VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Humirah Dost
6544 Braddock Road
Alexandria, VA 22312
(703) 909-6259

Current Inspector: Margaret Allworth (703) 209-3521

Inspection Date:

Complaint Related: No

Violations:

Standard #:	22VAC40-111-700-A
Description:	Based on a review of medications, 3 of 4 children's records did not have documentation of written authorization from the parent. Evidence: 1. Child #3's (start date: 1/23/2017) Epi-Pen Jr. and Children's Benadryl had corresponding medication authorization forms that did not contain documentation of parent signatures. 2. Child #5's (start date: 12/12/2016) Children's Benadryl did not contain documentation of a corresponding medication authorization form.
Plan of Correction:	We will have the parents sign today, and have the other parents contact the doctor and send us the forms as soon as possible.
Standard #:	22VAC40-111-700-C
Description:	Based on a review of medications, 1 of 4 medications had an expired medication authorization, and the family day home provider did not ensure that the medication was picked up within 14 days or that the authorization was renewed by the parent. Evidence: Child #5's (start date: 12/12/2016) Epi-Pen Jr. had a medication authorization form that expired 7/3/2018.
Plan of Correction:	We will have the parents contact the doctor and send us the forms as soon as possible.
Standard #:	22VAC40-111-830-A
Description:	Based on record review, the family day home did not ensure that emergency evacuation procedures were practiced monthly. Evidence: There was no documentation of a fire drill completed in December 2018.
Plan of Correction:	We will make sure to immediately note drills after they're practiced every month.
Standard #:	22VAC40-111-180-A
Description:	Based on record review, 3 of 3 caregiver and household member records did not contain documentation of a current report of tuberculosis screening form. Evidence: 1. Caregiver A's most recent documented TB was dated 10/3/2016 (expired 10/3/2018). 2. Caregiver B's (date of hire: 1/23/2017) most recent documented TB was dated 10/13/2016 (expired 10/13/2018). 3. Household member A's most recent documented TB was dated 10/27/2016 (expired 10/27/2018).
Plan of Correction:	We will get TB done as soon as possible.
Standard #:	22VAC40-111-240-A
Description:	Based on observation, areas and furnishings of the family day home were not maintained in a clean, safe, and operable condition. Evidence: A children's push toy in the outdoor play area had a broken steering wheel.
Plan of Correction:	The broken item was disposed of during inspection.
Standard #:	22VAC40-111-280
Description:	Based on observation, the family day home did not ensure that potentially poisonous substances, materials and supplies were stored away from food in areas inaccessible to children. Evidence: A container of hand sanitizer, and a plastic bin full of spray paints were sitting outside on the step in the children's outdoor play area.
Plan of Correction:	Items were moved out of reach of children during inspection. Moving forward, we will make sure they are always out of reach of children.
Standard #:	22VAC40-111-330-A
Description:	Based on observation, the family day home did not ensure that a landline telephone was available, operable, and accessible during the family day home's hours of operation. Evidence: There was no landline telephone available.
Plan of Correction:	We will purchase a new one.