VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Sherry Nazeri
18429 Mill Run Ct.
Leesburg, VA 20176
(703) 989-8826

Current Inspector: Derek Acosta (703) 554-4995

Inspection Date: Nov. 13, 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 22VAC40-191 Background Checks for Child Welfare Agencies 54.1-3408 Provider must be MAT certified to administer prescription medication.

Comments:

An unannounced monitoring inspection was completed today. The physical plant, 5 caregiver/household member files, 4 children's files, caregiver training, child nutrition, children's activities, emergency procedures, drills and supplies were inspected between 1-3:15pm. There were 4 children, totaling 13 points, under the supervision of 2 caregivers. During the inspection, children were observed enjoying free play, resting at nap time and being fed a bottle(infant) and eating afternoon snack. The interactions between the children and caregivers were seen to be positive and constructive in nature. Today, the children were served pasta, ground beef, potatoes, berries, apples, pears, and milk. The Provider is not currently certified in MAT (medication administration training). Should you have any questions, please contact me at mary.wizbicki@dss.virginia.gov.

Violations:

Standard #:	22VAC40-111-920
Description:	Based on observations, the menu for the current one-week period was not accurate. Evidence 1. According to the posted menu, the children were served pasta, ground beef, potatoes and milk today for lunch. However, the Provider stated that the children were also served berries, apples and pears but it was not listed on the menu.
Plan of Correction:	The Provider will make sure the menu is accurate.
Standard #:	22VAC40-111-100-A
Description:	Based on file review, 1 out of 4 children's records does not have documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence 1. Child #3 began care on 3/12/18. There is no physical on file.
Plan of Correction:	The Provider will ask the parents for this.
Standard #:	22VAC40-111-120-B
Description:	Based on file review, 2 out of 3 assistants do not have all required information on file. Evidence 1. Caregiver/household member #3 does not have the name address and telephone number of a person to be notified in an emergency. 2. Caregiver/household member #5 does not have the name address and telephone number of a person to be notified in an emergency documentation that two or more references as to character and reputation as well as competency were checked before employment began.
Plan of Correction:	The Provider will get this information.
Standard #:	22VAC40-111-60-A
Description:	Based on file review, 1 out of 4 children's records has not been updated annually. Evidence 1. Child #1's record was last updated on 9/7/17.
Plan of Correction:	The Provider will have this updated.
Standard #:	22VAC40-111-60-B
Description:	Based on file review, 1 out of 4 children's records do not have all required information. Evidence 1. Child #1 does not have the address for a second contact in case the parent cannot be reached.
Plan of Correction:	The Provider will get this information.
Standard #:	22VAC40-111-90-C
Description:	Based on file review, 1 out of 4 children's records does not have updated immunization records every six months up to the age of 2 years. Evidence 1. Child #1 is 16 months old. The most recent immunization record on file was completed when the child was 4 months old.
Plan of Correction:	The Provider will ask the parents for this.
Standard #:	22VAC40-111-180-A
Description:	Based on file review, 3 out of 5 caregiver/household members do not have a TB test/screening completed within the past two years. Evidence 1. Caregiver/household member #1's most recent TB test/screening was completed on 10/26/16. 2. Caregiver/household member #2's most recent TB test/screening was completed on 10/25/16. 3. Caregiver/household member #4's most recent TB test/screening was completed on 10/25/16.
Plan of Correction:	These will be completed again.
Standard #:	22VAC40-111-220-A
Description:	Based on file review, a medication was administered to a child by a caregiver who was not certified to administer medications. Evidence 1. Child #1 was given Tylenol on 9/19 at 1pm and 5pm by a caregiver who is not currently certified to administer medications.
Plan of Correction:	No medication will be given to children, unless a caregiver is certified to administer medications.
Standard #:	22VAC40-111-230-A
Description:	Based on file review, 1 caregiver does not have written documentation of orientation training. Evidence 1. Caregiver/household member #5 does not have documentation of having received orientation training.
Plan of Correction:	This will be completed and kept on file.
Standard #:	22VAC40-191-40-D-1-b
Description:	Based on file review, 1 out of 5 caregiver/household members does not have a completed sworn disclosure statement (SDS) prior to the first day of employment. Evidence 1. Caregiver/household member #5, who was present today, does not have a completed SDS.
Plan of Correction:	This will be completed.