VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Rossmary Acosta Escate
8507 Woodbine Lane
Annandale, VA 22003
(703) 678-3602

Current Inspector: Sheila F Nelson (804) 629-7489

Inspection Date: March 5, 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 Emergencies 22VAC40-111 Nutrition 22VAC40-80 THE LICENSING PROCESS. 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Child abuse and neglect 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs 22VAC40-665 Building or home maintenance.

Technical Assistance:

Background Check's information must be communicated to the Licensing Inspector within the next 10 days. More organization of paperwork, could help in keeping records more accessible for viewing.

Comments:

An unannounced renewal inspection was conducted today between 9:50 am and 1:45 pm. There were 7 children (22 points) present with one caregiver. We discussed the over point issue and what could be done including hiring full time and part time help. The entire physical plant, attendance records, children's records, caregiver records, household member's records, menu's, cribs, emergency plans, evacuation logs, bottles, and emergency supplies. There were no medications on site. The children were observed during hand-washing and diaper changing. The were also observed working on an art project, playing with toys and eating lunch. Lunch consisted of Chicken, rice, broccoli, fruit and milk. Areas of non compliance were cited on the Violation Notice. If you have any question, please contact Tanya.Johnson1@dss.virginia.gov or call 571.423.6392

Violations:

Standard #:	22VAC40-111-60-A
Description:	Based on a review of children's records, the Family Day Home failed to maintain up to date records for each child enrolled. Evidence: 1. Child #2's records do not have documentation of work name, work address or work phone number for father or signed emergency plan. 2. Child #3's records do not have documentation of an address for first emergency contact, authorization for pick up, medical insurance name, or medical insurance policy number. 3. Child #4's records do not have documentation of and address for the second emergency contact, medical insurance, or a medical insurance policy number. 4. Child #5's records do not have documentation of a second emergency contact, or authorization for pick up.
Plan of Correction:	I will get information from parents
Standard #:	22VAC40-111-80-A
Description:	Based on a review of children's records, the Family Day Home failed to ensure that within seven business days of the child;s first day of attendance at the famiy day home the provider shall obtain form the parent verification of the identity of the child. Evidence: Child #2 and 3's records do not contain documentation of identification of the children.
Plan of Correction:	I will get this from the parents.
Standard #:	22VAC40-111-170-A
Description:	Based on a review of records, the provider failed to obtain from each adult household member a current Report of Tuberculosis Screen form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form. Evidence: Household member #4 does not have a current report of Tuberculosis Screening Form.
Plan of Correction:	I will have her get one tomorrow. 03/06/2020
Standard #:	22VAC40-111-240-A
Description:	Based on observation, the Family Day Home failed to ensure that areas outside shall be maintained in a clean, safe and operable condition. Evidence: There is no barrier between the outside HVAC unit and the play area, children could get hurt by running into the unit or sticking something into the unit while it is operation.
Plan of Correction:	I will put a fence around the unit.
Standard #:	22VAC40-111-280
Description:	Based on observation, the Family Day Home failed to ensure that potentially poisonous substances shall be stored in areas inaccessible to children. Evidence: 1. Paint was stored in the bathroom used by the children in a closet accessible to children. 2. Cleaning supplies were stored in the kitchen under the sink in an unlocked cabinet accessible to children.
Plan of Correction:	I will move these things away from the children.
Standard #:	22VAC40-111-320-B
Description:	Based on observation, the Family Day Home failed to ensure that child resistant protective covers shall be installed on all unused electrical outlets and surge protectors. Evidence: In the living room around the corner form the kitchen, and electrical outlet did not have protective covers.
Plan of Correction:	I will replace it.
Standard #:	22VAC40-111-570-A
Description:	Based on observation and interview, the Family Day Home did not ensure that a caregiver does not exceed 16 points per caregiver. Evidence: On the date of inspection, from the start of inspection at 9:50 am until the conclusion of the inspection the Caregiver #1 had 7 children (22 points).
Plan of Correction:	I will start the paperwork to hire my live in relative to balance out the number of children.
Standard #:	22VAC40-191-40-D-4-a
Description:	Based on review of household member records, the provider failed to ensure that when a person 18 years old or older begins residing in the home a Sworn Statement or Affirmation is obtained prior to the first day of residence. Evidence: Household member #4 has been residing in home for 3 weeks. Will have her fill out Sworn Statement.
Plan of Correction:	From filled out and signed during inspection.
Standard #:	63.2-1721.1-B-2
Description:	Based on a review of household member records, the provider failed to obtain fingerprints check for household member. Evidence: Household member #4 does not have documentation of a fingerprint background check.
Plan of Correction:	I will obtain fingerprint check. Provider called OBI while inspector was on site.