VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Adelaide Nyamedi
15039 Coronet Place
Waterford, VA 20197
(571) 258-9124

Current Inspector: Mark Davis (804) 629-7103

Inspection Date: Feb. 13, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-111 Administration 22VAC40-111 Personnel 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:

Technical assistance was provided in the areas of handwashing, diapering, linens and updating forms and policies. Provider was reminded of soon-to-expire background checks.

Comments:

An unannounced monitoring visit was conducted today between the hours of approximately 9:45 am through 12:20 pm. There were 7 children (19 points) with the provider and an assistant. A sample of 7 children's files and 2 staff files were reviewed. activities observed on this date included: watching a video about colors and counting, toy play, lunch, diapering and transition to nap time. The caregivers were observed while supervising children, playing with the children, redirecting as necessary, serving lunch and diapering. On this date, the lunch included: pasta, meatballs with sauce, broccoli, applesauce and water. The physical space of the care area, required posted documents, evacuation drills and attendance records were also reviewed. There were no medications on site today. 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 #:	22VAC40-111-830-B
Description:	Based on record review and interview, it was determined that shelter-in-place procedures shall be practiced a minimum of twice per year. Evidence: 1) On the date of inspection, the emergency response drills log did not have shelter-in-place drills documented for the 2019 year. 2) The provider stated that they did not practice the drills.
Plan of Correction:	We will complete the shelter-in-place drills.
Standard #:	22VAC40-111-60-B
Description:	Based on record review, children's records did not contain all required information. Evidence: 1) The record for Child 6 did not contain the results of a health examination for the child, the address of an additional person to contact in case of an emergency if the parent cannot be reached and the policy number of the child's medical insurance, 2) The record for Child 7 did not contain the name, address and telephone number of an additional designated person to contact in case of an emergency if the parent cannot be reached. 3) The record for Child 4 did not contain the address of each custodial parent's place of employment. 4) The record for Child 2 did not contain the name of one custodial parent's place of employment.
Plan of Correction:	I will ask the parents for the information.
Standard #:	22VAC40-111-90-C
Description:	Based on record review, the provider did not obtain documentation of additional immunizations once every six months for children under the age of two years. Evidence: 1) The most recent immunization record for Child 4 (dob 03/12/18) was dated 03/14/2019. 2) The most recent immunization record for Child 5 (dob 03/08/18) was dated 03/11/2019. 3) The most recent immunization record for Child 6 (dob 12/17/18) was dated 03/07/2019. 4) The most recent immunization record for Child 7 (dob 07/29/18) was dated 07/29/2019.
Plan of Correction:	I will inform the parents.
Standard #:	22VAC40-111-210-A
Description:	Based on record review and interview, it was determined that caregivers did not complete a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: 1) The record for Staff 1 and Staff 2 had 12 hours each of training hours documented for the year 2019. 2) The provider stated that they will complete the training hours for the upcoming year.
Plan of Correction:	I had a family situation that took a lot of my time and attention and we couldn't complete the training hours.
Standard #:	22VAC40-111-280
Description:	Based on observation, it was determined that potentially poisonous substances,were not stored in areas inaccessible to children. Evidence: 1) In the bathroom of the care area, 4 cleaning agents, lotions and a shampoo bottle were stored under the sink in an unlocked cabinet.
Plan of Correction:	The cleaning agents were removed during the inspection.
Standard #:	22VAC40-111-530-F
Description:	Based on observation, soft bedding and plush toys were used in cribs while in use. Evidence: 1) 6 cribs were observed in the crib room. All six cribs had blankets in them. One of them had a pacifier with a small plush toy attached to it. 2) While transitioning to nap time, Child 4 (23 months), Child 5 (23 months), Child 6 (13 months) and Child 7 (19 months) were placed in these cribs to sleep. The blankets were still in the cribs. Child 6 (13 months) was using the pacifier with the plush toy attached.
Plan of Correction:	We will remove the blankets from the cribs. (The plush toy was removed during the inspection.)
Standard #:	22VAC40-111-530-G
Description:	Based on observation, children under two years of age were using pillows. Evidence: 1) 6 cribs were observed in the crib room. All six cribs had pillows in them. 2) While transitioning to nap time, Child 4 (23 months), Child 5 (23 months), Child 6 (13 months) and Child 7 (19 months) were placed in cribs to sleep. The pillows were still in the cribs.
Plan of Correction:	We will remove the pillows from the cribs.
Standard #:	22VAC40-111-680-A
Description:	Based on observation and interview, it was determined that caregivers were not washing their hands after diapering a child. Evidence: 1) Staff 1 was observed changing diapers to Child 1-7. She did not wash her hands after each child was diapered. 2) Staff 1 stated that she thought that using gloves was enough.
Plan of Correction:	I was using gloves to change the diapers. The bathroom is distant from the diapering area. We will come up with a system so we can wash hands.
Standard #:	22VAC40-111-680-B
Description:	Based on observation and interview, caregivers did not ensure that children's hands were washed with liquid soap and running water before eating and after diapering. Evidence: 1) Children were observed sitting down at the lunch table without washing their hands. 2) Staff 1 changed diapers for Child 1-7 and after diapering, each child was placed in their crib or cot without washing hands first. 3) Staff 1 stated that they wipe the children's hands before eating.
Plan of Correction:	We wipe the children's hands with baby wipes every time before eating. We instruct the children to keep their hands off while we are diapering to avoid them touching. The bathroom is distant from the diapering area. We will come up with a system so we can wash hands.
Standard #:	22VAC40-111-690-D
Description:	Based on observation, it was determined that the diapering surface was not cleaned and sanitized after each use. Evidence: 1) Observation of diapering procedures, on this date, determined that the diapering surface was not cleaned and sanitized between each diaper change.
Plan of Correction:	In the future, the diapering surface will be cleaned and sanitized after each diaper change.