VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Maria Arevalo
7850 Heritage Dr.
Annandale, VA 22003
(703) 608-7319

Current Inspector: Leah Pagala (703) 537-6757

Inspection Date:

Complaint Related: No

Violations:

Standard #:	8VAC20-770-60-B
Description:	Based on observation, an employee did not have completed sworn statement. Evidence: Caregiver 2 did not have a completed sworn statement. (Start date 12/10/2021)
Plan of Correction:	I will do the background check immediately.
Standard #:	8VAC20-770-60-C-2
Description:	Based on record review and observation, the provider did not obtain a central registry report within 30 days for caregiver. Evidence: Caregiver 2 does not have a central registry background check completed within 30 days of hire. (Date of hire 12/10/2021)
Plan of Correction:	I will do the background check right away.
Standard #:	8VAC20-800-830-A
Description:	Based on record review, emergency evacuation drills were not practices monthly. Evidence: The provider stated emergency evacuation drills were conducted monthly but there is no documentation to support.
Plan of Correction:	I will write down the drills.
Standard #:	8VAC20-800-960-D
Description:	Based on observation, infant formula was not prepared according to manufacturer's instructions. Evidence: An opened bottle of infant formula was observed on a counter. Manufacturer's instructions state once opened the formula must be refrigerated.
Plan of Correction:	Formula was placed in fridge.
Standard #:	8VAC20-800-960-K
Description:	Based on observation, baby food was served from the original container. Evidence: Caregiver 2 was observed feeding children from the orginal container.
Plan of Correction:	We will put the food in another bowl.
Standard #:	8VAC20-800-100-A
Description:	Based on record review, the provider did not obtain 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: Child 1 and 2 do not have documentation of a physical examination within 30 days after the first day of attendance. (Child 1 and 2, Start date: 11/8/2021)
Plan of Correction:	I will tell the parents to bring me a doctor's physical
Standard #:	8VAC20-800-120-B
Description:	Based on record review, the assistant's record was not complete. Evidence: The assistant's record is missing one reference.
Plan of Correction:	I will get the other reference.
Standard #:	8VAC20-800-50-A
Description:	Based on interview, the family day home did not keep a written record of attendance each day. Evidence: The provider stated attendance was not taken for the day.
Plan of Correction:	I will take attendance everyday.
Standard #:	8VAC20-800-60-B
Description:	Based on record review, the child's record did not contain all the required information. Evidence: Child 1 is missing child's emergency contacts, parent work and contact information, doctor's name and phone number, insurance policy name and number, first day of attendance, and any known allergies/medical concerns.
Plan of Correction:	I will tell the parents and get the information
Standard #:	8VAC20-800-70-A
Description:	Based on record review, the parents were not provided in writing all the information required. Evidence: The provider stated the parent was provided the files but has not returned the signed documentation regarding policies including but not limited to check in check out procedures, discipline policy, termination policy, fees, holidays and substitute provider.
Plan of Correction:	I will give the parents the information.
Standard #:	8VAC20-800-240-A
Description:	Based on observation, areas and furnishings of the family day home were not maintained in a safe condition. Evidence: In the area behind the stair well, there were several power tools accessible to children.
Plan of Correction:	We will clean up the area and make it safe. Provider and household member started to remove items at time of inspection.
Standard #:	8VAC20-800-530-F
Description:	Based on observation, soft bedding was used under and around an infant while sleeping. Evidence: Child 3 was observed with 1 blanket under him and 3 other blankets in the crib with the child.
Plan of Correction:	I will make sure not to put blankets with the babies.
Standard #:	8VAC20-800-540-B
Description:	Based on observation, infant walkers were being used. Evidence: One infant walker was in use by Child 1 and a second infant walker was observed though not in use.
Plan of Correction:	Walkers were removed from the home at the time of inspection.