VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Homa Alimi
9217 Haines Drive
Lorton, VA 22079
(571) 345-5256

Current Inspector: Kristy Atanackovic (804) 629-5032

Inspection Date: May 29, 2024

Complaint Related: Yes

Areas Reviewed:

8VAC20-800 Administration 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 Emergencies 8VAC20-820 THE LICENSE 8VAC20-770 Background Checks 63.2 Child abuse and neglect 8VAC20-790 Subsidy Program Vendor Requirements for Family Day Homes

Comments:

A complaint allegation regarding supervision and serious injury was received by the Fairfax Licensing office on 5/14/2024. An investigation was initiated on 5/29/2024 and a joint agency investigation on 06/04/2024. The investigation concluded on 6/11/2024. The investigation included interviews with the caregiver and witnesses. Written witness statements, written caregiver statements, children's records, and caregiver records were reviewed. Based on the preponderance of evidence gathered, the complaint is valid. 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 submit your plan of correction within 5 business days for it to be included on the website. Thank you for your cooperation during this inspection. If you have any questions regarding this inspection, contact kristy.atanackovic@doe.virginia.gov.

Violations:

Standard #:	8VAC20-800-840-B
Complaint related:	Yes
Description:	Based on record review, witness statements, and caregiver interviews, the provider failed to document all required information on the injury report. Evidence: 1. On 01/09/2023, Child #1 (two years old) sought outside medical attention for a facial laceration that was caused by being pushed by Child #3, which caused Child #1 to fall and hit their forehead on the corner of a windowsill in the home. 2. The injury report is missing a parent's signature.
Plan of Correction:	Soria and Homa have attended the Family Day Home Refresher Training on June 8, 2024 The policies and procedures have been printed. We did not know we had to report the incident. We are now aware and we have informed all caregivers of the appropriate incident reporting and recording procedures.
Standard #:	8VAC20-800-850-A
Complaint related:	Yes
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on medical documentation, photographs, witness statements, and caregiver interviews, the provider failed to report to the department within 24 hours of the circumstances surrounding an incident involving a serious injury to a child while under the family day home's supervision. Evidence: 1. On 05/14/2024, an outside source notified the department of an injury Child #1 (2 years old) sustained under the supervision of Caregiver #1 on 01/09/2023. 2. Child #1 (2 years old) sought outside medical attention for a facial laceration that was caused by being pushed by Child #3, which caused Child #1 to fall and hit their forehead on the corner of a windowsill in the home. 3. Child #1 received approximately 7-9 stitches to close the wound. 4. Caregiver #1 confirmed they did not report the incident to the department.
Plan of Correction:	All caregivers have been informed and trained that incidents must be reported within 24 hours of occurrence. All have been informed with a written document that each person has signed stating their acknowledgement and cooporation. All have agreed to adhere to the correct policies and procedures which have been printed out, handing out to all with a signed agreement that they have read it.
Standard #:	8VAC20-800-850-B
Complaint related:	Yes
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on medical documentation, photographs, witness statements, and caregiver interviews, the provider failed to complete and submit a written report to the department within five working days of the date the incident occurred of a serious injury to a child. Evidence: 1. On 05/14/2024, an outside source notified the department of an injury Child #1 (2 years old) sustained under the supervision of Caregiver #1 on 01/09/2023. 2. Child #1 (2 years old) sought outside medical attention for a facial laceration that was caused by being pushed by Child #3, which caused Child #1 to fall and hit their forehead on the corner of a windowsill in the home. 3. Caregiver #1 confirmed they did not file an injury report to the department.
Plan of Correction:	Soria and Homa have attended the Family Day Home Refresher Training on June 8, 2024 The policies and procedures have been printed. We did not know we had to report the incident. We are now aware and we have informed all caregivers of the appropriate incident reporting and recording procedures.
Standard #:	8VAC20-800-900-B
