VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jhoana Cuellar
6104 Dinwiddie Street
Springfield, VA 22150
(571) 243-5278

Current Inspector: Derek Acosta (703) 554-4995

Inspection Date: Aug. 1, 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 Emergencies 22VAC40-111 Nutrition 22VAC40-111 Transportation 22VAC40-80 THE LICENSE. 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

Comments:

An unannounced monitoring inspection was conducted from 10:00am-12:30pm. There were 11 children (1 child was the Provider's son) at the start of the inspection for a total of 28 points. One additional child arrived about an hour and a half after the inspection began, making the total 12 children and 29 points with two caregivers. A sample size of 5 children's records, 3 caregiver/household member records, the home, emergency materials, and the attendance were reviewed. The children were observed having circle time in English and in Spanish, singing songs, naming parts of the face, washing hands, and eating their lunch. If you have any questions, please contact me at shahana.green@dss.virginia.gov .

Violations:

Standard #:	22VAC40-111-60-B
Description:	Based on a review of children's records, 2 out of 5 children's records reviewed were not complete. Evidence: 1. Child #3 (start date: 5/20/2019) was missing documentation of a physical examination. 2. Child #5 (start date: 5/08/2017) was missing documentation of immunizations, documentation of a physical examination, full contact information (name, phone number, and address) for 1 of 2 required emergency contacts, as well as the address for the one emergency contact listed.
Plan of Correction:	We will get this information from the parents as soon as possible.
Standard #:	22VAC40-111-180-A
Description:	Based on a review of records, each caregiver and household member does not have a current report of tuberculosis screening. Evidence: 1. Caregiver #1's last tuberculosis screening is dated 11/3/2016. 2. Household Member #1's last tuberculosis screening is dated 12/1/2016.
Plan of Correction:	We will get updated TB screenings by this Friday.
Standard #:	22VAC40-111-570-A
Description:	Based on observation, the Provider did not ensure that the family day home did not exceed 16 points with out an additional caregiver. Evidence: 1. Caregiver #2 was observed as being the only Caregiver caring for the 11 children (28 points) for approximately 10 minutes until Caregiver #1 arrived.
Plan of Correction:	We will make sure that we have a back-up assistant with full paperwork in case we need to step out.
Standard #:	22VAC40-111-690-D
Description:	Based on observation, the changing table surface is not non absorbent. Evidence: 1. The changing pad has 4 areas in which there are tears in the surface, making the surface non absorbent.
Plan of Correction:	We will get a new changing pad.