VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Valeria Delgadillo
7404 Gary Street
Springfield, VA 22150
(571) 201-2938

Current Inspector: Stephanie Salvatori (571) 389-0980

Inspection Date: May 22, 2019

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 22VAC40-111 Nighttime Care 22VAC40-191 Background Checks for Child Welfare Agencies 54.1-3408 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs

Technical Assistance:

Licensing inspector discussed child abuse and neglect training and required posting of documents with provider.

Comments:

An unannounced monitoring inspection was conducted today from approximately 12:30-2:10pm. There were 7 children (16 points) in the direct care and supervision of 2 caregivers. A sample of 4 children's records and 2 caregivers records were reviewed. The children were observed eating lunch, washing hands, and napping. The provider will be running a summer camp this summer. One new caregiver has been hired since the last inspection. Areas of non-compliance are identified in this report. The exit interview was conducted with the provider. If you have any questions, contact Kimberly.Sawyer@dss.virginia.gov.

Violations:

Standard #:	22VAC40-111-800-B
Description:	Based on record review, the provider did not review and update the emergency plan at least annually. Evidence: The emergency plan was last updated 09/15/2017.
Plan of Correction:	Corrected during inspection
Standard #:	22VAC40-111-830-C
Description:	Based on interview and record review, emergency evacuation procedures were not documented. Evidence: 1. The emergency evacuation procedures for October 2018, March 2019 and April 2019 were not documented. 2. Caregiver A stated she forgot to document them.
Plan of Correction:	I always do it on the 11th.
Standard #:	22VAC40-111-120-B
Description:	Based on record review, the assistants' record was incomplete. Evidence: The record of Assistant A was missing the following required information: 1. Job Title; 2. Employment Date; 3. Age Verification; 4. Emergency Contact.
Plan of Correction:	I will complete the documents within two weeks.
Standard #:	22VAC40-111-60-B
Description:	Based on record review, children's records were incomplete. Evidence: 3 of 4 children's records reviewed were incomplete. 1. Child A was missing the employer phone number of both parents, the address of 1 of 2 required emergency contacts and medication authorization form. 2. Child B was missing the liability insurance statement. 3. Child C was missing the address of 1 of 2 required emergency contacts.
Plan of Correction:	I will contact the parents and have them get those ready for me.
Standard #:	22VAC40-111-200-A
Description:	Based on record review, the provider did not orient the assistant by the end of their first work week. Evidence: Assistant A did not have documentation of orientation on file.
Plan of Correction:	I will complete the documents within two weeks.