VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Residential Care
950 N. Washington Street
Suite 227
Alexandria, VA 22314
(202) 550-0545

Current Inspector: Kevin Lassiter (804) 241-2093

Inspection Date: Feb. 5, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-131 ORGANIZATION AND ADMINISTRATION 22VAC40-131 PROVIDER HOMES 22VAC40-131 CHILDREN'S SERVICES 22VAC40-131 ADDITIONAL REQUIREMENTS FOR SPECIFIC PROGRAMS 22VAC40-191 Background Checks for Child Welfare Agencies

Comments:

An unannounced, mandated, monitoring inspection was conducted on February 5th and 6th 2020 at Residential Care located at 950 N. Washington Street, Suite 227 Alexandria, Virginia 22314. The agency is currently providing services to three foster children and three foster families. At this inspection, three foster home records were reviewed and three foster children's records were reviewed. The Program Director and the Case Manager were available for the inspection. The Program Director and both Case Managers were available for the exit interview at the end of the second day. There were 11 citations for violations of the Standards for Licensed Child-Placing Agencies. Of those, 9 were key health and safety standards. The on site inspection on 2/05/20 began at 10:00 am and ended at 2:30 p.m. The on site inspection on 2/06/20 began at 10:00 am and ended at 1:00 p.m.The Acknowledgement of Inspection Conducted and Licensee Responsibility form was signed by the Program Director on 2/06/20. Upon receipt of the violation notice, the licensee must develop a plan of correction for each violation. The plan of correction must include the following: the steps to correct non-compliance with the standard(s); measures to prevent re-occurrence of non-compliance; person(s) responsible for implementation and monitoring of preventative measure(s); and date by which non-compliance will be corrected. The licensee has ten (10) calendar days from receipt of the inspection documentation to complete the section entitled "Plan of Correction", sign each page of the Plan of Correction and return it to the Licensing Office. The licensee retains a copy to be posted at the facility. Results of the inspection are subject to public disclosure and will be posted on the VDSS web site within five (5) days, regardless of whether or not the Plan of Correction has been completed.

Violations:

Standard #:	22VAC40-131-210-D
Description:	Violation: Based on a review of the foster home records for FH-1, FH-2, and FH-3 and an interview with agency representatives, the agency failed to provide annual training to the foster families as required. Evidence: 1) The most recent training documented in the files for FH-1, FH-2, and FH-3 was dated 11/15/18. 2) Agency representatives reviewed the files at the time of the inspection and acknowledged that annual training was not documented.
Plan of Correction:	Steps to correct non compliance with standards: RCI will develop a display grid that will indicate when all yearly training was provided to all foster parents during each calendar year Measures to prevent recurrence of non compliance: ? supervisor and case manager will check the displayed training grid to ensure annual compliance and file certificated of compliance ? case manager will locate online training sites for the foster that will be shared with foster parents to meet the requirement of annual training Person(s) responsible to monitor: Program Director and Child Placing Supervisor
Standard #:	22VAC40-131-230-C
Description:	Violation: Based on a review of the foster home records for FH-1 and FH-3 and an interview with agency representatives, the agency failed to re-evaluate the providers and assess all evaluation elements required for the initial home approval prior to the end of their 36-month approval periods. Evidence: 1) FH-1 and FH-3 each had homestudy re-evaluations that expired over 36 months ago. 2) Agency representatives reviewed the files at the time of the inspection and acknowledged that their re-evaluations were overdue.
Plan of Correction:	Steps to correct noncompliance with standards: RCI will set up a quarterly review process for all re evaluations to ensure compliance with this standard. Measures to prevent recurrence of non compliance: ? Oversize grid will be displayed in the office with foster parent initials to that will indicate six months before re evaluations is due ? At that six month mark the case manager will begin to collecting all are required all evaluations elements required Personal(s) responsible to monitor: Program Director and Child Placing
Standard #:	22VAC40-131-230-E
Description:	Violation: Based on a review of the foster home records for FH-1 and FH-3 and an interview with agency representatives, the agency failed to obtain tuberculosis screenings, confidentiality agreements and corporal punishment statements from the providers as part of the re-evaluation process. Evidence: 1) FH-1 and FH-3 each had outdated homestudy re-evaluations and supporting documentation. 2) Agency representatives reviewed the files at the time of the inspection and acknowledged that they didn't gather the required supporting documentation to re-evaluate the providers.
Plan of Correction:	Steps to correct non compliance with standards: RCI will collect the tuberculosis screening test, updated confidentiality agreements and corporal punishment statements from the foster parents FH- 1 and FH-3. Measures to prevent recurrence of non compliance ? RCI will use a oversized visual tool displayed on the office wall that will indicate six months before re- valuation which documents will be provided to the foster parent and collect by the case manger during home visits ? these documents will be reviewed by the Child placing supervisor to ensure compliance Person(s) responsible to monitor: Child Placing Supervisor and Program Director
Standard #:	22VAC40-131-290-F
Description:	Violation: Based on a review of the child's FC-1 file and an interview with agency representatives, the agency failed to arrange and document routine and recommended medical care for the child. Evidence: 1) The medical examination for FC-1 dated 4/19/19 recommended that "Pt. should follow up with her psychiatrist for medication and ongoing mental health issues". No follow up appointment was documented in the file. 2) The medical evaluation for FC-1 dated 5/16/19 recommended "full time spectacle Rx wear". There is no documentation in the file regarding glasses for FC-1. 3) Agency representatives reviewed the file at the time of the inspection and agreed that documentation of the follow up care was missing.
Plan of Correction:	Steps to correct non compliance with standards: RCI case manager will ensure that all follow up of routine medical recommendations are competed and filed Measures to prevent recurrence of non compliance: ? case managers supervisor will review all medical appointments monthly to ensure follow up and documentation of medical recommendations Person responsible to monitor: Child Placing Supervisor
Standard #:	22VAC40-131-320-E
Description:	Violation: Based on a review of the child's record (FC-1) and an interview with agency representatives, the agency failed to report a serious incident as required. Evidence: 1) A contact note dated 12/11/19 in the file of FC-1 documented an incident in which the child went to a motel and the police were called. This serious incident was not reported to the department's licensing representative. 2) Agency representatives reviewed the file an agreed that this was an oversight.
Plan of Correction:	Step to correct non compliance with the standards: RCI will immediately contact VDSS inspector within a 24 hour period for any serious incident. Measures to prevent recurrence of non compliance: ? RCI will develop an additional unusual incident form for that will be submitted to VDSS inspector ? This form will also be filed and shared with the appropriate local social service agencies Person responsible to monitor, implement and prevent recurrence: Child Placing Supervisor
Standard #:	22VAC40-131-330-G
Description:	Violation: Based on a review of the record for FC-1 an an interview with agency representatives, the agency failed to assess the relationship between the foster parent and the child during home visits in December of 2019. Evidence: 1) Two home visits were documented for FC-1 in December of 2019. The relationship between the foster parent and the child was not addressed at either visit as required. 2) Agency representatives reviewed the file at the time of the inspection. They acknowledged that the assessment of the relationship was not documented in the contact notes.
