VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jennifer Rivera Rodriguez
175 Queen Victoria Street
Culpeper, VA 22701
(540) 229-7684

Current Inspector: Kelly Adriazola (804) 840-8245

Inspection Date: Oct. 4, 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

Comments:

An unannounced monitoring and compliance inspection was conducted on-site October 4, 2023. The provider was available during the inspection. There were 12 children present with 3 staff 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 5 child records and 3 staff 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. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it to me within 5 business days from today. Please specify how the deficient practice will be or has been corrected. Your plan of correction should contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measures. Please do not use staff names; list staff by positions only.

Violations:

Standard #:	8VAC20-800-780-B
Description:	Based on record review and interview, the provider failed to obtain the parent's signed acknowledgement that an annual review of the emergency contact information for each child occurred. Evidence: The record of child #4, enrolled 06/05/22, contained documentation that thelast annual review was signed and dated 05/16/22. Caregiver #2 confirmed the absence of an annual review.
Plan of Correction:	Have parents sign annual reviews per tickler system in planner. Adding this to other paperwork train.
Standard #:	8VAC20-800-100-A
Description:	Based on review of children?s record and interview, the provider failed to obtain a physical examination by or under the direction of a physician prior to the child's attendance or within 30 days after the first day of attendance. Evidence: The record of child #1(age 6m), enrolled 06/11/23, contained documentation of a physical dated 07/19/23. The provider confirmed this was the only physical received.
Plan of Correction:	The parents must bring ALL info prior to child's start date.
Standard #:	8VAC20-800-70-A
Description:	Based on record review and interview, the provider failed to ensure that parents were provided the required information for parents before the child's first day of attendance. Evidence: 1. The record of child #1, enrolled 06/11/23, and child #2, enrolled 04/14/23, did not contain evidence that the parents of these children were provided in writing, the requirement for the parent to inform the family day home within 24 hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life-threatening diseases, which must be reported immediately. 2. The provider confirmed the written information for parents was rewritten and did not include this requirement.
Plan of Correction:	Addendum added to contract for children.
Standard #:	8VAC20-800-90-A
Description:	Based on a review of children's records and interview, the provider failed to obtain documentation that a child had been adequately immunized before the child attended the family day home. Evidence: The record of child #1 (age 6m), enrolled 06/11/23, contained immunizations dated 07/19/23. The provider confirmed these were the only immunizations received.
Plan of Correction:	All info before child's start date.
Standard #:	8VAC20-800-140-B-3
Description:	Based on a review of records and interview, the provider failed to ensure current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department. Evidence: The records of the provider and caregiver #2 contained documentation from the National CPR Foundation, which is not an approved certification. The provider confirmed the CPR certification that was taken was an online course.
Plan of Correction:	Provider and all staff will take in person first aid and cpr training.
Standard #:	8VAC20-800-140-B-4
Description:	Based on a review of records and interview, the provider failed to ensure current certification in first aid as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department. Evidence: The records of the provider and caregiver #2 contained documentation from the National CPR Foundation, which is not an approved certification. The provider confirmed the first aid course taken was online.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-540-A
Description:	Based on observation and interview, the provider failed to ensure that infant carrier seats, swings, strollers, feeding or activity tables, and high chairs shall be used according to the manufacturer's instructions and when occupied by a child, a safety strap shall be used and securely fastened. Evidence: A child was observed eating lunch in a high chair. The safety strap was not used and securely fastened. The provider confirmed the safety strap was broken.
Plan of Correction:	Highchairs have been discontinued.
Standard #:	8VAC20-800-680-A
Description:	Based on observation, the provider did not ensure that staff wash their hands with liquid soap and warm running water after diapering a child and before serving food. Evidence: 1. A caregiver was observed changing two diapers. The caregiver did not wash her hands after diapering the children. 2. Caregiver #3 did not wash hands prior to serving children lunch.
Plan of Correction:	Provider will retrain all staff on handwashing technique as a refresher for all staff to include provider. All hands washed after diapering and prior to handling food.
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 and before eating. Evidence: 1. Diaper changes of two children were observed. The two children did not have their hands washed after the diaper change. 2. 11 children were observed to not wash their hands before eating lunch.
Plan of Correction:	Provider will ensure that all children's hands are washed after diapering and before eating.