VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Delia Ochoa - Amini
3249 Jermantown Road
Fairfax, VA 22030
(571) 970-8187

Current Inspector: Ariel Hayes (804) 629-7124

Inspection Date: Sept. 17, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-111 Administration 22VAC40-111 Personnel 22VAC40-111 Household Members 22VAC40-111 Physical Health of Caregivers and Household Members 22VAC40-111 Caregiver Training 22VAC40-111 Physical Environment and Equipment 22VAC40-111 Care of Children 22VAC40-111 Preventing the Spread of Disease 22VAC40-111 Medication Administration 22VAC40-111 Emergencies 22VAC40-111 Nutrition 22VAC40-191 Background Checks for Child Welfare Agencies

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, including telephone contacts, documents review. A renewal inspection was initiated on 9/17/2021 and concluded on 9/23/2021. The provider was contacted by telephone and a virtual inspection was conducted. There were 6 children present with 1 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 2 child records, 2 pet records, and 3 staff and 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. Contact kara.vaughan@doe.virginia.gov with questions regarding this inspection.

Violations:

Standard #:	22VAC40-111-60-B
Description:	Based on record review, one of two children's records reviewed did not contain all required information. Evidence; Child 1's record did not contain a health insurance policy number.
Plan of Correction:	Provider obtained the policy number.
Standard #:	22VAC40-111-70-A
Description:	Based on record review, two of two children's records did not contain documentation that the provider had notified the parents of whether the family day home has a liability insurance policy. Evidence: Child 1's record contained the liability insurance disclosure form, but it was not signed by the parent. Child 2's record did not contain any documentation pertaining to liability insurance.
Plan of Correction:	Child 1 signed Child 2 signed in folder
Standard #:	22VAC40-111-170-A
Description:	Based on record review, one household member did not have a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form. Evidence: Adult 1 did not have record of Tuberculosis screening on file.
Plan of Correction:	Adult one - got a copy of TB test dated 3/1/2019.
Standard #:	22VAC40-111-460-C
Description:	Based on record review, one of the two dog records checked did not contain a current rabies vaccination. Evidence: Dog 1's record contains documentation of a rabies vaccination which expired on 6/4/2021.
Plan of Correction:	Dog 1- attach new copy with current date 6/29/2021. Due 6/29/2024.