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Farhana Ahmed
3120 South 13th Street
Arlington, VA 22204
(703) 271-0139

Current Inspector: Pernille Brandt (703) 203-8659

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 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
Please provide documentation that the CPS check for HHM was submitted within 10 days of receipt of the visit notes.

An unannounced monitoring visit was conducted from 9:00-10:30. Two caregivers were present with five day care children for eighteen points which is within ratios for supervision. Observed infant care, infants sleeping and free play. Reviewed physical space, records, emergency preparation, trainings and diapering area. Areas of non-compliance are identified in the violation notice. If you have any questions regarding the inspection, please feel free to contact me.
Thank you
Ann Dramstad
Licensing Inspector

Standard #: 22VAC40-111-60-B
Description: Based on record review, one of two children's records did not contain all required information.
Child #1 is missing a complete second emergency contact.

Plan of Correction: Requested information from parert

Standard #: 22VAC40-111-70-A
Description: Based on record review, one of two children's record did not have documentation that the parent had received in writing the required "Information For Parents" form that has policies and procedures for the Family Day Home.
Child #1 was missing a signed acknowledgement of the "Information For Parents" form, the signed liability form, the second page of the medication policy with signatures and the signed provision of relocation form.

Plan of Correction: Missing information was completed and parent has signed the forms.

Standard #: 22VAC40-111-510-C
Description: Based on observation, occupied cribs were less than 12 inches apart.
Three cribs were occupied in the sleeping area and were side to side with only an inch or two between each crib.

Plan of Correction: Changed the crib set-up to allow 12 inches between cribs.

Standard #: 22VAC40-191-40-D-5-a
Description: Based on provider statement, a household member (HHM) who has turned 14 years of age does not have a Central Registry Search.
HHM #1 turned 14 years of age in April 2019 and did not obtain a CPS form within 30 days of becoming 14 years of age.

Plan of Correction: A CPS form will be submitted within 10 days.


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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