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Elva Barboza
7521 Mc Whorter Place
Apt. T2
Annandale, VA 22003
(703) 980-6656

Current Inspector: Stacy Doyle (571) 835-0386

Inspection Date: March 7, 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
22VAC40-111 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
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:
The provider inquired on how to increase her capacity. It was explained that she would need zoning approval and then she could request a modification.

An unannounced renewal visit was conducted today between the hours of 10:00am through 1:00pm with the provider on site. There were 5 children (11 points) with the provider. A sample of 4 children's files and 3 staff/household member's files were reviewed. The children were engaged in the following: toy play, games, movie time, snack, bathroom breaks, hand washing, and other organized activities. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at 571-835-0386.

Standard #: 22VAC40-111-730-D
Description: Based on observation, refrigerated medication for caregivers and household members were not kept in a locked place using a safe locking method that prevents access by children. Evidence: 1. Six medications were in the refrigerator in the kitchen on the door shelf and were not kept locked. 2. A shoe box size box was fully contained with various medications on the refrigerator shelf and was not kept locked. The box had a top, but did not have a locking method on the box.

Plan of Correction: I will buy a box with a lock to put them in or buy a lock for the refrigerator.

Standard #: 22VAC40-111-760-A-1
Description: Based on observation, the first aid kit did not contain the minimum required items. Evidence: 1. The first aid kit was missing one triangular bandage and the first aid instructional manual.

Plan of Correction: I will get them.

Standard #: 22VAC40-111-830-A
Description: Based on review, the caregiver did not practice emergency evacuation procedures monthly with all children in care during all shifts that children are in care. Evidence: 1. The provider did not practice an emergency evacuation drill the month of February 2018.

Plan of Correction: I will make sure it is done each month.

Standard #: 22VAC40-111-920
Description: Based on observation, the menu for the current one-week period was not given to parents or posted or placed in an area accessible to parents. Evidence: 1. The provider had a menu inside a folder and did not have it posted for the parents to view or given to parents.

Plan of Correction: I posted on the bulletin board so that the parents can see it.

Standard #: 22VAC40-111-60-B
Description: Based on review and interview, four children's records were not complete. Evidence: 1. Child A, B, C and D did not have written authorization if the child is taken off the premises of the family day home as required by 22 VA 40-111-980 and the provider stated when the weather is better, she takes them to the neighborhood playground.

Plan of Correction: I will ask each parent to sign permission to take them off premises.

Standard #: 22VAC40-111-280
Description: Based on observation, potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates were not be stored away in areas inaccessible to children. Evidence: 1. One bottle of windex cleaner was under the kitchen sink in an unlocked cabinet and was accessible to children. 2. In the bathroom the children use, a container of clorox wipes was under the bathroom sink in an unlocked cabinet and one bottle of febreez deodorizer was on top of the bathroom counter.

Plan of Correction: I moved them to an area inaccessible immediately.

Standard #: 22VAC40-191-40-D-4-a
Description: Based on review, the provider had a person living in the home of the family day home and did not have a Sworn statement or affirmation prior to residing in the home. Evidence: 1. Household member B began living in the home on 03/01/2018 and did not have a Sworn Statement or Affirmation in the provider's records.

Plan of Correction: I will have her fill out the form today and will send the central registry this week and have her get fingerprinted.


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.