Complaint related:	No
Description:	Based on observation, Children were allowed to eat or drink while walking, running, playing, lying down, or riding in vehicles. Evidence: Child #5 and Child #6 were observed sleeping in a crib and each had a bottle next to them.
Plan of Correction:	All caregivers have been trained and reminded that no items are to be placed in the cribs and children are not allowed to eat or drink while, running, walking, playing, lying down or riding in vehicles.
Standard #:	8VAC20-800-120-B
Complaint related:	No
Description:	Based on record review, the provider failed to obtain all the information required for a caregiver?s record. Evidence: 1. There was no documentation of verification of age, job title, and date of employment for Caregiver #2. 2. There was no documentation of a person to be notified in an emergency for Caregiver #2. 3. There was no documentation that two or more references as to character and reputation as well as competency were checked before employment for Caregiver #2.
Plan of Correction:	All the required caregiver documentation has been gathered and placed in the correct ?ling system for easy and appropriate availability and access.
Standard #:	8VAC20-800-30-E
Complaint related:	Yes
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on witness and caregiver statements, the provider failed to ensure that the home's activities, services, and facilities are conducive to the welfare of children in care. Evidence: 1. On May 24, 2023, Witness #1 walked in an unlocked door, and observed Caregiver #1 sleeping on a couch in a room separate from where the children were located during the children?s nap time. The witness stated no one was present and supervising the children who were awake in their cribs, including Child #1 (2 years old) in their crib. 2. Additionally, Witness #1 observed Child #2 (4 years old) awake and confined to a bouncer in front of Caregiver #1. 3. At approximately 2:58 pm, Witness #1 texted Caregiver #1, stating that they had left the house with Child #1 and believed Caregiver #1 was sleeping. 4. At approximately 3:15 pm, Caregiver #1 texted Witness #1 stating that they had a migraine and fell asleep while talking to Child #2 (4 years old). 5. On May 29, 2023, Caregiver #2 emailed Witness #1 a letter on behalf of themselves and Caregiver #1 expressing their "deepest apologies" for the incident that occurred on May 24, 2023, which stated that it was their ?responsibility to lock the door before leaving their shift. The letter also stated Caregiver #2 told Household Member #1 to lock the door because Caregiver #1 was taking a nap.? 6. According to Caregiver #2 and Caregiver #1, Household member #1 was outside in the back driveway washing their car and they ?forgot to carry out the task? which led to the door being left unlocked.
Plan of Correction:	Additional locks and a camera system have been installed. All caregivers and household members have been informed and trained to be fully aware, keep the doors locked and to better communicate at all times. They have all been informed with a written document that each person has signed stating their acknowledgement and cooporation.
Standard #:	8VAC20-800-170-B
Complaint related:	No
Description:	Based on record review and caregiver interview, a caregiver failed to obtain a tuberculosis screening within the last 30 calendar days of the date of employment. Evidence: 1. The tuberculosis screening documentation on file for Caregiver #2 is dated 12/30/2022. 2. Caregiver #1 reported to the inspector on May 30, 2024, that Caregiver #2's employment date was 06/05/2023. 3. There is no written documentation of an employment date for Caregiver #2 in their record.
Plan of Correction:	We will make sure that ALL new hires are TB screened within the last 30 days before employment.
Standard #:	8VAC20-800-400-B
Complaint related:	No
Description:	Based on observation and interview, fans or other cooling systems were not used when the temperature of inside areas occupied by children exceeded 80?F. Evidence: 1. On June 4, 2024, the home?s thermostat measured 81 degrees at approximately 1:09 pm during the inspection. 2. There was a small air cooler blowing on one side of the childcare room but not on the side where four children were napping. The room where the four children were located was separated by ceiling-to-floor drapes, preventing airflow to the napping area. 3. A household member brought in a black portable fan after being told that the standards require a fan to be used in areas occupied by children. The caregivers then opened the drapes to either side of the room to allow airflow into the napping area.
