VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Ghazala Shah
14086 Baneberry Circle
Manassas, VA 20112
(703) 680-4610

Current Inspector: Angela Dudek (804) 629-8167

Inspection Date: Aug. 11, 2021 and Aug. 17, 2021

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 22VAC40-191 Background Checks for Child Welfare Agencies 54.1 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect 63.2 Licensure and Registration Procedures

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, including telephone contacts, documents review, and interviews. A renewal inspection was initiated on 8/11/2021 and concluded on 8/17/2021 with an exit interview. The provider was contacted by telephone and a virtual inspection was conducted. There were nine children present, ranging from 16 months to four years of age, with the provider and assistant supervising. The inspector reviewed compliance in the areas of administration, personnel, physical health of caregivers and household members, caregiver training, physical environment and equipment, care of children, preventing the spread of disease, medication administration, nutrition and emergencies. A total of two child records and four caregiver/household member records were reviewed. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the program. If you have further questions about this inspection please contact Donna Liberman at 540-359-5244 or Donna.Liberman@doe.virginia.gov.

Violations:

Standard #:	22VAC40-111-100-A
Description:	Based on a review of two children's records, the provider did not obtain documentation that each child has received a physical examination by or under the direction of a physician prior to the child's first attendance or within one month after attendance. Evidence: the records for child #1 and child #2 (date of first attendance: 5/10/2021) did not have documentation of a physical examination.
Plan of Correction:	Provider stated they will obtain the missing information.
Standard #:	22VAC40-111-110-B
Description:	Based on review of two children's records, not all immunization reports were signed by a licensed physician, the physician's designee, or an official of a local health department. Evidence: the immunization reports for child #1 and child #2 did not have any signature.
Plan of Correction:	Provider stated they will obtain the missing information.
Standard #:	22VAC40-111-120-A
Description:	Based on review of two caregiver records, it was determined that not all records contained all required information. Evidence: the record for caregiver #2 did not contain the date of employment or volunteering, or documentation of the education and training as required.
Plan of Correction:	Provider stated they will obtain the missing information and update the record.
Standard #:	22VAC40-111-180-A
Description:	Based on review of four caregiver/household member records, not all caregivers/household members had a repeat tuberculosis (TB) test/screening at least every two years from the date of the initial screening or testing. Evidence: the TB test/screening for household member #2 is dated 10/20/2018.
Plan of Correction:	Provider stated the household member will obtain an updated TB test/screening if/when they move back to Virginia.
Standard #:	22VAC40-111-200-A
Description:	Based on review of two caregiver records, the provider failed to have documentation that all caregivers received orientation training that includes job responsibilities, requirements for parental notifications, standards that relate to their job responsibilities, emergency evacuation, relocation, and shelter-in-place procedures, location of emergency numbers, first aid kit, and emergency supplies, confidentiality and requirements for reporting suspected child abuse and neglect by the end of their first day of assuming job responsibilities. Evidence: The record for caregiver #2 did not contain documentation of orientation training. The provider stated that caregiver #2 began acting as an assistant on 6/30/2021.
Plan of Correction:	Provider stated that an orientation will be given and documented in the record.