VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tara Koontz
98 Pleasant Hill Road
Harrisonburg, VA 22801
(540) 578-3499

Current Inspector: Stephanie Reed (540) 272-6558

Inspection Date: April 10, 2023

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. 8VAC20-770 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.

Comments:

A mandated monitoring inspection was conducted on April 10, 2023 from 10:15 A.M.-12:00 P.M. There were four children present, ranging in ages from five months to 19 months, for a total of 15 points with one caregiver supervising. The inspector reviewed compliance in the areas of administration, physical plant, staffing and supervision, programming, medication, special care and emergencies and nutrition. A total of four child records, one caregiver and two household member records 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. If you have any questions or concerns please contact the Licensing Inspector at 540-430-9257.

Violations:

Standard #:	22.1-289.035-A
Description:	Based on a review of records, the provider failed to complete an updated sworn disclosure statement every five years. Evidence: 1. The sworn disclosure statement on record for the provider expired on 04/02/2023. 2. The provider verified an updated sworn disclosure statement had not been completed.
Plan of Correction:	An updated sworn disclosure statement was completed and sent to the Licensing Inspector.
Standard #:	22.1-289.036-A
Description:	Based on a review of household member records, the provider failed to update the sworn disclosure statements every five years. Evidence: 1. The sworn disclosure statements for Household Member #1 and #2 expired on 04/02/2023. 2. The provider verified that an updated sworn disclosure statement had not been completed for the Household Members.
Plan of Correction:	The sworn disclosure statements were updated and sent to the Licensing Inspector.
Standard #:	8VAC20-800-140-B-3
Description:	Based on review of records, the provider did not ensure they had a current certification in cardiopulmonary resuscitation (CPR). Evidence: 1. The record of the provider contained a cardiopulmonary resuscitation (CPR) certification that expired on 12/31/2022. 2. The provider verified that the cardiopulmonary resuscitation (CPR) certification had expired.
Plan of Correction:	The provider will reach out to a local resource to see if there is a class available. Once the certification is completed the provider will send evidence to the Licensing Inspector.
Standard #:	8VAC20-800-140-B-4
Description:	Based on review of records, the provider did not ensure they had a current certification in First Aid. Evidence: 1. The record of the provider contained a First Aid certification that expired on 12/31/2022. 2. The provider verified that they did not have a current certification n First Aid.
Plan of Correction:	The provider will reach out to a local resource to get scheduled to obtain the first aid certification. Once obtained the provider will send evidence to the Licensing Inspector that it has been completed.
Standard #:	8VAC20-800-210-A
Description:	Based on review of provider records, the provider failed to ensure that a minimum of sixteen hours of training was completed annually. Evidence: 1. The provider had not completed any training for the fiscal year April 2022-April 2023. 2. The provider verified that there had been no training completed within the last year.
Plan of Correction:	The provider will work on getting her training hours for the fiscal year 2023-2024 started and completed within the required timeframe.