VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Shalla Flores
3425 West Ox Road
Herndon, VA 20171
(703) 860-3939

Current Inspector: Charles Perkins (703) 309-3963

Inspection Date: Dec. 12, 2023

Complaint Related: No

Areas Reviewed:

8 VAC 20-800 Administration 8 VAC 20-800 Personnel 8 VAC 20-800 Household Members 8 VAC 20-800 Physical Health of Caregivers and Household members 8 VAC 20-800 Caregiver Training 8 VAC 20-800 Physical Equipment and Environment 8 VAC 20-800 Care of Children 8 VAC 20-800 Preventing the Spread of Disease 8 VAC 20-800 Medication Administration 8 VAC 20-800 Emergencies 8 VAC 20-800 Nutrition 8 VAC2 0-820 THE LICENSE 8 VAC 20-820 THE LICENSING PROCESS 8 VAC 20-770 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

Technical Assistance:

Discussion on enrollment and updated household certification documents.

Comments:

This monitoring inspection was initiated by licensing staff and concluded on 12/12/2023, between the hours of 2:30 pm to 4:40 pm. There were 6 children present (17 points), ranging from infant to preschool-age, with 2 caregivers supervising. The children were engaged in the following: toy play, games, music, movie time, freeplay, diapering, hand washing, and other organized activities. 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 9 children records, 1 household record, and 2 staff records were reviewed. Information gathered during the inspection determined that there were (5) non-compliances with the applicable standards. These violations were documented on the Violation Notice issued to the home. If you should have any questions, please call or send an email to charlie.perkins@doe.virginia.gov. Thank you. Charlie Perkins, Licensing Inspector (703) 309-3963

Violations:

Standard #:	8VAC20-800-780-B
Description:	Based on review, 5 of 9 children files indicated that documentation of the annual review of each child's listed emergency contact information was not conducted and recorded by each child's parent. Evidence - On the date of inspection (12/12/2023), the following children did not have documentation of file of their annual emergency contact information review: 1. Child #1 (last dated - 02/12/22), 2. Child #2 (last dated - 08/02/22), 3. Child #3 (last dated - 10/20/21), 4. Child #6 (last dated - 09/07/22), 5. Child #9 (last dated - 11/09/22).
Plan of Correction:	All missing information / documentation will be obtained and placed on file.
Standard #:	8VAC20-800-100-A
Description:	Based on review, 3 of 9 children files indicated that the Provider did not obtain documentation of a physical examination (by or under the direction of a physician) within 30 days after the first day of attendance. Evidence - 1. On the date of inspection (12/12/2023), the following children did not have documentation of a physical examination available for review: Child #4 (start date - 05/25/2023), Child #5 (start date - 10/18/2023), and Child #9 (start date - 11/10/2022). 2. Child #4, Child #5, and Child #9 were all in attendance on the date of inspection.
Plan of Correction:	All missing information / documentation will be obtained and placed on file.
Standard #:	8VAC20-800-70-A
Description:	Based on review, 4 of 9 children files indicated that not all of the required documentation was contained within each child's record. Evidence - On the date of inspection (12/12/2023), the following documents were not available for review: 1. Information for Parents form was not signed by the parents of: Child #6, and Child #9. 2. Medication Administration - Decision to Administer form was not available for - Child #3, Child #5, Child #6, and Child #9.
Plan of Correction:	All missing information / documentation will be obtained and placed on file.
Standard #:	8VAC20-800-80-A
Description:	Based on review, 1 of 9 children files indicated that documentation that the proof of identification for each child was reviewed by the provider was not available. Evidence - 1. On the date of inspection (12/12/2023), the review of the proof of identification for Child #6 was not documented by the provider. 2. The start date for Child #6 was listed as 09/22/2022.
Plan of Correction:	All missing information / documentation will be obtained and placed on file.
Standard #:	8VAC20-800-90-A
Description:	Based on review, 1 of 9 children files indicated that the Provider did not obtain documentation that a child has been adequately immunized (according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations). Evidence - 1. On the date of inspection (12/18/2023), documentation of an immunization record for Child #4 was not available for review. 2. The start date for Child #4 was listed as 05/25/2023 and was in attendance of the date of inspection.
Plan of Correction:	All missing information / documentation will be obtained and placed on file.