Plan of Correction:	The air conditioning has now been i??xed and all the caregivers have been informed of the correct standard and procedures should the air conditioning system break again.
Standard #:	8VAC20-800-510-A
Complaint related:	No
Description:	Based on interviews, a child was not provided with an individual crib, cot, rest mat, or bed for resting or napping. Evidence: 1. On May 24, 2023, Witness #1 observed Caregiver #1 sleeping on a couch in the living room during the children?s nap time and Child #2 (4 years old) awake and confined to a bouncer in front of Caregiver #1. 2. According to Caregiver #1, Child #2 (4 years old) was not awake but was sleeping in a bouncer provided by the child?s parents for use after Child #2 returns to the family day from school. 3. Caregiver #1 stated that the bouncer used for Child #2 was frayed and ripped in several areas. 4. An Interview with Witness #2 revealed the Provider was never given instructions to use a seating accommodation for Child #2?s nap.
Plan of Correction:	The bouncer was provided by the parent. If parents provide us with their own personal bedding or equipment, we will make sure they ?t the requirements and guidelines. If they do ?t, we will use them. If not, we will inform the parents we CANNOT use them.
Standard #:	8VAC20-800-530-F
Complaint related:	No
Description:	Based on observation and caregiver interview, soft bedding was used under or around infants including, but not limited to, pillows, quilts, comforters, sheepskins, or stuffed toys. Evidence: Child #4 (22-month-old) had a tie-dye stuffed toy in their crib while napping.
Plan of Correction:	All caregivers have been trained and reminded that no items are to be placed in the cribs.
Standard #:	8VAC20-800-560-A
Complaint related:	Yes
Description:	SYSTEMIC DEFICIENCY REPEAT VIOLATION Based on witness and caregiver statements, a caregiver failed to provide direct care and supervision of each child at all times by maintaining awareness of and responsibility for each child in care. Evidence: 1. On May 24, 2023, Witness #1 stated they were able to walk into the unlocked home, walk through the first floor of the home, and pick up her child without anyone being aware. The witness stated they walked past the children?s area and observed Caregiver #1 sleeping on a couch in the living room during the children?s nap time. The living room is located towards the back of the house. 2. Witness #1 stated that they texted Caregiver #1 at approximately 2:37 pm stating that they were "on the way? to pick up Child #1. 3. Upon arrival, Witness #1 knocked on the door approximately two times before noticing it was unlocked and walked inside the home. 4. While walking through the home Witness #1 observed several older children awake, including Child #1 (2 years old) in their cribs. 5. Additionally, Witness #1 observed Child #2 (four years old) awake and confined to a bouncer in front of Caregiver #1. 6. At approximately 2:58 pm, Witness #1 texted Caregiver #1, stating that they had left the house with Child #1 and believed Caregiver #1 was sleeping. 7. At approximately 3:15 pm, Caregiver #1 texted Witness #1 stating that they had a migraine and fell asleep while talking to Child #2 (4 years old). 8. Electronic communication was provided by the caregiver and the witness verified no one else was present in the home to supervise the children.
Plan of Correction:	We have since hired a new full time assistant caregiver and have informed and trained all to provide supervision at all times. Shifts have been designed to also support this. All have been informed with a written document that each person has signed stating their acknowledgement and cooperation.
Standard #:	8VAC20-800-630-A
Complaint related:	No
Description:	Based on caregiver interview, the caregiver failed to arrange equipment, materials, activities, and schedules in a way that promotes desirable behavior. Evidence: 1. Caregiver #1 stated that Child #2 (4 years old) is hyper, and they occasionally put them in a playpen rather than a seat to help them stay calm. 2. Caregiver #1 stated Child #2 is placed in a bouncer that has a belt because the child does not stay seated. 3. Utilizing a bouncer and playpen is not appropriate for a 4 year old to encourage a child to keep quiet and seated.
Plan of Correction:	We have since hired a new full time assistant to help with arranging more activities and have purchased more learning equipment and materials. We will advise the parents that we cannot take their direction for individual personalized care if it does not ?t with the requirements, policies and guidelines.