VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ms. Mary Almy
1315 Coltrane Dr
Portsmouth, VA 23701
(757) 541-3144

Current Inspector: Trisha Brown (757) 404-2601

Inspection Date: May 17, 2022

Complaint Related: No

Areas Reviewed:

8VAC20-800 Administration 8VAC20-800 Personnel 8VAC20-800 Household Members 8VAC20-800 Physical Health of Caregivers and Household members 8VAC20-800 Caregiver Training 8VAC20-800 Physical Equipment and Environment 8VAC20-800 Care of Children 8VAC20-800 Preventing the Spread of Disease 8VAC20-800 Medication Administration 8VAC20-800 Emergencies 8VAC20-800 Nutrition 8VAC20-800 Transportation 8VAC20-800 Nighttime Care 8VAC20-770 Background Checks 20 Access to minor?s records 22.1 Background Checks Code, Carbon Monoxide 54.1 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect

Technical Assistance:

Technical assistance was provided in the following areas: background checks, child records, physical environment, emergency procedures, carbon monoxide detectors, staff records and allergies.

Comments:

An unannounced monitoring inspection was conducted on 5/17/22 from 9:45am - 11:15pm. During the inspection there were eight children in care, ages eleven months old to four years old (18 points), with one caregiver present. Records were reviewed for five children, two caregivers and two household members. Children were observed completing various activities in the family day home. There is no medications in the family day home. Emergency plan and emergency supplies 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, and were discussed with the provider during the exit interview.

Violations:

Standard #:	22.1-289.035-A
Description:	Based on a review of two caregiver records, it was determined that the facility did not ensure that all employees before five years since the dates of the last most recent search of the central registry complete an updated search of the central registry. Evidence: 1. The record for caregiver #1 contained a search of the central registry finding that was dated 4/27/17. 2. Caregiver #1 confirmed that update that she had not completed an updated search of the central registry finding.
Plan of Correction:	The provider responded: An updated search of the central registry will be completed for caregiver #1.
Standard #:	8VAC20-800-760-A
Description:	Based on a review of the first aid kit for the family day home, it was determined that the provider did not ensure that all of the required items are present in the first aid kit for the family day home. Evidence: 1. There were no triangle bandages in the first aid kit for family day home. 2. Caregiver #1 confirmed the first aid kit for the family day home did not contain all of the required items.
Plan of Correction:	The provider responded: Triangle bandages will be added to the first aid kit for the family day home.
Standard #:	8VAC20-800-830-A
Description:	Based on a review of the emergency drill log and interview, it was determined that the provider did not ensure that emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care. Evidence: 1. There was no documentation on the emergency drill log to demonstrate that an emergency evacuation practice drill was completed in March 2022 and April 2022. 2. Caregiver #1 confirmed that emergency evacuation practice drills were not completed in March 2022 and April 2022.
Plan of Correction:	The provider responded: We will ensure that practice emergency evacuation drill is completed each month.
Standard #:	8VAC20-800-60-B
Description:	Based on a review of five children's records, it was determined that the provider did not ensure they maintain and keep at the family day home a complete record for each child enrolled that contains all required information. Evidence: 1. The record for child #1, present during the inspection, did not contain the medical insurance policy number, the authorization to receive emergency medical care, and any documentation of whether or not child #1 had previously attended child care. 2. The record for child #2, present during the inspection, did not contain the address and phone numbers for the emergency contacts. 3.,The record for child #4, present during the inspection, did not contain the address for the first emergency contact, the information for parents document and the liability insurance document. 4. The record for child #5, present during the inspection, did not contain the complete address for the emergency contacts, medical insurance number, any documentation of whether or not child #1 had previously attended child care, the authorization for emergency medical care and the information for parents document.. 5. Caregiver #1 reviewed the records for child #1, child #2, child #4, and child #5, and confirmed the records were not complete.
Plan of Correction:	The provider responded: The parents of each child will be asked to provide the missing information.
Standard #:	8VAC20-800-180-A
Description:	Based on a review of two caregiver records, it was determined that the provider did not ensure that at least every two years from the date of the first initial screening or testing, staff members shall obtain and submit the results of a follow-up tuberculosis screening. Evidence: 1. The record for caregiver #1, contained documentation of TB screening that was dated 11/17/19. 2. The record for caregiver #2, contained documentation of TB screening that was dated 12/8/19. 3. Caregiver #1 confirmed that neither caregiver had not completed an updated TB screening.
Plan of Correction:	The provider responded: Both caregivers will complete an updated TB screening.
Standard #:	8VAC20-800-210-A
Description:	Based on a review of two caregiver records, it was determined that the provider did not ensure that all caregivers complete 16 hours of training annually. Evidence: 1. There was not documentation available for viewing during the inspection to demonstrate that caregiver #1 and caregiver #2 had complete 16 hours of training for the previous year. 2. The provider confirmed the both caregivers had not completed the required 16 hours of annual training.
Plan of Correction:	The provider responded: Going forward all caregivers will complete 16 hours of training annually.
Standard #:	8VAC20-800-350-E
Description:	Based on observation, it was determined that the provider did not ensure that hot water at taps available to children shall be maintained within a range of 105?F to 120?F. Evidence: 1. The hot water tap in the bathroom used by the children in care had a temperature of 143 degrees. 2. the provider confirmed that the hot water tap used by the children in care was not within the required temperature range.
Plan of Correction:	The provider responded: The temperature on the water heater will be turned down to ensure that it is in the required temperature range.
Standard #:	8VAC20-800-570-A
Description:	Based on observation and interview, it was determined that the provider did not ensure that a caregiver does not exceed 16 points. Evidence: 1. The Licensing Inspector arrived at the family day home and found caregiver #1 working alone with 8 children. Based on the children's ages, caregiver #1 was caring for a group of children that was 18 points. 2. Caregiver #1 confirmed that she had exceeded the maximum number of points for a single caregiver.
Plan of Correction:	The provider responded: We will ensure that each caregiver is responsible for no more that 16 points. A new caregiver is being hired currently.
Standard #:	8VAC20-820-120-E-2
Description:	Based on observation and interviewed, it was determined that the provider did not ensure that the findings of the most recent inspection of the family day home were posted. Evidence: 1. The findings from the most recent inspection of the family day home were not posted. 2. Caregiver #1 confirmed that the most recent inspection of the family day home were not posted.
Plan of Correction:	The provider responded: We will that the findings of the most recent are always posted.