VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Alicia Villagra
4102 Dakota Court
Alexandria, VA 22312
(703) 914-4923

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

Inspection Date: Feb. 25, 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 22VAC40-191 Background Checks for Child Welfare Agencies 63.2 Licensure and Registration Procedures

Technical Assistance:

Technical assistance was provided on the areas of documentation, handwashing and diapering procedures, cleaning and sanitizing procedures and attendance documentation.

Comments:

An unannounced monitoring visit was conducted today between the hours of approximately 9:45 am through 12:10 pm. There were 12 children (33 points) with the provider and an assistant. A sample of 6 children's files and 5 staff/household member's files were reviewed. The children were observed during the following: free toy play, completing a ladybug craft with the provider, dance and music time, bathroom breaks, hand washing, transition to lunch and lunch. Cribs, the physical space of the care area, evacuation drills, attendance records, and the Emergency Preparedness Plan were 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 #:	22VAC40-111-800-B
Description:	Based on documentation review, the provider did not review the emergency plan at least annually and update the plan as needed. Evidence: 1) The emergency preparedness and response plan most recent review was dated 1/18/2019.
Plan of Correction:	I will review the Emergency Plan and update as needed.
Standard #:	22VAC40-111-830-D
Description:	Based on records review, records of emergency evacuation and shelter-in-place drills were not maintained for one year. Evidence: 1) On the date of inspection, the emergency evacuation and shelter-in-place drills log for the 2019 year was not available for review. 2) The provider stated she had recently discarded the log while cleaning the fdh.
Plan of Correction:	I will ensure to keep the emergency drill log.
Standard #:	22VAC40-111-920
Description:	Based on observation, substituted food was not listed on the menu for the current one-week period. Evidence: 1) On the date of inspection (02/25/2020), the menu for the day listed lunch as: lentils, red/white potatoes, brown rice and green beans. The lunch served on that day consisted of rice, chicken breast, vegetables, apple sauce and milk. These substitutions were not listed on the menu.
Plan of Correction:	I will make sure substitutions are listed on the menu.
Standard #:	22VAC40-111-120-B
Description:	Based on record review, not all assistants' files contained all required information. Evidence: 1) The file for Staff 3 did not contain required information as: employment date, address, age verification, and that two or more references as to character and reputation as well as competency were checked before employment. 2)The file for Staff 2 did not have documentation that a second reference as to character and reputation as well as competency were checked before employment.
Plan of Correction:	Missing information for Staff 2 and 3 will be collectedmand filed.
Standard #:	22VAC40-111-60-B
Description:	Based on record review, children's files did not contain all required information. Evidence: 1) The records for Child 1 and Child 2 did not contain an address for one of the custodial parent's place of employment. 2) The record for Child 4 did not contain a phone number for one of the custodial parent's place of employment. 3) The record for Child 3 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. 4) The record for Child 2 did not contain a policy number for the child's medical insurance and first date of attendance.
Plan of Correction:	Child 1, 2, 3, and 4 will have their records updated to reflect this missing information.
Standard #:	22VAC40-111-70-A
Description:	Based on record review, not all parents were provided in writing of all required information for the family day home (fdh) before the child's first day of attendance. Evidence: 1) The record for Child 1 did not have a signed form with the fdh's operating information and other required information.
Plan of Correction:	Signed form with fdh's operating information will be completed for Child 7.
Standard #:	22VAC40-111-170-A
Description:	Based on record review, the provider did not obtain from each adult Household Member (HM) prior to coming into contact with children a current Report of Tuberculosis (Tb) Screening form. Evidence: 1) On the date of inspection there was no documentation available for review that a Tb screening result was obtained for HM 1.
Plan of Correction:	HM1 will complete a Tb screening form.
Standard #:	22VAC40-111-200-A
Description:	Based on record review, the provider did not orient the substitute provider by the end of their first week of assuming job responsibilities. Evidence: 1) The file for Staff 3 (doh unknown) did not contain documentation of having completed mandatory orientation training.
Plan of Correction:	Documentation for completion of orientation training for Staff 3 will be collected.
Standard #:	22VAC40-111-530-F
Description:	Based on observation, soft bedding and stuffed toys were being used in cribs around infants. Evidence: 1) Three cribs occupied with children ages 8 months, 7 months and 13 months were observed having stuffed toys and blankets in them.
Plan of Correction:	Soft bedding and toys will be removed from cribs.
Standard #:	22VAC40-111-600-B
Description:	Based on observation, infants and toddlers spent more than 30 minutes of consecutive time during waking hours confined in a crib, high chair or other confining piece of equipment. The intervening time period between confinements were not at least one hour. Evidence: 1) Child 2 was observed being moved to a high chair after waking up from their nap. 20 minutes later, Child 2 was moved to the crib where they stayed for 30 minutes and then was moved back to the high chair for 25 more minutes and then was moved back to the crib. 2) Child 4 was observed in the crib, awake, for 50 minutes. Child 4 was taken out of the crib and was observed during 40 minutes dancing and playing with other children. Child 4 was then moved to a high chair where he stayed for 30 minutes.
Plan of Correction:	Will ensure that infants and toddlers spend at least one hour between confinement periods and will train assistants and substitutes.
Standard #:	22VAC40-111-680-B
Description:	Based on observation, caregivers did not ensure that children's hands were washed with liquid soap and warm running water after diapering. Evidence: 1) Staff 2 was observed changing the diaper of Child 2. After the diaper change, Child 2 was placed in a high chair without first washing Child 2's hands with liquid soap and running water.
Plan of Correction:	Will ensure that staff wash children's hands after diapering.
Standard #:	22VAC40-111-690-D
Description:	Based on observation, the diapering surface was not non absorbent and washable and was not cleaned and sanitized after each use. Evidence: 1) The diapering surface had small rips on it which prevents it from being nonabsorbent. 2) Staff 2 was observed changing the diaper of a child and did not clean and sanitize the diapering surface after they were finished.
Plan of Correction:	I will replace the diapering surface and make sure staff clean and sanitize it after each use.
Standard #:	22VAC40-191-40-C-1-c
Description:	Based on record review, the provider did not obtain a sworn statement or affirmation for all household members (HM) in the family day home. Evidence: 1) On the date of inspection, no sworn statement or affirmation was available for review for HM 1.
Plan of Correction:	HM1 will complete the sworn statement affirmation.
Standard #:	22VAC40-191-40-D-4-a
Description:	Based on record review, the provider did not obtain a search of central registry for all household members (HM) in the family day home. Evidence: 1) On the date of inspection, no search of central registry results were available for review for HM 1.
Plan of Correction:	HM1 submitted a central registry search on 03/02/2020.
Standard #:	63.2-1721.1-B-2
Description:	Based on record review, the provider did not obtain a criminal history record check (fingerprints) for all household members (HM) in the family day home. Evidence: 1) On the date of inspection, no background check results were available for review for HM 1.
Plan of Correction:	HM1 visited a Fieldprint office on 02/28/2020.