VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Delia Ochoa - Amini
3249 Jermantown Road
Fairfax, VA 22030
(571) 970-8187

Current Inspector: Ariel Hayes (804) 629-7124

Inspection Date: Dec. 9, 2021

Complaint Related: Yes

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 Medication Administration 22VAC40-111 Emergencies 22VAC40-80 THE LICENSE. 22.1 Background Checks Code; carbon monoxide detectors

Comments:

A complaint investigation was conducted on December 9, 2021 regarding diaper changing. Interviews were conducted, and documentation was reviewed. There was not a preponderance of evidence to support the allegation regarding improper diaper changes and the complaint was deemed "not valid". Violations, not related to the complaint, are identified in the Violation Notice. Please contact Kara Wright at kara.vaughan@doe.virginia.gov with questions regarding this inspection.

Violations:

Standard #:	22.1-289.036-B-2
Complaint related:	No
Description:	Based on record review, the provider did not obtain the results of a national criminal history check for one staff member prior to employment. Evidence: Adult 2's record lists the staff hire date as 7/28/2021. The results of a criminal history check present in the staff member's file are dated 9/1/2021.
Plan of Correction:	Provider submitted paperwork on timely manner. Due to covid records took longer to receive.
Standard #:	8VAC20-800-700-A
Complaint related:	No
Description:	Based on provider statement and interviews conducted, the provider administered prescription and non prescription medication to a child in a manner not consistent with the home's written medication policies and without written authorization from the child's parent. Evidence: The provider stated that prescription and non-prescription topical medication was applied to Child 3 on multiple occasions. The provider's medication policy states that the provider with not administer prescription or non-prescription medication. There was no written authorization from the Child's parent to provide either the prescription or non-prescription medication, The provider stated that written authorization was never obtained prior to administering the medication.
Plan of Correction:	All ready answer in section one. [sic]
Standard #:	8VAC20-800-750-A
Complaint related:	No
Description:	Based on record review, provider statement, and interviews conducted, the provider applied topical skin products without written parent authorization noting any known adverse reactions. Evidence: Diaper rash cream was regularly applied on Child 3's skin. A written parent authorization was not obtained by the provider.
Plan of Correction:	Allredy answer in section 1, 3 and 7. [sic]
Standard #:	8VAC20-800-800-B
Complaint related:	No
Description:	Based on record review, the provider did not review the emergency plan at least annually and update the plan as needed. Evidence: The most recent review of the emergency plan was conducted on 7/31/2019.
Plan of Correction:	Emergency plan form was in the daycare bulletin board. The same form was already emailed to the inspector for my license renewal . October 2021.
Standard #:	8VAC20-800-100-A
Complaint related:	No
Description:	Based on record review, two children whose records were reviewed or requested, did not contain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance. Evidence: 1. Child 1's record was not present at the family day home on the date of inspection and documentation of a physical examination by or under the direction of a physician could not be produced. 2. Child 4's record did not contain documentation of a physical examination by or under the direction of a physician.
Plan of Correction:	All realy answer in section #9. [sic]
Standard #:	8VAC20-800-50-A
Complaint related:	No
Description:	Based on record review and provider statement, the family day home did not keep a written record of children in attendance each day. Evidence: The provider stated that she did not take attendance on the date of inspection. The most current attendance records, reviewed on the date of inspection, were dated September 15, 2021.
Plan of Correction:	Provider for the last 30 years takes attendance every. The day of the inspection the provider did not take attendance yet THAT DAY when she arrived. She didnit ast about other attendance list. She found attendance list dated 9/15/2021 among the other papers she was reviewing. [sic]
Standard #:	8VAC20-800-60-A
Complaint related:	No
Description:	Based on record review and provider statement, the provider did not maintain an up-to-date record at the family day home for each enrolled child. Evidence: On the date of inspection there was no record present for Child 1. The provider stated that Child 1 was formally enrolled and was attending just for the day. The previous record for the child was not present in the family day home.
Plan of Correction:	[Child 1] is my former student enroll in a different school now. [Child 1]'s sister [another child] is my current student. That day the Mother needed to have both of then in one place to go directly to the airport. [sic]
Standard #:	8VAC20-800-60-B
Complaint related:	No
Description:	Based on record review three of three children's records reviewed did not contain all required information. Evidence: 1. Child 2's record did not contain: Parent's signed acknowledgement of the receipt of the information required by 22 VAC 40-111-70 or written authorization if a caregiver is to administer prescription or nonprescription medication to the child. 2. Child 3's record did not contain: the child's first and last dates of attendance; the name address and phone number of one of two persons to contact in the event the child's parents cannot be reached; the child's health insurance policy number; parent's signed acknowledgement of the receipt of the information required by 22 VAC 40-111-70; written authorization if a caregiver is to administer prescription or nonprescription medication to the child. 3. Child 4's record did not contain: the child's medical insurance policy number; the results of a health examination for the child; immunization records for the child.
Plan of Correction:	Child 2's form was signet see copy attached. [sic] Child #3's all ready answer in section #1 and #3. [sic] Child #4, is corrected see copy attached.
Standard #:	8VAC20-800-70-A
Complaint related:	No
