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Hayat Khalifa
42065 Foley Headwaters Street
Aldie, VA 20105
(703) 793-0605

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: Dec. 20, 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

Technical Assistance:
Discussed maintaining all documents in the records as required by the licensing standards.

Comments:
An unannounced monitoring inspection was conducted on 12/12/20 between the hours of 10:45 am through 1:45pm with the provide on site. There were 13 children (35points) with the provider and two caregivers present. A sample of 5 children's files and 5 caregiver/household member's files were reviewed. The children were observed eating lunch, playing with toys, singing, and during naptime. The physical space, emergency supplies, evacuation drills, attendance records, and the Emergency Preparedness Plan 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 #: 22VAC40-111-800-B
Description: Based on record review, the provider did not review the emergency plan at least annually and document in writing each review and update to the emergency plan.

Evidence: The most recent documented update of the Emergency Preparedness and Response plan was dated 8/13/18.

Plan of Correction: Corrected during inspection.

Standard #: 22VAC40-111-120-B
Description: Based on record review, 2 of 3 caregiver records did not contain all required information.

Evidence:
1. The record for Caregiver #1 did not contain verification of age.
2. The record for Caregiver #2 did not contain date of employment.

Plan of Correction: I will update the records.

Standard #: 22VAC40-111-40-A
Description: Based on observation and provider interview, the provider did not ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home.

Evidence:
Upon arrival at the family day home, there were 13 children present. The family day home license permits a capacity of 12 children. The provider acknowledged being over capacity and stated that on the morning of this inspection, a parent brought a child who normally only attends in the afternoon once another child leaves.

Plan of Correction: I will not allow more than 12 children at a time.

Standard #: 22VAC40-111-50-E
Description: Based on record review and caregiver interview, records and reports on children were not maintained and made accessible to the department's representative for two years from the date of termination of services for 2 of 5 children.

Evidence:
1. Child #2 began attending the family day home on 5/16/18. The first documentation of immunizations in the record for Child #2 were dated 5/30/19.
2. Child #3 began attending the family day home on 9/4/18. The first documentation of immunizations in the record for Child #3 were dated 6/5/19.
3. The provider stated once immunization records were updated, the provider was removing the previous immunization documents from the file.

Plan of Correction: I will not take the immunizations out of the file.

Standard #: 22VAC40-111-60-B
Description: Based on record review, 3 of 5 records did not contain all required information.

Evidence:
1.The records for Child #1 and Child #3 did not contain the telephone number for the father's place of employment.
2. The record for Child #2 did not contain the address and telephone number of each parent's place of employment. The record for Child #2 did not contain the policy number of the child's medical insurance.

Plan of Correction: I will get the information from the parents.

Standard #: 22VAC40-111-230-A
Description: Based on record review, the provider did not maintain written documentation of one caregiver's orientation training.

Evidence: The record for Caregiver #2 did not contain documentation of orientation training.

Plan of Correction: I will update the record.

Standard #: 22VAC40-191-40-D-4-a
Description: Based on record review, the family day home did not obtain a sworn statement of affirmation when a person in the home becomes 18 years old.

Evidence:
Household Member #1 turned 18 years old on 5/5/19. Documentation of a sworn statement of affirmation was not available for review during this inspection.

Plan of Correction: I will have them complete a sworn statement.

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.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.

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