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Dina Revollo
6526 Roosevelt Street
Falls church, VA 22043
(703) 241-3827

Current Inspector: Anansa Archer-Hicks (703) 268-3295

Inspection Date:

Complaint Related: No

Violations:
Standard #: 22VAC40-111-60-B
Description: Based on a review of children's records, 1 of 4 children's records did not contain documentation of all of the required documentation. Evidence: Child #3's (start date: 11/24/2018) record did not contain documentation of a completed physical form signed by a physician.

Plan of Correction: I will ask the parents to bring the physical today.

Standard #: 22VAC40-111-170-A
Description: Based on a review of household member records, 1 of 3 household member records did not contain documentation of a current report of TB screening form. Evidence: Household member A's record did not contain documentation of a current report of TB screening form.

Plan of Correction: They will go get their TB tests completed tomorrow.

Standard #: 22VAC40-111-180-A
Description: Based on a review of household member records, 1 of 3 household member records did not contain documentation of a current report of TB screening form every two years from the date of the first screening. Evidence: Household member C's most recent document TB screening was dated 11/9/2016 (expired: 11/9/2018).

Plan of Correction: They will go get their TB tests completed tomorrow.

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.

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