Description:	Based on record review, two of three children's records reviewed, did not contain documentation that the parents were notified in writing about the family day home's: Operating information including the hours and days of operation, holidays or other times closed, and the telephone number where a message can be left for a caregiver; Schedule of fees and payment plans; Check in and check out procedures; Policies for the administration of medications; Whether or not there is liability insurance of at least $100,000 per occurrence and $300,000 aggregate in force on the family day home operation; Requirement for the family day home to notify the parent when the child becomes ill and for the parent to arrange to have the child picked up as soon as possible if so requested by the home; Requirement for the parent to inform the family day home within 24 hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life-threatening diseases, which must be reported immediately; Requirement for the child to be adequately immunized; Requirement for paid caregivers to report suspected child abuse or neglect according to ? 63.2-1509 of the Code of Virginia; Custodial parent's right to be admitted to the family day home any time the child is in care; General daily schedule that is appropriate for the age of the enrolling child; Policies for the provision of food; Presence of a pet or animal in the home; Discipline policies including acceptable and unacceptable discipline measures; Amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider; Provisions of the family day home's emergency preparedness and response plan; Policies for termination of care; and Address of the website of the department, with a note that a copy of this regulation and additional information about the family day home may be obtained from the website, including compliance history that includes information after July 1, 2003. Evidence: Child 2 and Child 3's record did not have documentation that the parents had been informed, in writing, of required policies.
Plan of Correction:	Information for parents is provided in a complete padage (handbook) at the time of enrollment. Eeach package includes all the required information (hours of operation, administration of medication, Holidays, etc.) [sic] Each child has the liability form provided by the licensing office signed by the parents in their folder. Find copies attached.
Standard #:	8VAC20-800-90-A
Complaint related:	No
Description:	Based on record review, two children whose records were reviewed or requested, did not contain documentation that the children have been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations. Evidence: 1. Child 1's record was not present at the family day home on the date of inspection and a record of immunization could not be produced. 2. Child 4's record contained a record of immunization that did not contain a statement that the child was adequately immunized, and was not signed, stamped, or dated by a licensed physician, the physician's designee, or an official from the health department.
Plan of Correction:	Child #1 already answered in section 6. Child #4 copy attached.
Standard #:	8VAC20-800-130
Complaint related:	No
Description:	Based on interviews conducted, one caregiver was not able to speak in English as necessary to carry out assigned job responsibilities or communicate effectively with emergency responders. Evidence: Adult 2 was unable to answer the inspector's questions, and Adult 1 was needed to translate to obtain information about the names of children in care and how often diaper changes were conducted.
Plan of Correction:	Adult #2 is under provider supervision she is learning English. She understand but she got nervous when inspector talk to her. Adult #2 is a very loving person. She communicates efectibly with children because they are learning Spanish. In case of emergency she will respond promptly. [sic]
Standard #:	8VAC20-800-140-D
Complaint related:	No
Description:	Based a review of written communication, the provider did not record and sign the time of arrivals and departures on each day that the substitute provider works. Evidence: On 10/18/2021 the provider notified a parent that she would be leaving the family day home and that primary care would be provided by the substitute provider. On the date of inspection, there was not a record in the family day home of times that the substitute provider was working.
Plan of Correction:	Provider had a Dr's appointment. Which was cancelled by the Dr.
Standard #:	8VAC20-800-180-A
Complaint related:	No
Description:	Based on record review, the provider did not obtain for each caregiver a current Report of Tuberculosis Screening form, in accordance with the requirements in 22 VAC 40-111-170, every two years from the date of the first screening or more frequently as recommended by a physician or the local health department. Evidence: The Tuberculosis screening for Adult 3 is dated 4/10/2017.
Plan of Correction:	Adult # 3 is not residing or working at the day care. The day before inspection she had a medical procedure and she needed her family's moral support. Inspector was informed of this fact.
Standard #:	8VAC20-800-210-A
Complaint related:	No
Description:	Based on record review and provider statement, in addition to satisfactory completion of first aid training and CPR training, caregivers did not obtain a minimum of sixteen clock hours of training annually in areas relevant to their job responsibilities. Evidence: On the date of inspection, there was not any documented training obtained in the previous year for Adult and Adult 2.
Plan of Correction:	Due to Covid I didn't do any training. I just register to do a Zoon class with ATI Institute. [sic]
Standard #:	8VAC20-800-220-A
Complaint related:	No
Description:	Based on provider statement and written communication with the parents of a child, the provider administered prescription medication to a child without satisfactorily completing a training program for this purpose developed or approved by the Board of Nursing and taught by a registered nurse, licensed practical nurse, doctor of medicine or osteopathic medicine, or pharmacist. Evidence: The parents of Child 3 provided prescription topical ointment to the provider for use on their child. The provider stated that she applied this ointment on the child's skin several times. The provider did not, complete an approved training program to administer prescription or non-prescription medication.
Plan of Correction:	Child #3 is withdrawl from daycare. In the future I will not apply any medication to children. [sic]
Standard #:	8VAC20-800-560-A
Complaint related:	No
Description:	Based on observation, caregivers on site did not provide direct care and supervision of each child at all times. Evidence: Four infants were observed sleeping in a room outside of direct sight and sound of caregivers. There was not a baby monitor in use and for a period of 45 minutes there was no in-person observation of each sleeping infant.
Plan of Correction:	Provider and Assistant are in the same area at all times. Monitor is installed in the nursery room my ears and eyes are open when my children are napping. [sic]