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Amena Sultana
5213 Juliet Street
Springfield, VA 22151
(703) 354-2286

Current Inspector: Mary J. Wizbicki (703) 479-4707

Inspection Date: Dec. 6, 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
22VAC40-191 Background Checks for Child Welfare Agencies
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs

Technical Assistance:
Reviewed the DSS sample forms to be used. Once the fingerprints have been completed and reviewed by the LI, the license will be issued.

Comments:
An announced initial inspection was completed today. The physical plant, 3 caregiver/household member files, 4 children's files, caregiver training, child nutrition, children's activities, emergency procedures, drills and supplies were inspected between 11:15am-12:45pm There were 4 children, totaling 15 points, under the supervision of the Provider. Today, the children played with puzzles, listened to storytime, enjoyed free play and rested at nap time. The interactions between the children and caregivers were seen to be positive and constructive in nature. Today, the children were served spaghetti with ground beef and tomato sauce, bananas 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 #: 22VAC40-111-760-A-1
Description: Based on observations, the first aid kit did not include all required items. Evidence 1. The first aid kit does not have 2 triangular bandages.

Plan of Correction: The Provider will buy these.

Standard #: 22VAC40-111-920
Description: Based on observations, the menu did not list any substituted foods. Evidence 1. Today's menu had the following being served to the children "ground beef, spaghetti noodles, tomato sauce, broccoli and milk". However, instead of being served broccoli, the children were given bananas.

Plan of Correction: The Provider will make changes to the menu (if needed).

Standard #: 22VAC40-111-100-A
Description: Based on file review, 3 out of 4 children's records do not have documentation of a physical examination. Evidence 1. Children #1, #2 and #4 do not have physical examinations on file.

Plan of Correction: The Provider will ask the parents for these.

Standard #: 22VAC40-111-50-A
Description: Based on interview, the Provider does not have a daily record of children in attendance. Evidence 1. The Provider completes a daily report for the children, but does not keep a record of children in care each day.

Plan of Correction: The Provider will keep attendance daily

Standard #: 22VAC40-111-60-B
Description: Based on file review, 4 out of 4 children's records do not have all required information. Evidence 1. Children #1-#4 do not have the name, address and telephone number of each custodial parent's place of employment. 2. Children #1 and #2 do not have the name, office address and telephone number of the child's physician. 3. Children #1-4 do not have the name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached. 4. Children #1-4 do not have the name and policy number of each child's medical insurance. 5. Children #1-4 do not have documentation of their first day of receiving care at the FDH.

Plan of Correction: The Provider will give the parents the DSS sample forms to complete.

Standard #: 22VAC40-111-70-A
Description: Based on file review, 4 out of 4 children's parents were not provided in writing all required information. Evidence 1. Children #1-4 do not have "Information for Parents", "Medication Policy" and "Liabiliity Insurance Statement" forms on file.

Plan of Correction: These will be printed and given to the parents to review and sign.

Standard #: 22VAC40-111-90-C
Description: Based on file review, 2 out of 4 children's records do not have additional immunizations every six months up to the age of 2 years. Evidence 1. Child #2 is 13 months old. The most recent immunization record on file was completed when the child was 6 months old. 2. Child #4 is 12 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 these.

Standard #: 63.2-1721.1-B-2
Description: Based on file review and interview, it was determined that 3 out of 3 caregiver/household adult members have not completed fingerprints checks. Evidence 1. Caregiver/household members #1-3 have not had a fingerprint check completed.

Plan of Correction: The Provider will follow the instructions that were emailed by the department to have this completed,

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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