VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Khalida Kazimi
25814 Turlough Terrace
Chantilly, VA 20152
(571) 245-2103

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: Aug. 8, 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 8VAC20-820 THE LICENSING PROCESS 8VAC20-770 Background Checks 22.1 Background Checks Code, Carbon Monoxide 63.2 Child abuse and neglect

Comments:

An unannounced renewal inspection was conducted on 8/8/2023 from 11:30am-1pm. There were 4 children present directly supervised by the provider and 1 assistant caregiver. The home, 2 caregiver records, 2 children?s records, 2 household member?s records, evacuation drills, and emergency supplies were inspected. Children were observed playing freely and eating lunch. Areas of non-compliance are identified in the Violation Notice. If you have any questions regarding this inspection, please contact the Licensing Inspector at jessica.willis@doe.virginia.gov or 571-352-1453.

Violations:

Standard #:	22.1-289.035-A
Description:	Based on record review, results of the search of the Central Registry were not obtained every five years for 1 caregiver. Evidence: 1. The most recent Central Registry search results in the record for Caregiver #1 were dated 01/22/2018.
Plan of Correction:	The provider will submit documentation that the search was requested within 10 business days.
Standard #:	8VAC20-800-800-B
Description:	Based on record review, the provider did not review the emergency plan annually. Evidence: 1. The most recent documented review of the emergency preparedness plan was dated 07/12/2022.
Plan of Correction:	We will review the plan today.
Standard #:	8VAC20-800-60-B
Description:	Repeat Violation Based on record review, 2 of 2 children's records reviewed did not contain all required information. Evidence: 1. The records for Child #1 and 2 did not contain the address and phone number of the father's place of employment. 2. The records for Child #1 and 2 did not contain the policy number of the child's medical insurance 3. The records for Child #1 and 2 did not contain 1 of 2 required designated persons to contact in case of an emergency if the parent cannot be reached 4. The record for Child #2 did not contain written authorization for emergency medical care should an emergency occur and the parent cannot be located immediatel.
Plan of Correction:	We will ask the parents for the information.
Standard #:	8VAC20-800-70-B
Description:	Based on record review, the provider did not obtain the parent's written acknowledgement of the receipt of all requried information. Evidence: 1. The records for Child#1 and 2 did not contain written acknowledgement of the receipt of whether or not there is liability insurance 2. The record for Child #2 did not contain written acknowledgement of the receipt of the provisions of the family day home's emergency preparedness and response plan;
Plan of Correction:	We will ask the parents for the forms or have them sign new ones.
Standard #:	8VAC20-800-80-C
Description:	Based on record review, the provider did not document the method of verification of the child's age and identity; Evidence: 1. The records for Child #1 and 2 did not contain documentation of the date of verification of the child's age and identity and the signature of person viewing the documentation.
Plan of Correction:	The date and signature will be added.
Standard #:	8VAC20-800-530-F
Description:	Based on observation, soft bedding was used under an infant. Evidence: 1.Child #3 was observed sleeping in a crib while using a pillow.
Plan of Correction:	We will remove the pillow.