VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tacna De Gallo
21046 Mossy Glen Terrace
Ashburn, VA 20147
(703) 726-0142

Current Inspector: Maria Robles-Lopez (703) 397-3827

Inspection Date: Feb. 10, 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 54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:

Conversation was held on the topics of medication, diapering and household members.

Comments:

An unannounced monitoring visit was conducted today between the hours of approximately 9:00 am through 2:15 pm. There were 5 children (10 points) directly supervised by the provider and an assistant. A sample of 5 children's files and 3 staff/household member's files were reviewed. The children were observed in the following: free toy play, games, singing with the provider, bathroom breaks, hand washing, transition to lunch and lunch. Cribs, the physical space of the care area, emergency supplies, evacuation drills, attendance records, medications and the Emergency Preparedness Plan were reviewed. Areas of non-compliance are identified in the violation notice. If you have any questions regarding this inspection, please contact the Licensing Inspector, Maria Robles at maria.robles-lopez@dss.virginia.gov.

Violations:

Standard #:	22VAC40-111-720-A
Description:	Based on observation and interview, nonprescription medication was not labeled with the child's name. Evidence: 1) A milk of magnesia bottle for Child 3 was not labeled with the child's name. A bottle of cough syrup for Child 4 and Child 5 was not labeled with the children's names. 2) The provider stated to the LI the names of the children to whom the medication was for.
Plan of Correction:	We will label the medication with the children's names.
Standard #:	22VAC40-111-730-A
Description:	Based on observation and interview, medications for children in care were not stored separately from medications for household members and caregivers. Evidence: 1) A box with pills was stored among the children's medication. 2) Staff 2 identified the pills as hers and stated that she stored the medication there so she would not forget to take it.
Plan of Correction:	Corrected during inspection.
Standard #:	22VAC40-111-730-D
Description:	Based on observation and interview, 7 of 7 medications (4 non-prescription and three prescription) were observed on site and not kept in a locked place using a safe locking method that prevents access by children. Evidence - 1. On the date of inspection, seven medications were observed on site. All seven were stored on a high shelf, but were not in a locked place. 2. The Provider stated (during an interview conducted on the date of inspection) that one of the medications was from a child who was no longer in attendance.
Plan of Correction:	We will lock the medication.
Standard #:	22VAC40-111-760-A-1
Description:	Based on review and interview, the first aid kit at the Family Day Home did not contain all of the required items. Evidence: 1) On the date of inspection, two triangular bandages were not available for review. 2) The Provider stated that the first aid kit did not contain triangular bandages.
Plan of Correction:	I will get the triangular bandages.
Standard #:	22VAC40-111-780-B
Description:	Based on record review, 3 out of 5 children files reviewed did not contain a review with the parent of the emergency contact information (as required in 22 VAC 40-111-60 B 2) to ensure that the information was correct at least annually. Evidence - 1. On the date of inspection the following children were without an update within the past year: Child #1 (09/27/2015), Child #2 (05/01/2018), Child #3 (03/21/2018). 2. This information was documented on each child record.
Plan of Correction:	I will ask the parents for the information.
Standard #:	22VAC40-111-830-A
Description:	Based on record review, emergency evacuation procedures were not practiced at least monthly. Evidence: 1) The emergency evacuation drills log for the 2019 year did not have evacuation drills documented for the months of September, October, November and December.
Plan of Correction:	We will make sure that we complete the fire drills monthly.
Standard #:	22VAC40-111-60-B
Description:	Based on record review, it was determined that children's files did not contain all required information. evidence: 1) The record for Child 2, Child 4 and Child 5 did not contain a telephone number of one of the custodial parent's place of employment. 2) The record for Child 2, Child 4 and Child 5 did not contain the policy number of the child's medical insurance. 3) The record for Child 4-5 did not contain name, address and telephone number of an additional designated person to contact in case of an emergency if the parent cannot be reached and the office address and telephone number of the child's physician. 4) The record for Child 2, Child 4 and Child 5 did not contain the first dates of attendance. 5) The record for Child 4-5 did not contain written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately and the results of a health examination for the child.
Plan of Correction:	I will ask the parents for the information.
Standard #:	22VAC40-111-70-A
Description:	Based on record review, it was determined that parents were not provided in writing of required information of the family day home (fdh) before the child's first day of attendance. Evidence: 1) The records for Child 4 (start date 02/03/2020) and Child 5 (start date 02/03/2020) did not contain a signed form with the information of the fdh and the policies for the administration of medications and whether or not there is liability insurance on the fdh operation.
Plan of Correction:	I will ask provide the parents the information.
Standard #:	22VAC40-111-170-A
Description:	Based on record review and interview, the provider did not obtain from each adult household member a current Report of Tuberculosis (Tb) Screening. Evidence: 1) The record for Household member 1 did not contain a Tb screening. 2) The provider stated that she had not obtained a tb screening report for Household member 1.
Plan of Correction:	We will have it completed as soon as possible.
Standard #:	22VAC40-111-210-A
Description:	Based on record review, 1 of 2 staff files indicated that not all staff had achieved a total of 16 hours of annual training. Evidence: 1) On the date of inspection, Staff #2 had a total of 6 hours of training for the year of 2019.
Plan of Correction:	We will make sure to complete the 16 hours of training for this upcoming year.
Standard #:	22VAC40-111-280
Description:	Based on observation and interview, it was determined that two potentially poisonous substances were not stored away in areas inaccessible to children. Evidence: 1) A bottle of dish washing detergent was observed on the sink in the bathroom of the child care area. 2) A bottle of bleach cleaner was stored in an unlocked cabinet under the sink in the bathroom of the child care area.
Plan of Correction:	We will move the dish soap and lock the cabinet.
Standard #:	22VAC40-111-320-I
Description:	Based on observation and interview, a working smoke detector was absent in the hallway outside the sleeping room of the children in care. Evidence - 1. On the date of inspection, a smoke detector was observed attached to the ceiling without its cover. The battery was also observed missing. 2. The Provider stated that she forgot to have it fixed.
Plan of Correction:	I will get it fixed.
Standard #:	22VAC40-111-340-C
Description:	Based on observation and interview, paper towel were not available within the bathroom located in the child care area. Evidence - 1. On the date of inspection, paper towels were not available for use in the bathroom located in the child care area. 2. The Provide stated that the children were using a cloth to dry their hands.
Plan of Correction:	Corrected during inspection.
Standard #:	22VAC40-191-40-C-1-c
Description:	Based on record review and interview, it was determined that no sworn statement was completed for every adult living in the family day home. Evidence: 1) The record for Household member 1 did not contain a sworn statement affirmation. 2) The provider stated that Household member 1 has not completed an sworn statement affirmation.
Plan of Correction:	We will complete the sworn statement.
Standard #:	63.2-1721.1-B-2
Description:	Based on record review and interview, it was determined that no criminal history records check was completed for every adult living in the family day home. Evidence: 1) The record for Household member 1 did not contain a criminal history records check (fingerprinting) results. 2) The provider stated that Household member 1 has not completed a criminal history records check (fingerprinting) results.
Plan of Correction:	We will make the appointment to complete the fingerprints.