VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Fatemeh Ranjbarkohan
745 Bonnie Ridge Drive, NE.
Leesburg, VA 20176
(703) 888-9118

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

Inspection Date: April 6, 2022

Complaint Related: No

Areas Reviewed:

8VAC20-800 Administration 8VAC20-800 Physical Health of Caregivers and Household Members 8VAC20-800 Medication Administration 8VAC20-800 Emergencies 8VAC20-800 Nutrition

Technical Assistance:

Discussion was held on the following topics: * Daily attendance: The intent of this standard is to ensure that providers, emergency back-up caregivers, and emergency responders are aware of and can account for children in care at any one time each day. If the provider and children have to evacuate or shelter in place, the written record of children in attendance is an ?essential document? that must be available to the provider after the evacuation/sheltering so that the provider has a master list of all children in attendance that day. * Medication and the requirements for storage, administration, written authorizations and the family day home medication policies. * Rest areas, cribs and linens.

Comments:

An unannounced monitoring inspection was conducted on 04/06/2022 between the hours of approximately 2:30 pm through 4:20 pm. There were 11 children present, ranging in ages from 3 months to 3 years, with 3 staff supervising. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming, medication, special care and emergencies and nutrition. A total of 4child records and 4 staff 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 any questions regarding this inspection, please contact the Licensing Inspector, Maria Robles at maria.robles@doe.virginia.gov.

Violations:

Standard #:	8VAC20-800-730-D
Description:	Based on observation and interview with the provider, medication was not kept in a locked place using a safe locking method that prevents access by children. Evidence: 1) On the date of inspection, an epinephrine injector was observed in a desk organizer on a table in the kitchen. 2) The provider stated that the medication belonged to Child #5.
Plan of Correction:	I gave back to the mother of child
Standard #:	8VAC20-800-830-A
Description:	Based on documentation review and interview with the provider, emergency evacuation procedures were not practiced monthly. Evidence: 1) On the date of inspection, there were no emergency drills documented for the months of January 2022, February 2022 and March 2022. 2) The provider stated that they had forgotten to conduct emergency evacuation drills on those months.
Plan of Correction:	I explained that because e didn't have fences outside we couldn't take the kids.
Standard #:	8VAC20-800-920
Description:	Based on documentation review, observation and interview with the provider, the menu for the current one-week period was not dated and did not list food substitutions. Evidence: 1) The menu available for review was not dated for the current one-week period. 2) The inspector observed the afternoon snack being served was string cheese, blueberries, and a muffin, however, the snack listed in the menu for the day was pretzel and yogurt. The substitution was not listed. 3) The provider stated that the lunch served today was rice, spinach, red beans and beef, however, the lunch listed on today's menu was chicken nuggets and veggies. The substitution was not listed.
Plan of Correction:	**plan of corrections not provided**
Standard #:	8VAC20-800-60-B
Description:	Based on record review, children's records did not contain all required information. Evidence: 1) The record for Child #3 did not contain the name, address and telephone number of a second designated person to contact in case of an emergency if the parent cannot be reached. The record for Child #4 did not contain the address and telephone number of one custodial parent's place of employment.
Plan of Correction:	It is completed by parents.
Standard #:	8VAC20-800-180-A
Description:	Baes on record review and interview with the provider, the provider did not obtain for each caregiver a current Report of Tuberculosis (Tb) Screening form every two years. Evidence: 1) The most recent Tb screening report in the record for Staff #1 was dated 07/09/2019. 2) The provider acknowledged not having completed the screening.
Plan of Correction:	Tb screening has been completed.
Standard #:	8VAC20-800-280
Description:	Based on observation, potentially poisonous substances, supplies such as cleaning agents were not stored in areas inaccessible to children. Evidence: 1) A bottle of bathroom cleaning product ("Scrubbing Bubbles") was observed in the cabinet under the sink of the care area. The cabinet did not have a locking mechanism.
Plan of Correction:	The product was moved to a higher shelf during the inspection.
Standard #:	8VAC20-800-480-D
Description:	Based on observation, equipment used by children was not used in accordance with the manufacturer's instructions. Evidence: a] Child #1 was observed sitting on a bouncy seat and the safety buckles were not strapped. b] Child #3 (13 months old) was observed napping in a bassinet that was labeled appropriate for use up to 5 months or 30 lbs. and not to be used for extended periods of sleep. c] Child #5 was sitting in a baby swing and the safety buckles were not strapped.
Plan of Correction:	We will take care of those.
Standard #:	8VAC20-800-680-A
Description:	Based on observation, it was determined that caregivers did not ensure to wash their hands with liquid soap and warm running water after coming in contact with any body fluids. Evidence: 1) On the date of inspection, Staff #3 was observed wiping the nose of Child #6. Staff #3 did not wash their hands after wiping Child #6's nose.
Plan of Correction:	We will do it for sure.
Standard #:	8VAC20-800-680-B
Description:	Based on observation of diapering procedures, it was determined that caregivers did not ensure that children's hands are washed with liquid soap and warm running water before eating and after diapering. Evidence: 1) On the date of inspection, the inspector observed children transitioning from naptime, to free play to afternoon snack. Children were playing and caregivers helped them sit down and served them their food. They did not wash the hands of the children before the children eating their food. 2) On the date of inspection, Staff #3 was observed changing the diapers of Child #6. After Staff #3 finished changing Child #6's diaper, Child #6 was returned to the care area. Staff #3 did not wash Child #6's hands.
Plan of Correction:	We will do it for sure.
Standard #:	8VAC20-800-690-D
Description:	Based on observation of diapering procedures, it was determined that the diapering surface was not nonabsorbent and washable and it was not cleaned and sanitized after each use. Evidence: 1) On the date of inspection, the inspector observed that the changing pad had a soft fabric cover and that after the caregiver was done diapering a child, they did not clean and sanitize the surface. This fabric cover prevents the diapering surface from being nonabsorbent and washable.
Plan of Correction:	We will do it for sure.
Standard #:	8VAC20-800-690-E
Description:	Based on observation, soiled disposable diapers and wipes were not disposed of in a leak-proof or plastic-lined storage system that is either foot operated or used in such a way that neither the caregiver's hand nor the soiled diaper or wipe touches the exterior surface of the storage system during disposal. Evidence: 1) The trash can in the diapering area is not foot operated. The inspector observed how a caregiver touched the lid of the trash can in order to lift/open it to dispose of a soiled diaper and afterwards, dispose of a wipe.
Plan of Correction:	I bought one of that.