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Brenda Arevalo
25791 Rawley Springs Drive
Chantilly, VA 20152
(703) 402-6431

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: Sept. 24, 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
22VAC40-191 Background Checks for Child Welfare Agencies
63.2 Licensure and Registration Procedures

Technical Assistance:
Discussed paperwork required for children and caregivers prior to start date.

Comments:
An unannounced monitoring inspection was conducted on 09/24/2019 between the hours of 11 am through 2pm with the provider on site. There were 11 children present (29 points) with the provider and one assistant caregiver. A sample of 5 children's files and 3 caregiver's files were reviewed. The children were engaged in the following: free play and nap time. The physical space, evacuation drills, and attendance records were reviewed. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at jessica.willis@dss.virginia.gov or 571-352-1453.

Violations:
Standard #: 22VAC40-111-790
Description: Based on observation, required telephone numbers were not posted in the family day home.

Evidence:
The provider has not posted 911 and the poison control phone number in the family day home.

Plan of Correction: It was posted on my old refrigerator but I had it replaced. I will post them today on my refrigerator.

Standard #: 22VAC40-111-100-A
Description: Based on review of records, the caregiver did not obtain documentation of a physical examination within 30 days after the first day of attendance.

Evidence:
The record for Child #3 (start date 01/07/2019) did not contain documentation of a physical examination within 30 days.

Plan of Correction: I will ask the parent today to send it to me.

Standard #: 22VAC40-111-120-B
Description: Based on review of records, the record for each caregiver did not contain the required information.

Evidence:
1. The records for Caregiver #2(start date 07/22/2019) and Caregiver #3 (start date 09/23/2019) did not contain documentation that two or more references as to character and reputation as well as competency were checked before employment.
2. The records for Caregiver #2 and Caregiver #3 did not contain documentation of name, address, and telephone number of a person to be notified in an emergency.
3. The record for Caregiver #3 did not contain documentation of verification of age.

Plan of Correction: I will update their files.

Standard #: 22VAC40-111-90-C
Description: Based on review of records, the family day home did not obtain documentation of additional immunizations once every six months for one child under the age of two years.

Evidence:
The record for Child #1 (age 23 months) contained documentation of immunizations dated 01/02/2019.

Plan of Correction: I will ask the parent today to bring them as soon as possible.

Standard #: 22VAC40-111-200-A
Description: Based on review of records, one caregiver record did not have documentation of having completed orientation training by the end of their first week of assuming job responsibilities.

Evidence:
The record for Caregiver #2 (start date 07/22/2019) did not contain documentation of orientation training within their first week of employment.

Plan of Correction: I will do the orientation tomorrow.

Standard #: 22VAC40-111-340-C
Description: Based on observation, there was no toilet tissue contained within the bathroom of the family day home.

Evidence: The bathroom used by children in the family day home did not contain toilet tissue.

Plan of Correction: Corrected during inspection.

Standard #: 63.2-1720.1-B-2
Description: Based on review of records, one caregiver did not submit to fingerprinting prior to their first day of employment.

Evidence:
Caregiver #3 began employment on 9/23/2019. Documentation of a completed fingerprint check for Caregiver #3 was not available during the inspection. Provider acknowledged documentation was missing and stated she asked Caregiver #3 to assist today so that she would not be out of ratio.

Plan of Correction: I will make the appointment today for her to go get her fingerprints.

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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