VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Elena Maldonado
6606 Moly Drive
Falls church, VA 22046
(703) 615-3127

Current Inspector: Keesha Minor (571) 596-3660

Inspection Date: Oct. 26, 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 8VAC20-800 Transportation 8VAC20-820 THE LICENSE. 8VAC20-820 THE LICENSING PROCESS. 22.1 Background Checks Code, Carbon Monoxide 54.1 Provider must be MAT certified to administer prescription medication.

Technical Assistance:

1. Discussed attendance record requirements. Children should not be listed present until they arrive. 2. Reviewed the emergency preparedness plan and recommended evacuation/relocation not occur due to an exterior threat such as a shooting incident, as the plan states. 3. All reference checks are to be signed and dated. 4. Crib sheets should be checked daily for cleanliness and pulled tightly prior to children being placed in the cribs. 5. All caregivers are to be able to speak, read and write in English.

Comments:

An unannounced renewal inspection was conducted at 9:35am. Observed 10 children totaling 26 points with 3 caregivers. Children were playing with toys, puzzles, washing hands, eating a morning snack, and reading books during the inspection. The daycare areas of the home were found to be clean and well supplied with toys and equipment for the children. Areas of non-compliance with standards and laws reviewed were found. Questions about this inspection may be directed to pamela.sneed@doe.virginia.gov Note: The licensee should submit the plan of corrections within 5 business days of receipt of this report for the plans to be included and posted on the VDOE website.

Violations:

Standard #:	22.1-289.011-F
Description:	Based on observations made, the licensee failed to ensure that the findings from the most recent inspection were posted in a conspicuous place on the licensed premises. Evidence: The inspection report dated 8/15/23 was not posted. The inspection acknowledgement form dated 4/19/23 was posted.
Plan of Correction:	a. I now posted the inspection report dated 8/15/23 in a conspicuous place. b. compliance is achieved, and consider the matter resolved.
Standard #:	22.1-289.023-A
Description:	Based on observations made, the Notice of Intent issued by VDOE to reduce the licensed capacity and require the licensee to contact parents, guardians, or other responsible persons regarding health and safety violations was not posted in a prominent place at each public entrance of the licensed premises. Evidence: The Notice of Intent and supporting violation notices were not posted in the home.
Plan of Correction:	I acknowledge the violation and apologize for any oversight in this matter. We take our responsibility as childcare providers very seriously and are committed to providing a safe and nurturing environment for the children in our care. We understand that the Notice of Intent and the accompanying violation notices should have been prominently posted at each public entrance of the licensed premises, as mandated by the VDOE. Upon receiving your notice, I took immediate action to rectify this issue. The Notice of Intent and supporting violation notices have now been prominently posted a visible area ensuring that parents, guardian, and responsible persons are well-informed about the health and safety violations and the required reduction in-licensed capacity.
Standard #:	8VAC20-800-730-D
Description:	Repeat violation. Based on observations made, the licensee failed to ensure that a medication belonging to a household member was kept in a locked place. Evidence: A bottle of over-the-counter pain reliever was found to be on an open shelf in the kitchen and not locked.
Plan of Correction:	1. Immediate Corrective Action: 1. I removed the unsecured medication from the open shelf immediately. 2. Secured the medication in a locked cabinet or container inaccessible to children. 2. Explained the severity of the violation and importance of maintaining a safe environment for children to staff members. I will continue monitoring and supporting efforts to ensure future compliance.
Standard #:	8VAC20-800-800-B
Description:	Based on records reviewed, the licensee failed to ensure that the emergency preparedness plan was reviewed/updated annually. Evidence: The emergency plan was last dated by the provider on 6/30/17.
Plan of Correction:	I acknowledge that the emergency preparedness plan was last dated and provided on 6/30/17. I understand the importance of maintaining an up-to-date emergency. to rectify this situation, I have taken the following actions: preparedness plan to ensure the safety and well-being of the children under our care. I have immediately revised the emergency preparedness plan to reflect the current date and made the necessary updates to ensure that it complies with all relevant regulations and guidelines.
Standard #:	8VAC20-800-830-B
Description:	Based on records reviewed, 0 of 2 shelter-in-place drills were not practiced in the last 12 months. Evidence: According to the shelter-in-place log sheet the last practice drill was conducted on 10/12/22.
Plan of Correction:	To address the violation of not conducting 2 out of 2 requires shelter-in-place drills int he last 12 months, I will develop a plan of action that includes the following steps: a. Monitor Compliance: Implement a system for tracking and documenting shelter-in-place drills going forward to ensure ongoing compliance. b. Conduct Drills. I will ensure that the rescheduled drills are conducted as planned. Document the dates and outcomes of these drills. c. Regular Review: Review the corrective action plan and make necessary adjustments to maintain compliance with shelter-in-place drill requirements. By following this plan of action, I am addressing the violation, bringing the organization back into compliance, and establish a framework for ongoing adherence to shelter-in-place drill requirements.
Standard #:	8VAC20-800-920
Description:	Based on observations made and interview conducted, the licensee failed to ensure that the menu for the current one-week period was given to or placed in an area where parents could view. Evidence: The menu was not posted in the home for viewing. When the inspector asked how parents know what food is being served/on the menu Caregiver #1 said the parents say they don't need to know.
Plan of Correction:	1. Corrective Action: a. Discussed the violation with Caregiver #1. b. Emphasize the importance of transparency in menu planning for parents. c. Explain the regulatory requirement to provide menus for the current one-week period and make them accessible to parents. d. I rectify the issue immediately. 2. Menu is posted immediately for the current one-week period in a visible area accessible to parents. b. The posted menu is clear, legible and contains information about all meals and snacks provided to the children. 3. Training and Education: a. I will continue to conduct additional training and education to all caregivers, including Caregiver #1, on the importance of following regulations and being transparent with parents regarding the menu.
Standard #:	8VAC20-800-60-B
Description:	Repeat violation. Based on records reviewed, 3 of 10 children's records reviewed did not include documentation of required information. Evidence: 1. Child #16- There was no documentation of 1 of 2 emergency contact persons to include name, address and phone number. 2. Child #17 - There was no documentation of 1 of 2 emergency contact persons to include name, address and phone number. 3. Child #18 - There was no documentation of 1 of 2 emergency contact persons to include name, address and phone number.
Plan of Correction:	1. Communications with the Responsible Party: I contacted the responsible parents to provide the missing documentation for maintaining child at daycare. I emphasized the importance of maintaining accurate and complete records for the safety and well-being of the children in the daycare. 2. Request Immediate Corrective Action: Instructed the responsible/parent to take immediate action to address the missing information for the three children (Child #16, Child #17, and Child #18). As of 10/27/23 I ensure information included: Emergency contact persons' names, addresses, and phone numbers, is promptly added to the children's records.
Standard #:	8VAC20-800-90-C
Description:	Based on records reviewed, 1 of 10 children's records did not include documentation of immunizations every 6 months until the age of 2 years old. Evidence: The immunizations on-file for Child #18 were dated April 2022 when the child was 6 months old.
Plan of Correction:	Thank you for bringing to my attention the immunization documentation concern for Child #18. I appreciate your diligence in conducting the inspection. Upon receiving the violation notice, I immediately reviewed and rectified the situation. I have ensure that Child #18's immunizations are now up to date as per the requirements, with the necessary documentation in place. Going forward, we will maintain strict adherence to the immunization schedule for all children under our care, including regular updates and tracking until the age of 2 years old.
