VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tegist Hailu
43057 Battery Point Place
Leesburg, VA 20176
(703) 966-5247

Current Inspector: Sarah Marbert (703) 479-4678

Inspection Date: Sept. 5, 2024

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 Physical Equipment and Environment 8VAC20-800 Care of Children 8VAC20-800 Preventing the Spread of Disease 8VAC20-800 Emergencies 8VAC20-800 Nutrition 8VAC20-770 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

Comments:

An unannounced, on-site monitoring inspection was initiated and completed on 09/05/2024, as a part of the licensure period. The on-site inspection began at 8:00 am and ended at 9:26 am. The inspector reviewed compliance in the areas listed above. There were 11children present and 3 staff. The inspector reviewed 9 children?s records, two household records and 2 staff records on-site. This inspection included; document review, tour of the facility, interviews, and observations. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations are documented on the violation notice issued to the program.

Violations:

Standard #:	22.1-289.011-F
Description:	Repeat Violation Based on observation, documents required by the Superintendent were not posted. Evidence: 1. The most recent inspection was conducted on 4/3/24. The inspection paperwork posted was dated 9/19/23. 2. The most recently issued licensed was not posted. The posted license expired 5/16/24.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-50-A
Description:	Based on a review of documentation, a written record of children in attendance was not kept. Evidence: At LI arrival, no attendance was available for the 5 children present. The attendance sheet presented for review later was not accurate, as a child was listed that was not present.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-60-B
Description:	Repeat Violation Systemic Deficiency Based on a review of records, child records did not contain all required information. Evidence: 9 records were reviewed. 1. 1 record did not contain documentation of the first date of attendance. (Child #9) 2. 2 records did not contain Proof of birth documentation that was signed by the [person viewing the document. (Children #6, 9) 3. 2 records did not contain documentation of health insurance name and policy number. (Children # 4,5)
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-70-B
Description:	Repeat Violation Systemic Deficiency Based on a review of records, child records did not contain written acknowledgment of all policies and procedures. Evidence: 1. No medication policy is marked on the decision to administer medication form and the form is not signed by the parent. (Child 3) 2. The Decision to administer medication policy form is not signed by the parent. (Children # 2,9)
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	8VAC20-800-180-A
Description:	Based on a review of records two adult records did not contain documentation of a subsequent Tuberculosis(TB) screening, within two years from the date of the previous screening. Evidence: 1. The negative results on file for Adult A is dated 8/21/22 (expired). 2. the negative results on file for Adult B is dated 8/20/22 (expired).
Plan of Correction:	Not available online. Contact Inspector for more information.