VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Sherry Brown
2422 Windbreak Drive
Alexandria, VA 22306
(703) 765-0820

Current Inspector: Ann Dramstad (703) 314-0860

Inspection Date: Jan. 27, 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 22VAC40-111 Transportation 22VAC40-80 THE LICENSING PROCESS. 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Licensure and Registration Procedures

Technical Assistance:

Consultation was given on record management, background checks, trainings and the licensing process. The provider does not need to be licensed as she is watching less than 4 children.

Comments:

An unannounced monitoring visit was conducted from 10:00-12:00. One child was present (2 Points) with two caregivers. Observed physical space, emergency preparation, training certificates, nutrition, records and background checks. Areas of non-compliance are identified in the violation notice. If you have any questions regarding the inspection, please feel free to contact me. Thank you Ann Dramstad Licensing Inspector 703-314-0860 ann.dramstad@dss.virginia.gov

Violations:

Standard #:	22VAC40-111-770
Description:	Based on observation, a non-medical supply was not available in the family day home Evidence: A battery operated flashlight was not available.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-820
Description:	Based on provider log, no shelter-in place drills were conducted for the past year. Evidence: No shelter-in place drills were documented on the evacuation and emergency log.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-990-B
Description:	Based on provider statement, the provider does not have all required information/supplies in her vehicle. Evidence: The provider stated that no first aid kit, the provider's personal information (address, phone number), a copy of the child's emergency contact and written permission to transport was in the car when transporting children from the daycare.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-120-B
Description:	Based on record review, the Assistant record did not contain all required information. Evidence: Assistant #1 (hired 6/2019) was missing two references prior to employment and an emergency contact.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-60-B
Description:	Based on record review, 3 of 3 children's records did not contain all required information. Evidence: Child # 1 and 2 were missing a parent work phone number. Child #3 was missing parent work addresses, physician address and physician phone number
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-70-A
Description:	Based on record review, 1 of 3 children's records did not contain all required Information For Parents. Evidence: Child #3 was missing a signed acknowledgement of the "Provision for Emergency Relocation"
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-90-A
Description:	Based on record review, a child attended the family day home without documentation of immunizations. Evidence: Child #3's first day of attendance was 1/17/2020 and no documentation of immunizations was available.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-170-A
Description:	Based on provider statement, a household member does not have 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: The Provider stated that HHM #1 did not have a TB screening form and has been in the home since December 2019.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-200-C
Description:	Based on record review, no orientation documentation was available to verify the provider went over all policies and procedures of the family day home within a week of hire, Evidence The Assistant start date was 6/2019 and no signed orientation was available to verify orientation was conducted.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-210-A
Description:	Based on provider statement and documentation of training certificates, the annual 16.0 hours of annual training has not been completed. Evidence: The Provider only completed 2.0 of the 16.0 required hours for the licensure year 2019.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-240-A
Description:	Based on observation, areas of the home are not maintained in a safe, clean and safe operable condition. Evidence: 1. The door leading into the small room in the basement was hanging off a door hinge and splinting wood was at the top were it had come off the hinge. 2. The room on the main floor leading into the bathroom was located was inaccessible due to the large amount of personal belongings stacked high and cluttering all open areas.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-280
Description:	Based on observation, hazardous substances were not inaccessible to children. Evidence: 1. 2 cans of insecticide were sitting by the front door 2. Lysol wipes were in the main level bathroom 3. Air freshener was in the kitchen.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-111-320-G
Description:	Based on provider statement, the wood burning fireplace has not been annually inspected. Evidence: The fireplace was not inspected annually as confirmed by the provider. Previously cited 6/2019.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-191-40-D-4-a
Description:	Based on provider statement, a household member (HHM) does not have a Sworn Disclosure Statement (SDS) or Central Registry results within 30 days of when the person begins residing in the home. Evidence: A HHM began living full time in the home in December 2019 and has not completed a SDS. The provider has not submitted the CPS request for the HHM by the end of 30 days of residence.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	63.2-1721.1-B-2
Description:	Based on provider statement, a household member has not submitted to fingerprinting as required prior to moving into the home. Evidence: The provider stated that a household member has been in the home since 12/2019 and fingerprinting has not been requested.
Plan of Correction:	Not available online. Contact Inspector for more information.