VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Maria Reyes
1378 Butter Churn Drive
Herndon, VA 20170
(571) 306-9512

Current Inspector: Stacy Doyle (571) 835-0386

Inspection Date: Oct. 6, 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 8VAC20-820 THE LICENSE. 8VAC20-820 THE LICENSING PROCESS. 8VAC20-770 Background Checks 22.1 Background Checks Code, Carbon Monoxide 54.1 Provider must be MAT certified to administer prescription medication. 63.2 Child abuse and neglect

Comments:

An unannounced monitoring inspection was conducted today from 9:42am-10:46am with the provider on site. There was 1 child in care and 2 resident children with 1 caregiver. One child?s file and 2 caregivers/household member's files were reviewed. The children were engaged in the following: toy play and watching tv. The physical space, attendance records, first aid kit, drill record and the Emergency Preparedness Plan were reviewed. There were no medications on site. Areas of non-compliance are identified in the violation notice. Please contact me if you have any questions at Stacy.Doyle@doe.virginia.gov or 571-835-0386.

Violations:

Standard #:	8VAC20-770-40-D-4-a
Description:	Based on review of household members records, the provider did not obtain a completed sworn disclosure statement for each household member when the person began residing in the home and did not obtain the central registry results within 30 days of a person residing in the home. Evidence: 1. Household Member #1 (moved in July 1, 2022) had a sworn disclosure statement dated 7/21/2022 and did not have the central registry results. Central Registry results were sent to the household member instead of the provider.
Plan of Correction:	I will resend it.
Standard #:	8VAC20-800-760-A-1
Description:	Based on observation, the first aid kit did not contain the minimum requirements. Evidence: 1. The provider's first aid kit was missing the following: first aid instruction manual.
Plan of Correction:	I will buy a new one.
Standard #:	8VAC20-800-830-A
Description:	Based on review of the emergency response drill record, the provider did not practice the emer gency evacuation procedures monthly with all caregiversand children in care during all shifts that children are in care. Evidence: 1. The provider did not practice an emergency evacuation drill in June 2022, July 2022 and August 2022.
Plan of Correction:	I will do it every month.
Standard #:	8VAC20-800-50-C
Description:	Based on observation, the provider did not keep information contained in a child's record confidential. Evidence: 1. The provider had the supplemental page posted on the wall from the 4/21/2022 inspection. The page is considered confidential.
Plan of Correction:	I will not post it.
Standard #:	8VAC20-800-170-A
Description:	Based on review of household member records, the provider did not obtain from each adult household member a current report of Tuberculosis Screening prior to coming into contact with children. Evidence: 1. Household Member #1 (Move in date 7/01/2022) had a tuberculosis screening dated 7/21/2022.
Plan of Correction:	In the future, I'll make sure it's done before moving in.
Standard #:	8VAC20-800-320-A
Description:	Based on observation, small electrical appli- ances such as toasters were not unplugged when not in use. Evidence: 1. A toaster was plugged into the electrical outlet and was not being used.
Plan of Correction:	I will disconnect it and will remind her.
Standard #:	8VAC20-800-320-B
Description:	Based on observation, the provider failed to cover all unused electrical outlets accessible to children under 5 years of age with child-protec- tive covers. Evidence: 1. In the Dining room, four unused electrical outlets were not covered.
Plan of Correction:	I will cover them now.
Standard #:	8VAC20-800-320-I
Description:	Based on observation, the provider did not have smoke detectors on each level of the home. Evidence: 1. The provider did not have a smoke detector on the top upstairs level.
Plan of Correction:	I will tell him to connect it tonight.