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

Current Inspector: Nancy Radcliffe

Inspection Date: Dec. 7, 2017

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
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
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.

Comments:
An unannounced monitoring visit was conducted today between the hours of 11:44am through 3:00pm with the provider on site. There were 7 children (28 points) with the provider and one assistant. A sample of 5 children's files and 3 staff/household member's files were reviewed. The children were engaged in the following: toy play, nap time, infant feeding, and diaper changing. The home was clean and play area was organized. The caregiver is First Aid and CPR certified. She does not have MAT certification to administer medication. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Stacy.Doyle@dss.virginia.gov 571-835-0386.

Violations:
Standard #: 22VAC40-111-710
Description: Based on review, the caregiver does not meet the requirements in 22 VAC 40-111-220A to administer medication. Evidence: 1. The caregiver's Medication Administration Training (MAT) expired on 4/2015.

Plan of Correction: Planning to do that in a month. [sic].

Standard #: 22VAC40-111-830-C
Description: Based on review, the caregiver did not have documentation maintained of emergency evacuation and shelter in place drills. Evidence: 1. The caregiver did not have documentation of the October or November emergency evacuation drill or the shelter in place drills.

Plan of Correction: Corrected by Thursday. [sic].

Standard #: 22VAC40-111-120-B
Description: Based on review, two Assistants records did not contain the required information. Evidence: 1. Assistant A's record was missing the date of employment, age verification, name, address and telephone number of a person to be notified in an emergency and two references. 2. Assistant B's record was missing the date of employment, name, address and telephone number of a person to be notified in an emergency and two references.

Plan of Correction: This will be done this week. [sic].

Standard #: 22VAC40-111-60-B
Description: Based on review, three of five children's records were incomplete. Evidence: 1. Child B and Child E were missing the child's nickname. 2. Child D was missing the child's nickname and the medical insurance policy number.

Plan of Correction: Corrected. [sic].

Standard #: 22VAC40-111-170-A
Description: Based on review, the provider did not obtain from each caregiver at the time of hire a current report of tuberculosis screening form with it documenting the absence of tuberculosis in a communicable form. Evidence: 1. Assistant B did not have documentation of a tuberculosis screening form with it documenting the absence of tuberculosis in a communicable form.

Plan of Correction: She, Assistant B, will do that by the end of the month. [sic].

Standard #: 22VAC40-111-200-C
Description: Based on review, Assistant A did not have documentation of the orientation signed and dated by the provider and assistant provider. Evidence: 1. The Assistant A has been working for the provider for more than one week and did not have documentation of the orientation signed by the provider and assistant.

Plan of Correction: Will be done by Tuesday. [sic].

Standard #: 22VAC40-111-220-A
Description: Based on review, the caregiver has agreed to administer prescription medication or non-prescription medication, however has not satisfactorily completed a retraining at three year intervals for the Medication Administration training(MAT) . Evidence: 1. The caregiver's Medication Administration training expired April 2015.

Plan of Correction: No medication administration until retraining. [sic].

Standard #: 22VAC40-111-250-C
Description: Based on observation, items tied across the top or corner of a crib or toys hung from the sides with strings or cords were not removed when the child begins to push up on hands or knees or is five months of age, whichever occurs first. Evidence: 1. Two cribs had toys hanging on the sides and were used by infants over five months of age.

Plan of Correction: Corrected. [sic].

Standard #: 22VAC40-111-320-G
Description: Based on review, the wood burning fireplace was not inspected and cleaned annually by a knowledgeable inspector to verify that the device is properly installed, maintained, and cleaned as needed. Evidence: 1. The provider had documentation of the last inspection and cleaning being in December 2013.

Plan of Correction: Monday appointment on 12/11/2017. [sic].

Standard #: 22VAC40-111-320-I
Description: Based on interview, the provider had open and obvious fire hazards. Evidence: 1. The provider stated she did not have a working smoke detector on the first level. She stated it needed a new battery.

Plan of Correction: Battery is on. Corrected. [sic].

Standard #: 22VAC40-111-510-A
Description: Based on observation and interview, each child is not provided with an individual crib, cot, rest mat or bed for resting or napping. Evidence: 1. Seven infants were present during the inspection. The provider had three cribs. The provider stated that the infants share the cribs and take turns.

Plan of Correction: Planning to buy more cribs this month. [sic].

Standard #: 22VAC40-111-520-B
Description: Based on observation, cribs were being used as a play space for infants. Evidence: 1. During the inspection, one infant was in a bouncing seat inside the crib.

Plan of Correction: No bouncing seat in cribs. Corrected. [sic].

Standard #: 22VAC40-111-550
Description: Based on observation, a play pen is used for the designated sleeping area for an infant. Evidence: 1. Infant A (11 month old) was sleeping in a play pen during the inspection.

Plan of Correction: More crib add. [sic].

Standard #: 22VAC40-191-40-D-1-b
Description: Based on review, two assistants did not have the central registry or criminal history records before 30 days of employment. Evidence: 1. Assistant A had documentation that the central registry and criminal record was sent, but was not in her file. There is no documentation of a start date for the Assistant, however the provider stated it was in November 2017. 2. Assistant B did not have documentation that the central registry or criminal record was sent and was not in her file. There is no documentation of a start date for the Assistant, however the provider stated it was in September 2017.

Plan of Correction: Assistant A file is complete. Assistant B will apply for central registry. [sic].

Standard #: 22VAC40-191-40-D-1-c
Description: Based on review, the provider did not obtain a central registry finding before five years, since the last date of the central registry. Evidence: 1. The provider did not have a current central registry in her file. She stated she threw away the last one and thought she had obtained an updated form. The form that was in her file was dated 3/28/2017 that it was received by the office of background investigations, but it was not filled out on the back of the form with the information needed.

Plan of Correction: will be sending again. The copy is a in file. [sic].

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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