Plan of Correction:	Step to correct non compliance with the standards: Case managers supervisor will provide additional guidance to ensure that the relationship between the foster and child are assess during the home visits. Measures to prevent recurrence of non compliance ? Monthly the case manager will discuss with the supervisor their assessment the relationship between the foster parent and the child Person responsible to monitor, implement and prevent recurrence: Child Placing Supervisor and case manager
Standard #:	22VAC40-131-340-F-5
Description:	Violation: Based on a review of the child's file for FC-3 and an interview with agency representatives, the agency failed to document the involvement of the child's birth parents in the development of the quarterly report. Evidence: 1) The quarterly progress report for FC-3 covering the period from 6/28/19 through 9/30/19 does not document the involvement of the child's parents. FC-3 currently has a return home goal. 2) Agency representatives reviewed the file at the time of the inspection and acknowledged that the birth parents were not involved in the development of the plan.
Plan of Correction:	Steps to correct non compliance with standards: RCI will sent a correspondence to the birth parents and copy the local social service case manager to invite the birth parents to the child?s quarterly service plan Measures to prevent recurrence of non compliance: ? Case managers supervisor will review the invite list for all service plan meetings to ensure that birth parents have been invited. Person responsible to monitor, implement and prevent recurrence : Child Placing Supervisor and case manager
Standard #:	22VAC40-131-340-K
Description:	Violation: Based on a review of the child's file for FC-3 and an interview with agency representatives, the agency failed to document that copies of the child's quarterly report were provided to the birth parents. Evidence: 1) The quarterly progress report for FC-3 covering the period from 6/28/19 through 9/30/19 does not document that the birth parents received a copy as required. FC-3 currently has a return home goal. 2) Agency representatives reviewed the file at the time of the inspection and acknowledged that there bwas no way to verify that the birth parents received a copy.
Plan of Correction:	Steps to correct non compliance with standards: RCI will develop a form for the birth parents participation that will document that th e birth parents received a copy of the child?s quarterly report by mail or in Measure to prevent recurrence of non compliance: ? Case manager and the supervisor will correspond directly with birth parents to ensure that they received copies and document results in the child quarterly report. Person responsible to monitor, implement and prevent recurrence: Case manager and Child Placing Supervisorperson;
Standard #:	22VAC40-131-350-A
Description:	Violation: Based on a review of the children's records for FC-1 and FC-3 and an interview with agency representatives, the agency failed to review the progress of the children within 90 days of the most recent review. Evidence: 1) The most recent progress review for FC-1 was dated 10/10/19. 2) Agency representatives reviewed the child's file at the time of the inspection and acknowledged that the quarterly review was overdue.
Plan of Correction:	Steps to correct noncompliance with standards: RCI will establish a protocol to check on the child?s progress on a monthly bases in preparation for the 90 review. Measures to prevent recurrence of non compliance: ? Child placing supervisor and the case manager will bi monthly review the children progress in reaching goals and make document the monthly progress to be included in the 90 day review Person responsible of monitor, implement and prevent recurrence: Case manager, Child Placing Supervisor and Program Director
Standard #:	22VAC40-131-350-B
Description:	Violation: Based on a review of the child's record for FC-1 and an interview with agency representatives, the agency failed to include elements in the most recent quarterly report. Evidence: 1) The quarterly report for FC-1 dated 10/10/19 does not address 350.B.1 progress the child has made toward reaching each goal 350.B.2 goals and objectives the child has met 350.B.4 a description of any changes that need to be made to the service plan 350.B.7 a description of any new needs identified 2) Agency representatives reviewed the file at the time of the inspection and acknowledged that the information listed above was not included in the quarterly report.
Plan of Correction:	Steps to correct non compliance with standards: RCI will ensure that the quarterly reports include all elements describing the child?s progress toward reaching each goal and objective during the stated quart. Measures to prevent recurrence of non compliance: ? case managers supervisor will attend service plan quarterly meetings to ensure that the child progress with their goal and objectives are clearly documented and discussed in the quarterly report ? supervisor will review the child plan with the case manager to monitor/ensure the child?s progress is fully documented ? RCI will create a orientation manual for all services plans to ensure that the new case managers are in compliance with the standards Person responsible to monitor: Child Placing Supervisor
Standard #:	22VAC40-131-370-M-14
Description:	Violation: Based on a review of the foster home record for FH-1 and an interview with agency representatives, the agency failed to list a foster child, FC-1 that was placed with the family to the list of children placed. Evidence: 1) The record of children placed form contained in the foster family file did not include FC-1. 2) Agency representatives reviewed the file at the time of the inspection and acknowledged that it was an oversight not to document FC--1 on the record of children placed form in the family file.
Plan of Correction:	Steps to correct non compliance with standards: RCI will immediately add the child to the list of children placed. Measure to prevent recurrence of non compliance: ? Case manager will ensure that all new placed children will be listed in the file ? Supervisor will monitor the list children placed monthly Person responsible to monitor, implement and prevent recurrence : Case manage and Child placing