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Dina Revollo
6526 Roosevelt Street
Falls church, VA 22043
(703) 241-3827

Current Inspector: Sarah Marbert (703) 479-4678

Inspection Date: Dec. 11, 2023

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 Caregiver Training
8VAC20-800 Physical Equipment and Environment
8VAC20-800 Care of Children
8VAC20-800 Preventing the Spread of Disease
8VAC20-800 Medication Administration
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

Technical Assistance:
Discussed with provider:
Methods to tighten crib sheets as needed, waterproof mattress coverings (mattress not in use during the inspection).
Model forms will be sent: Emergency Preparedness Plan, emergency evacuation drill form, new Sworn Disclosure Statement form (11/22)

Comments:
An unannounced monitoring inspection was conducted today.
There were 12 children present (40 points) with 3 caregivers.
Emergency evacuation drills, bathroom supplies, fridge/freezer temperatures, and age appropriate toys were all in compliance today.
See Violation Notice for non-compliances cited today.
Children were observed washing their hands, playing with a variety of toys and games and preparing for lunch.
If you have any questions regarding this inspection, you may contact me at (703) 479-4678 or at Sarah.Marbert@doe.virginia.gov.
LI was present today from 10:40AM - 11:55AM.

Please submit your plan of correction within 5 business days in order for it to be included on the website.

Violations:
Standard #: 22.1-289.035-B-2
Description: Based on provider statement, there were no fingerprint results available for one caregiver present.
Evidence:
Caregiver B (Substitute) did not have any fingerprint results on file.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 8VAC20-770-60-B
Description: Based on provider statement, one caregiver present did not have a completed Sworn Disclosure Statement (SDS) available for review.
Evidence:
Caregiver B's record did not have a completed SDS available for review.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 8VAC20-800-760-A-1
Description: Based on a revie of the first aid kit, the kit was incomplete.
Evidence:
There was only 1triangular bandage.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 8VAC20-800-800-B
Description: Based on a review of the emergency preparedness plan, the plan has not been reviewed and updated annually.
Evidence:
The emergency plan was last dated 10/5/2020.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 8VAC20-800-60-B
Description: Based on a review of records, child records did not contain all required information.
Evidence:
Child #1's record lists a diagnosed food allergy. There was no information provided for actions to take in the event of an allergic reaction. The FARE form available for review was not complete, or signed by a physician.
Child #2's record did not contain health insurance policy information.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 8VAC20-800-200-A
Description: Based on a review of records, one caregiver record did not contain documentation of orientation.
Evidence:
Caregiver C's record had no orientation document available for review.

Plan of Correction: Not available online. Contact Inspector for more information.

Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.


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