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Maryam Yousefzadeh
13105 Willoughby Point Drive
Fairfax, VA 22033-1427
(703) 973-0989

Current Inspector: Nancy Radcliffe

Inspection Date: Aug. 30, 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.
63.2 General Provisions.
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.

Comments:
An unannounced monitoring/renewal inspection was conducted today. There were 4 children (12 points) directly supervised by 2 staff (the provider arrived after the start of the visit). The home, 1 staff record, 1 child?s records, evacuation drills, emergency supplies, and policies were inspected. There were no medications on site today. Children were observed playing freely and eating snack. There was an abundant supply of books, toys, and materials for the children. The home was clean and organized. Areas of non-compliance are identified in this report. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 10 calendar days from today. If you have any questions regarding this inspection, please contact the Licensing Inspector. Keesha Minor (keesha.minor@dss.virginia.gov) (703)479-4680

Violations:
Standard #: 22VAC40-111-800-B
Description: Based on review, the provider failed to annually updated the emergency preparedness plan on an annual basis. Evidence: Reviewed the emergency preparedness plan and found that it had not been updated on an annual basis.

Plan of Correction: It has been updated

Standard #: 22VAC40-111-120-B
Description: Based on review, the provider failed to ensure that the assistant's records contained the required information. Evidence: 1) the assistant's record did not have documentation of age verification 2) the assistant's record did not have documentation of 2 reference checks completed prior to the first day of employment

Plan of Correction: Age verification completed will get references verified.

Standard #: 22VAC40-111-60-B
Description: Based on review, the provider failed to ensure that children's records contained the required minimum information. Evidence: Reviewed 1 child's record and found that they were missing documentation of a second emergency contact.

Plan of Correction: All documentation has been updated.

Standard #: 22VAC40-111-150-D-1
Description: Based on review, the provider failed to ensure that the assistant had documentation of CPR. Evidence: the provider was out of the home, leaving the assistant and the substitute in the home watching children, neither of which had current CPR training.

Plan of Correction: Working with assistant to get the CPR

Standard #: 22VAC40-111-150-D-2
Description: Based on review, the provider failed to ensure that the assistant had documentation of first aid. Evidence: The provider was out of the home, leaving the assistant and a substitute alone with the children. Reviewed the assistant's file and found that the assistant, nor the substitute, did not have documentation of first aid.

Plan of Correction: Working with assistant to get the first aid

Standard #: 22VAC40-111-200-C
Description: Based on review, the provider failed to ensure that documentation of orientation shall be signed and dated by the provider and substitute. Evidence: Reviewed 1 staff record and found that the record did not have documentation of orientation training.

Plan of Correction: It has been completed

Standard #: 22VAC40-111-320-A
Description: Based on observation, the provider failed to ensure that small electrical appliances are unplugged unless being used by the caregiver. Evidence: observed that the provider had a small white toaster plugged in and not in use.

Plan of Correction: Small appliances are being kept unplug

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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