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Ms. Cynthia Holmes
26070 Old Office Road
Culpeper, VA 22701
(540) 854-8939

Current Inspector: Michelle W. Argenbright (540) 848-4123

Inspection Date: April 23, 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
22VAC40-111 Transportation
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 caregiver annual training and children's immunization records. The risk assessments for violations were provided. It is important that you check your email for the results of the fingerprint background checks, print the results, and place the information in your records. If you have any concerns, call the office of background investigations in Richmond. We talked about sources for training such as online courses. Also, we reviewed the ways you can document the annual review and training for the emergency response plan.

Thank you for your assistance during today's unannounced inspection, conducted in conjunction with a subsidy vendor inspection, from 11:15 PM to 3:25 PM. Today, there were four children in care during the day with one resident child, ages infancy through four years (seventeen points) with two caregivers. Five school age children received care before and after school. I viewed activities, daily routines, staffing, supervision, interactions with children, equipment, diapering procedures, lunch, menu, five records for children, four records for caregivers and residents, caregiver training, emergency supplies and drill records, emergency planning, posted information, menu, hand washing routines, indoor and outdoor areas. The provider read to children who were laying on their mats at the start of rest time. The children went outside to play after nap time. The infants were provided comfort, regular feedings and needed attention. We reviewed your procedures for transportation to area parks and for local outings. Let me know if you need any assistance. 540/430-9259

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 that child 3 obtained the required immunizations prior to initial attendance. Evidence: Child 3 was present for care and the first date of attendance written in the record was April 9, 2018. The provider indicated that the immunization record was requested from the parent and not provided. There were no medical reports in the record.

Plan of Correction: The provider will request and obtain a copy of the immunization report from the parent. The provider will tell parents of new children that the immunization record is required by the first day.

Standard #: 22VAC40-111-90-C
Description: Based on a review of five records for children, and an interview with the provider, the provider failed to obtain documentation of additional immunization records by every six months for children under the age of two years. Evidence: Child 2 will not be two years old until August 2019 and the last immunization report was from September 28, 2017. Child 5 will not be two years old until June 2018 and the last immunization report was from September 19, 2017.

Plan of Correction: The provider will ask the parent to provide another immunization record from the doctor's office. The provider will use a way to remind herself about asking for another immunization report when children are under age two.

Standard #: 22VAC40-111-210-A
Description: Based on a review of documented annual training for caregiver 1 and 2, and an interview with the provider, the caregivers did not obtain a minimum of sixteen clock hours of training in addition to first aid and CPR. Evidence: Caregiver 1 had only ten hours of documented training from February 2017 to 2018. Caregiver 2 completed eleven hours and thirty minutes of training by April 13, 2018.

Plan of Correction: The caregivers will locate online courses to take during the year to complete sixteen hours of annual training. The provider will keep track of the completed training and due dates.


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.