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Jennifer Rivera Rodriguez
175 Queen Victoria Street
Culpeper, VA 22701
(540) 229-7684

Current Inspector: Chrystal King (804) 297-4469

Inspection Date: Jan. 29, 2018

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
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 children's records, caregiver's records and disposal of diapers/wipes. The risk assessments for violations were provided.

Comments:
Thank you for your assistance during today's unannounced monitoring inspection conducted from 11:40 AM to 4:00 PM. Today, there were eight children, infancy through age three (twenty-four points), with two caregivers. I viewed daily routines, meals/snacks, activities, equipment, staffing, supervision, interactions with children, posted information, five records for children, four records for caregivers/residents, caregiver training, injury record, emergency supplies and drill records, emergency plan, diapering procedures, indoor and outdoor areas. The children were provided appropriate sleep accommodations. Caregiver's responded to the infant's needs for care and attention. A variety of toys were available for the children. We discussed the plans for caregiver training with the visiting infant-toddler connection representative.

Let me know if you need any assistance. 540/430-9259

Violations:
Standard #: 22VAC40-111-100-A
Description: Based on a review of five records for children, and an interview with the provider, the physical examination record for child 2 was not obtained within thirty days of initial attendance. Evidence: The first day of care was December 5, 2017. The provider indicated that the record was requested and not provided.

Plan of Correction: The provider immediately messaged the parent and requested a copy of the physical examination record which will be obtained by FAX. The provider will use a reminder system, such as on the phone and a calendar, for tracking when the physical examination records are due within the first month of enrollment if they are not provided by the first date of attendance.

Standard #: 22VAC40-111-120-B
Description: Based on a review of four records for caregivers/residents, and an interview with the provider, the provider failed to check at least two references regarding character and competency before caregiver 2 began working with the children. Evidence: Caregiver 2 began work on January 6, 2018 and there were not any documented references in the file. The provider indicated that reference check forms were given to the caregiver who was asked to provide the references and the forms were not returned. When asked, the provider said that no telephone reference checks were attempted.

Plan of Correction: At least two references will be obtained for the record by the time the caregiver returns to work. In the future, if written records have not been provided by the caregiver at the time of hire, the provider will conduct reference checks by phone and document the information for the file.

Standard #: 22VAC40-111-90-A
Description: Based on a review of five records for children, and an interview with the provider, the provider failed to obtain documentation of immunizations for child 2 prior to initial attendance. Evidence: The first date of care was documented as December 5, 2017. The provider indicated that she requested the information which was not received.

Plan of Correction: The provider immediately messaged the parent and arranged to receive a copy of the immunization report from the child's physician by FAX. In the future, when enrolling new children the provider will tell parents that a signed immunization report is required before a child can start attending.

Standard #: 22VAC40-111-90-C
Description: Based on a review of five records for children, and an interview with the provider, the immunization record for child 1 was not updated as required every six months for children under two years of age. Evidence: The only immunization report in the file was completed on June 27, 2017 and the child is under age one.

Plan of Correction: The provider immediately contacted the parent with a message and requested a copy of the immunization record for child 1. The provider will use reminder systems on the phone and a calendar for tracking when updated immunization records are due so that they are obtained no later than six months from the date of the last report. The provider will continue to remind parents to bring a copy of updated records when children are taken to doctor appointments.

Standard #: 22VAC40-111-690-E
Description: Based on observation of two separate diaper changes for children, and interviews with the provider, the provider failed to dispose of the used diapers and wipes by using the foot operated pedal of the disposal container so that the caregiver's hands did not touch the exterior surface of the storage system during disposal. Evidence: The provider was seen pushing the lid open with her hand while holding the used diaper or used wipes and paper towels, and then pushing the items into the partially opened container. The provider indicated that the foot pedal opening mechanism does work.

Plan of Correction: The provider will post a reminder about using the foot pedal. The provider will make sure the foot pedal is within reach and used each time the used diapers, wipes and paper towels are disposed in the covered container.

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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