VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jamila Shah
5353 Truman Avenue
Alexandria, VA 22304
(703) 678-5079

Current Inspector: Charles Perkins (703) 309-3963

Inspection Date: July 13, 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 ?8VAC20-820 THE LICENSE. ?8VAC20-820 THE LICENSING PROCESS. ?8VAC20-820 HEARINGS PROCEDURES. ?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 ?8VAC20-790 Subsidy Program Vendor Requirements for Family Day Homes

Technical Assistance:

Discussion of the submitted FDH Initial Application for licensure. The Business Entity A (page 13) was not submitted (a blank copy will be sent); the staff information form will need to be completed; and the budget form will need to be completed. The one crib observed on site had a manufacture date of July 2015. A carbon monoxide detector was also observed on site.

Comments:

This initial inspection was initiated by licensing staff and concluded on 07/13/2022, between the hours of 10 am to 12 pm. There were no child care children present, 3 resident children (3 points), with 1 caregiver. The inspector reviewed compliance in the areas of administration; physical plant; staffing; programming; special care and emergencies; nutrition; and documentation submitted with the initial FDH application. A total of 1 staff records, and 6 household records were reviewed. No children are currently enrolled. Therefore, no children records were able to be reviewed at this time. Information gathered during the inspection determined that there were (8) non-compliances with the applicable standards, and code. These violations were documented on the Violation Notice issued to the home. If you should have any questions, please call or send an email to charlie.perkins@doe.virginia.gov. Thank you. Charlie Perkins, Licensing Inspector (703) 309-3963

Violations:

Standard #:	22.1-289.036-B-1
Description:	Based on review, 1 of 1 staff record, and 3 of 6 household records indicated that a current sworn statement or affirmation (SDS) form was available. When applying, SDS cannot be older than 90 days. Evidence - 1. On the date of inspection (07/13/2022), the following records were missing a current SDS form: Staff #1 (form dated - 09/15/2021); Household Member #1 (dated - 09/24/21); Household Member #5 (SDS form was not available); and Household Member #6 (SDS form was not available). 2. This was confirmed on the date of inspection with the Provider.
Plan of Correction:	New background checks will be obtained for all applicable adults.
Standard #:	22.1-289.036-B-2
Description:	Based on review, 1 of 1 staff record, and 3 of 6 household records indicated that a current fingerprint check (FPC) was available. When applying, FPC cannot be older than 90 days. Evidence - 1. On the date of inspection (07/13/2022), the following records were missing a current FPC form: Staff #1 (form dated - 01/19/2022); Household Member #1 (dated - 01/19/22); Household Member #5 (FPC form was not available); and Household Member #6 (FPC form was not available). 2. This was confirmed on the date of inspection with the Provider.
Plan of Correction:	New background checks will be obtained for all applicable adults.
Standard #:	22.1-289.036-B-3
Description:	Based on review, 1 of 1 staff record, and 3 of 6 household records indicated that a current copy of the results of a search of the central registry (CPS) for any founded complaint of child abuse or neglect was available. When applying, CPS check cannot be older than 90 days. Evidence - 1. On the date of inspection (07/13/2022), the following records were missing a current CPS check: Staff #1 (form dated - 01/18/2022); Household Member #1 (dated - 01/18/22); Household Member #5 (CPS check was not available); and Household Member #6 (CPS check was not available). 2. This was confirmed on the date of inspection with the Provider.
Plan of Correction:	New background checks will be obtained for all applicable adults.
Standard #:	8VAC20-800-770
Description:	Based on observation, the FDH did not have a working portable battery-operated weather band (WB) radio, and extra batteries. Evidence - 1. A WB radio was not available for review on the date of inspection (07/15/2022). 2. This was confirmed on the date of inspection by the Provider.
Plan of Correction:	A WB radio will be purchased.
Standard #:	8VAC20-800-790
Description:	Based on observation, emergency number were not posted in a visible area close to the telephone. Evidence - 1. On the date of inspection (07/15/2022), the following emergency telephone numbers were not posted: 911, the phone number of the responsible person for emergency backup care as required in 8VAC20-800-800 A 3, and the number for the regional poison control center. 2. This was confirmed on the date of inspection by the Provider.
Plan of Correction:	All required information will be posted.
Standard #:	8VAC20-800-120-B
Description:	Based on review, 1 of 1 staff record indicated that there were not at least 3 references on file for the applicant. Evidence - 1. On the date of inspection (07/13/2022), Staff #1 did not have at least 3 references on file at the FDH. 2. These references were also missing from the submitted Initial Family Day Home (FDH) license application.
Plan of Correction:	References will be obtained and placed on file.
Standard #:	8VAC20-800-140-B-2
Description:	Based on review and interview, 1 of 1 staff record indicated that at least three months of programmatic experience was not available. Evidence - 1. On the date of inspection (07/13/2022), documentation of the Provider's past experience working with children and/or in a licensed child care environment was not available for review. 2. The Provider stated (during an interview conducted on the date of inspection) that she has had 4 to 6 months of experience working with children and that a resume will be created to reflect this information.
Plan of Correction:	The Provider's experience will be documented on a resume.
Standard #:	8VAC20-800-170-B
Description:	Based on review, 1 of 1 staff record, and 3 of 6 household records indicated that current tuberculosis (TB) documentation was available. When applying, TB documentation cannot be older than 30 days. Evidence - 1. On the date of inspection (07/13/2022), the following records were missing a current TB documentation: Staff #1 (form dated - 01/16/2022); Household Member #1 (dated - 01/17/22); Household Member #5 (TB documentation was not available); and Household Member #6 (TB documentation was not available). 2. This was confirmed on the date of inspection with the Provider.
Plan of Correction:	TB documentation will be obtained and/or updated.