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Carmen Guzman
25324 Fairbanks Place
South riding, VA 20152
(703) 217-0158

Current Inspector: Whitney Mcgrath (571) 835-4717

Inspection Date: Oct. 25, 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

Technical Assistance:
Licensing Inspector (LI) had a discussion with the provider about leaving the family day home. When the provider leaves the home for any purpose and a second caregiver is required due to points, the second caregiver must have a record including but not limited to, documentation of orientation, health and safety trainings as well as all background checks. This discussion had already taken place at the provider's last inspection on 3/14/2019.

Child #5's emergency medication has expired and will need to be replaced as soon as possible in case of an accidental exposure to an allergen.

The next anticipated inspection will be the provider?s renewal inspection. Provider was reminded to have all renewal application documents completed and sent into licensing office 45 days prior to expiration for processing. The renewal application is available on the VDSS website.

Today an unannounced Monitoring inspection took place between 9:20am and 11:20am. There were 10 children present with the provider and 2 assistant for a total of 26 points within the supervision guidelines. The provider was not home at the start of the inspection; the children were observed watching a television show, playing with blocks and singing songs. Hand washing procedures were observed prior to the children eating a morning snack. A complete inspection of the physical plant, children and staff records, fire drill log, menu, attendance and emergency procedures were observed during this inspection. There were three medications and authorizations reviewed today. Thank you for your cooperation. If you have any questions, please email me at

Standard #: 22VAC40-111-700-B
Description: Based on record review, a parents written authorization for medication was not renewed after 10 working days.
Evidence: Child #3's medication authorization was signed by the parents on 10/3/2019. The form has expired and was not renewed.

Plan of Correction: I'll talk to the parents tonight to see if they want to keep the medicine here or if they want to take it home. If they keep it here they can fill out a new authorization.

Standard #: 22VAC40-111-120-B
Description: Based on record review, assistant's files did not contain all required information.
Evidence: Caregiver #3's file did not contain documentation of date of employment, verification of age, name address and phone number of an emergency contact or two reference checks.

Plan of Correction: I'll definitely get it done.

Standard #: 22VAC40-111-170-A
Description: Based on observation and interview, the provider did not obtain from each caregiver a report of Tuberculosis (TB) screening prior to coming into contact with children.
Evidence: Caregiver #3 was observed working with the children during today's inspection. The provider has confirmed that she has not obtained a TB screening from caregiver #3.

Plan of Correction: She'll get this done on Saturday.

Standard #: 22VAC40-111-220-A
Description: Based on a review of medications and interview, children with emergency medication were not always in care of a caregiver who has satisfactorily completed a training program to safely perform medication administration.
Evidence: Child #3 and Child #5 both have emergency medication kept at the family day home. The provider is the only caregiver trained to safely administer medication. Child #3 and Child #5 were both observed in care at the start of today's inspection; the provider was not home.

Plan of Correction: I'll talk to one of the other provider's about getting MAT trained.


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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