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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: April 10, 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 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.

Technical Assistance:
We discussed the requirements for staffing, and caregiver/resident records. The risk assessments for violations were provided. We talked about the requirements for annual reviews and updates for the emergency plans and children's records due later this year. Also, we talked about your plans for annual training.

Comments:
Today, an unannounced renewal inspection was conducted from11:30 AM to 5:00 PM. Today, there were ten nonresidential children and one resident child in care (ages infancy through four years/35 points) with two to three caregivers. Two school age children attended after school. I viewed activities, equipment, daily routines, diapering procedures, staffing, supervision, interactions with children, menu/snack, posted information, emergency planning and drill records, pet record, five records for children, five records for caregivers/residents, caregiver training, indoor and outdoor areas. There has not been any medication for children. The children were provided close supervision during nap time. The caregivers were observed responding promptly to infants' needs for care and comfort. A variety of toys were available for play time. Hand washing routines were adhered to. A representative with infant and toddler connection has been visiting to provide training and assist the caregivers with quality improvements.

A renewed license will be recommended. Let me know if you need any assistance. 540/430-9259

Violations:
Standard #: 22VAC40-111-120-B
Description: Based on a review of five records for caregivers and residents, and an interview with the provider, there was required information missing from the records of caregiver/resident 3 and caregiver 4. Evidence: The original central registry check for caregiver/resident 3 was not maintained in the record. The provider showed the inspector the date of payment for the request of the central registry check in August 2017. The central registry findings were not available that were due within thirty days in September 2017. The provider indicated that the background check was misplaced in the home and another one was requested after searching for the original.
There was only one documented reference check in the file of caregiver 4 who began work on February 8, 2018.

Plan of Correction: A second central registry check was completed for caregiver/resident 3 on March 30, 2018. The provider called the Richmond agency during the inspection to inquire about findings from the original background check for 2017. If the information from the original report is obtained, it will be placed in the file. The provider will make sure all information received by mail is placed with the caregiver files. The provider immediately contacted caregiver 4 and asked for a copy of the second reference that she was told was previously obtained. Caregiver 4 emailed a copy of the second reference check. In the future, the provider will make sure at least two reference checks are obtained at the time of hire.

Standard #: 22VAC40-111-170-A
Description: Based on a review of five records for caregivers/residents, and an interview with the provider, the provider did not obtain a tuberculosis screening and statement from caregiver 2 before contact with children. Evidence: Caregiver 2 began work on February 26, 2018 and the TB statement was completed on March 12, 2018. The provider indicated that the caregiver waited for an appointment with the local health department.

Plan of Correction: If an appointment with the local health department is not available before initial employment, the provider will request a caregiver to obtain a TB screening and statement from a different health care provider.

Standard #: 22VAC40-111-230-A
Description: Based on a review of five records for caregivers/residents, and an interview with the provider, the provider did not maintain a copy of the first aid and CPR certificate in the record of caregiver 4. Evidence: There was not a copy of the card in the file. The provider indicated that caregiver 4 completed a course on March 10, 2018 at the same time as caregiver 2 and resident/caregiver 3. Also, the provider said that caregiver 4 asked for her original card and a copy was not made for the record.

Plan of Correction: The provider sent a message to caregiver 4 and asked her to email a copy of the first aid/CPR certificate. The information will be maintained in the record.

Standard #: 22VAC40-111-570-A
Description: Based on observation of the children and caregivers present, and a determination of the ages and points per caregiver after arrival at 11:30 AM, the provider did not ensure that each caregiver did not exceed sixteen points for meeting staffing ratios for just over forty minutes. Evidence: Upon arrival, there were ten children in care and one resident three year old present with the provider and an assistant. The children observed were six infants (4 points each), one toddler (3 points each), and four preschool age children (2 points each). The provider indicated that the second regular assistant was home with a sick child. Also, the substitute assistant, a resident adult, went to a school to pick up a sick child. When asked, the provider indicated there were thirty five points and this was confirmed by reviewing the attendance sheet and ages of the children present. The substitute assistant returned at 12:10 and was determined to be gone for between forty and forty-five minutes.

Plan of Correction: The provider has two possible back-up caregivers in mind to ask to work in the event two assistant caregivers are needed and two of the regular caregivers are not available for any amount of time such as due to illness. If an additional substitute caregiver is hired, all required records will be obtained.

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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