VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Marzieh Mirzasalehi
43101 Gatwick Squar
Ashburn, VA 20147
(703) 726-2501

Current Inspector: Derek Acosta (703) 554-4995

Inspection Date: Jan. 14, 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

Comments:

An announced monitoring inspection was conducted January 14 2020 between 10:00am and 11:45am. There were 3 day care children in the direct care of the provider and an assistant. The provider's child was present. Children were observed playing, being diapered, washing hands, and eating. Areas of non-compliance are listed on the violation notice. If you have any questions about this inspection please contact me at 703-554-4995 or at derek.acosta@dss.virginia.gov

Violations:

Standard #:	22VAC40-111-760-A-1
Description:	Based on observation, the provider did not have a complete first aid kit that contained all of the required items. Evidence: The first aid kit did not contain 2 triangular bandages, tweezers, and a pair of scissors.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-800-A
Description:	Based on observation, the provider does not have a written emergency and response plan. Evidence: The provider stated that she has the document, but has not filled it out yet.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-70-A
Description:	Based on observation, the provider did not obtain required parental documents prior to children's first day in care. Evidence: Child #1, Child #2, and Child #3 records do not have the day care liability insurance form, the medication administration form, and emergency preparedness form.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-191-40-C-1-a
Description:	Based on record review, the provider did not have a sworn statement or affirmation able to be reviewed at the time of the initial inspection. Evidence: Provider stated that she had sent the form to Office of Background Investigations with the Central Registry Search
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-191-40-C-1-c
Description:	Based on record review, the provider did not have a sworn statement or affirmation able to be reviewed for household member #1 at the time of the initial inspection. Evidence: Provider stated that she had sent the form Household Member #1 completed to Office of Background Investigations with the Central Registry Search
Plan of Correction:	Not available online. Contact Inspector for more information.