Standard #:	8VAC20-800-240-A
Description:	Repeat violation. Based on observations made, an area of the daycare and a piece of equipment were not maintained in a safe condition. Evidence: 1. Child #15 was observed climbing onto and falling off of a stack of carpet squares (the carpet appeared to be replacement squares for the existing carpet in the daycare area) and underneath of an adjacent table. The child's head narrowly missed hitting the tabletop edge. While Child #15 was underneath the table a second child, Child #10, climbed onto the carpet squares. The carpet squares were located between the wall and a table where children were sitting. 2. The diaper changing pad had 2 areas where the vinyl cover was torn and the interior foam padding was exposed.
Plan of Correction:	1.1 I removed the stack of carpet squares immediately to eliminate the risk of children climbing on them and falling off. 1.2 I relocate properly store the replacement carpet squares in a secure area away from the daycare space to prevent access by the children. 1.3 I ensure that all furniture and equipment in the daycare area are regularly inspected for safety and maintained in good condition by me (EM). Any damaged or unsafe items have been removed. 1.4 I will conduct additional ongoing staff training to raise awareness of child safety issues, emphasizing the importance of supervision and prompt intervention when hazardous situations arise. 1.5 I will continuously monitoring/supervision to prevent the recurrence of such incidents. Staff members should continue to be actively present and engaged int the daycare area at all times to ensure child safety. Unsafe Diaper Changing Pad 2.1 I immediately replaced the diaper changing pad with a new, undamaged one to ensure safety and comfort of the children during diaper changes. 2.2 I implemented a regular equipment maintenance schedule to inspect all equipment and materials used in the daycare. This schedule is included checking for any tears, damage, or wear and tear on the equipment. 2.3 I will ensure that all staff members responsible for diaper changing are trained to recognized and report damaged equipment, and they should promptly request replacements when necessary. 2.4 Maintain an inventory of essential daycare supplies and equipment, including diaper changing pads, and order replacements in advance to avoid prolonged use of damaged items.
Standard #:	8VAC20-800-280
Description:	Repeat violation. Based on observations made, the licensee failed to ensure that potentially poisonous substances were stored in areas not accessible to the children. Evidence: 1. A spray bottle labeled "bleach + water" was sitting on the front edge of an open shelf adjacent to the diaper changing table. The shelf was approximately 37" from the floor and within reach of children. 2. An assortment of cleaning supplies to include cans of spray disinfectant, toilet cleaner, rubbing alcohol, and other bathroom cleaning products were stored in an unlocked cabinet under the sink in the bathroom used by children located on the mid-level of the home and within reach of children. 3. Air freshener products (3) were found to be sitting on a table at the entrance to the home adjacent to the children's cubbies and within reach of children. 4. Two (2) containers of burn cream/gel were on top of the children's cubbies on the mid-level of the home and within reach of children.
Plan of Correction:	1. Immediate Corrective Action: I removed the spray bottled labeled "bleach + water" from the front edge of an open surface to a safe and inaccessible location. I ensure and I will continue to make sure that the spray bottle is properly sealed and labeled in accordance with safety standards. 2. Comprehensive Inventory Assessment: I conducted a thorough inventory assessment of all potentially poisonous substances within the daycare facility. This Inventory will be ongoing I ensured all substances are clearly labeled, stored in their original containers, and located in a secure, locked cabinet/storage area that is out of children's reach. 3. Staff Training and Awareness: I provided all daycare staff with updated training on the proper storage of potentially poisonous substances. I emphasized the importance of immediately cleanup after using such substances and safe disposal practices. Completion Timeline: The above action steps have been completed/implemented immediately. I will perform regular inspections, audits, and reviews an on ongoing basis to maintain compliance and prevent further violations. [sic]
Standard #:	8VAC20-800-570-A
Description:	Repeat violation. Based on observations made, a caregiver was left alone with 10 children totaling more than the 16 points allowed. Evidence: Caregiver #2 left the daycare area (in the basement) and went upstairs for a period of 2 minutes leaving Caregiver #3 alone with 10 children totaling 26 points. During this time an older child was observed punching a younger child in the back with their fist twice and the caregiver was unaware until the inspector alerted her.
Plan of Correction:	1. Immediate Action Takend: a) I ensured and I will continue the immediately safety and well-being of all children present in my daycare. 2. Immediate Corrective Actions: a. Reinforced the daycare's staffing and child-to-caregiver ratio policies to all staff members, emphasizing the importance of compliance. b. Provide additional training to all caregivers, with an emphasis on child safety and supervision techniques. c. Implemented stricter protocols for communication and accountability when multiple caregivers are present, ensuring that no child is left unsupervised or in excess of the allowed capacity. d. I will monitor an ongoing bais to ensure that staffing and child-to-caregiver ratios are consistently maintained. e. I will conduct surprise spot checks and inspections to verify that the corrective actions are being followed. This plan of action addresses the violation, seeks to prevent future occurrences, and prioritizes the safety and well-being of the children in the daycare. [sic]
Standard #:	8VAC20-800-680-A
Description:	Repeat violation. Based on observations made, a caregiver did not wash their hands with soap and water before serving food to the children. Evidence: Caregiver #3 was playing with children before helping to serve the morning snack. She did not wash her hands when assisting with snack.
Plan of Correction:	1. Training: I will ensure that all caregivers are reminded of and they have received retraining on proper handwashing techniques as per the guidelines set the regulatory authority. 2. Supervision: I implemented stricter supervision to monitor and ensure that all caregivers wash their hands with soap and water before any food-related tasks, especially when interacting with children. 3. Reminders: I placed clear and visible reminders near food preparation areas and in common caregiver spaces to remind them of the importance of handwashing.