provider and parent for the files of child 1 and 2. All required information regarding parent work information, addresses/phone numbers, emergency contacts, allergies, and authorized pick-up information were not in the file of child 3.

Plan of Correction: The provider will arrange for the parents of child 1, 2 and 3 to complete all required paperwork with the provider and maintain the information in each child's record. In the future, if children are beginning care that might be temporary, the provider will still require the parents to complete the information, agreements and written authorizations required for each child before they are left in the care of the provider.

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. (Repeat violation.) Evidence: The start date in the record was March 12, 2015. There was not any written information about orientation training in the record.

Plan of Correction: The provider will use a model form to document the orientation training that was provided for caregiver 2. The provider will use the checklist on the model form for caregiver's records to make sure all listed information has been added to the file folder.

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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