VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Mia Stewart
7225 Plantation Road
Roanoke, VA 24019
(540) 580-1554

Current Inspector: Rebecca Forestier (540) 309-2835

Inspection Date: Dec. 1, 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 LICENSE PROCESS 8VAC20-820 HEARING 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

Comments:

An unannounced renewal inspection was conducted on 12/01/2022. There were 10 children, ages 4 months-2 years, totaling 27 points, and a total of 3 caregivers present during the inspection. The inspector reviewed compliance in the areas of administration, personnel, household members, caregiver training, physical equipment and environment, care of children, preventing the spread of disease, emergencies and nutrition. A total of five children?s records, three caregiver records, two household members? records and three pet record were reviewed. The children were observed during free choice play, lunch and nap time. The inspector discussed safe sleep, emergency preparedness and administering medication requirements with the provider. The inspector arrived for the inspection at 11:30 am and departed at 2:00 pm. Information gathered during the inspection determined non-compliance with applicable standards or law and violations were documented on the violation notice issued to the provider.

Violations:

Standard #:	8VAC20-800-730-D
Description:	Based on observation, the provider failed to ensure that medication, including medications for caregivers and household members, shall be kept in a locked place using a safe locking method that prevents access by children. Evidence: There was a bottle of children?s allergy medication in a storage cube of the changing table. The medication was not locked to prevent access by children.
Plan of Correction:	The medication was locked during the inspection.
Standard #:	8VAC20-800-750-A
Description:	Based on observation and interviews, the provider failed to ensure that when topical skin products such as diaper ointment the product shall be in the original container and, if provided by the parent, labeled with the child?s name. Evidence: There were 3 diaper ointments and 1 diaper powder in a storage cube of the changing table that were not labeled with children?s names. Caregiver 1 verified that the topical skin products had been provided by parents.
Plan of Correction:	Will throw them all away.
Standard #:	8VAC20-800-830-C
Description:	Based on interviews, the provider failed to ensure that documentation shall be maintained of emergency evacuation and shelter-in-place drills to include all of the elements as required by the standards. Evidence: Caregiver 1 stated that the drills had been conducted but that they had not been documented. The required elements of the emergency evacuation and shelter-in-place drills were not available for review.
Plan of Correction:	Will document drills.
Standard #:	8VAC20-800-880
Description:	Based on observation, the provider failed to ensure that when family day homes provide meals or snacks, the family day home shall follow the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United Stated Department of Agriculture. Evidence: All of the required components for lunch were not provided. Lunch requires the following 5 components: fluid milk, meat/meat alternate, vegetables, fruits and grains. The children were served the following: a hotdog, ? slice of bread, French fries, pineapples and juice. The children were not provided a fluid milk with their meal.
Plan of Correction:	Going to go buy milk.
Standard #:	8VAC20-800-900-B
Description:	Based on observation, the provider failed to ensure that children shall not be allowed to eat or drink while walking, running, playing, lying down or riding in vehicles. Evidence: Child 6, Child 8 and Child 10 were observed walking around the child care room while drinking from their cups.
Plan of Correction:	Will not have cups accessible to the children. Will give water breaks during the day.
Standard #:	8VAC20-800-100-A
Description:	Based on record review, the provider failed to ensure that prior to a child?s attendance or within 30 days after the first day of attendance, documentation of a physical examination by or under the direction of a physician shall be obtained. Evidence: 1. The record for Child 2 contained a documented start date of 09/09/2022; the record did not contain documentation of a physical examination. 2. Caregiver 1 stated that the start date for Child 3 was 11/29/2021; the record did not contain documentation of a physical examination. 3. The record for Child 5 contained a documented start date of 10/10/2022; the record did not contain documentation of a physical examination.
Plan of Correction:	Will let the parents know today what is missing.
Standard #:	8VAC20-800-120-B
Description:	Based on record review, the provider failed to ensure that assistant caregiver records shall contain all of the elements as required by the standards. Evidence: The record for Caregiver 3 did not contain the following information: verification of age; and documentation that two or more references as to character and reputation as well as competency were checked before employment (there was only one reference in the record).
Plan of Correction:	Got the ID today and will also get another reference today.
Standard #:	8VAC20-800-60-B
Description:	Based on record review, the provider failed to ensure that children?s records shall contain all of the elements as required by the standards. Evidence: 1. The record for Child 1 did not contain the following information: name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached (the address for the second designated person was incomplete). 2. The record for Child 2 did not contain the following information: the telephone number of the child?s physician; and the name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached (there were no addresses provided for the two designated contacts). 3. The record for Child 3 did not contain the following information: the first date of attendance; and documentation of the review of the child?s emergency contact information (the most recent review took place on 11/29/2021). 4. The record for Child 5 did not contain the following information: name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached (there were no addresses provided for the two designated contacts)
Plan of Correction:	Will let the parents know today what is missing.
Standard #:	8VAC20-800-90-A
Description:	Based on record review, the provider failed to ensure that before a child may attend the family day home, documentation that the child has been adequately immunized shall be obtained. Evidence: 1. The record for Child 2 contained a documented start date of 09/09/2022; the record did not contain documentation of immunizations. Child 2 was in care during the 12/01/2022 inspection. 2. The record for Child 4 contained a documented start date of 04/01/2021; the immunization record was dated 11/22/2021. 3. The record for Child 5 contained a documented start date of 10/10/2022; the record did not contain documentation of immunizations. Child 5 was in care during the 12/01/2022 inspection.
Plan of Correction:	Will let the parents know today what is missing.
Standard #:	8VAC20-800-170-A
Description:	Based on record review, the provider failed to obtain from each caregiver, at the time of hire, a report documenting the absence of tuberculosis. Evidence: The record for Caregiver 3 contained a documented hire date of 10/31/2022. The record did not contain documentation of a tuberculosis screening.
Plan of Correction:	Has an appointment for Monday.
Standard #:	8VAC20-800-590-A
Description:	Based on observation, the provider failed to ensure that infants shall be placed on their backs when sleeping or napping. Evidence: Child 5, determined to be 4 months old, was observed being placed in their crib on their stomach to sleep.
Plan of Correction:	All children will be placed on their backs for sleeping.
Standard #:	8VAC20-800-680-B
Description:	Based on observation, the provider failed to ensure that children?s hands are washed with liquid soap and warm running water after diapering. Evidence: Child 1 was observed during a diaper change. Child 1?s hands were not washed with liquid soap and warm running water after the diaper change. Child 1 was observed returning to normal activities after the diaper change.
Plan of Correction:	Caregiver and children will wash hands together after diapering.