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Farzana Khan
43841 Laurel Ridge Drive
Ashburn, VA 20147
(703) 723-2957

Current Inspector: Eureka Nance (703) 638-5968

Inspection Date: Jan. 6, 2020

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
63.2 Child abuse and neglect
63.2 Licensure and Registration Procedures

Technical Assistance:
Discussion on staff and household records.

Discussed documents required for the renewal application.

An unannounced monitoring inspection was conducted today approximately 10:00 am-2:00 pm. There were 10 children (27 points) supervised by 3 direct care staff. The physical plant, 3 staff records, 1 household record, 6 children?s records, children's nutrition, supplies, evacuation drills, injury reports, emergency supplies, and policies were inspected. Medications were not on-site today. The playground and surfacing were inspected. The children were observed in free play in center activities, group time, lunch, and napping. Hand washing was observed during the inspection. There were age appropriate materials for all children. Staff-to-child ratios were in compliance.

If you have any questions regarding this inspection, please call or send an email.

Eureka Nance, Licensing Inspector

Standard #: 22VAC40-111-100-A
Description: Based upon review of 1 out of 7 children records, the provider did not obtained documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance.
1. Child #1 (D.O.E. 9/16/19), physical examination results were not available in the child?s record.
2. The provider verified that she had not received physical examination from parent for Child #1.

Plan of Correction: Will give parent today.

Standard #: 22VAC40-111-60-A
Description: Based on children's record review, 3 out 7 records reviewed did not have the required information.
Evidence: Child #1, #5, and #7 record did not have documented of address of designated persons to contact in case of an emergency if the parent cannot be reached.

Plan of Correction: Will give to parents today.

Standard #: 22VAC40-111-170-A
Description: Based on household records review, the provider did not obtain from each adult household member prior to coming into contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.
Evidence: 1. Household #2 and #3, did not have documentation available for review in record of a current Report of Tuberculosis Screening.

Plan of Correction: Will complete as soon possible.

Standard #: 22VAC40-111-210-A
Description: Based on staff records review, 2 out 2 records, the provider did not maintain that caregivers obtained 16 clock hours of training annually.
Evidence: Staff #1 completed 5.5 hours of annually training.
Staff #2 completed 12 hours of annual training.

Plan of Correction: Will take additional training to complete hours.

Standard #: 22VAC40-191-40-C-1-c
Description: Based on household records review, 2 of 3 records reviewed did not have sworn statement or affirmation, search of central registry.
Evidence: Household #2 and #3 records does not have documentation of a sworn statement or affirmation and search of central registry.

Plan of Correction: Will complete as soon as possible

Standard #: 63.2-1721.1-B-2
Description: Based on household records review, 2 out 3 records, the provider did not ensure household members submitted to fingerprinting.
Evidence: Household #2 and #3 did not have initial fingerprint checks.

Plan of Correction: Will complete as soon as possible.


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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