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Irma Puza
6913 Rolling Road
Springfield, VA 22152
(703) 505-2806

Current Inspector: Sarah Zirzow (703) 479-4675

Inspection Date: May 12, 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 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
22VAC40-80 THE LICENSE.
22VAC40-191 Background Checks for Child Welfare Agencies

Comments:
This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia.

A monitoring inspection was initiated and concluded on May 12, 2021. The provider was contacted by telephone to initiate the inspection. There were six children(13pts) present and two staff. The inspector emailed the provider a list of items required to complete the inspection. The Inspector reviewed two children?s records and two staff records submitted by the facility to ensure documentation was complete.
Information gathered during the inspection determined non-compliance(s) with applicable standards or law and violations were documented on the violation notice issued to the facility.

The Licensing Inspector has reviewed with the provider COVID-19 Essential Guidance for Child Care programs.

Thank you for your cooperation today. If there are any questions, please contact karen.dickens@dss.virginia.gov.

Violations:
Standard #: 22VAC40-111-780-B
Description: Based on record review and interview, the provider did not obtain the parent's signed acknowledgment of the annual review of the emergency contact information.
Evidence:
1. Child #1's(Start date 8/12/2019) record did not contain a parent's acknowledgment of an annual review for year one and year two.
2. Child #2's (Start date 04/1/2019) record did not contain a parent's acknowledgment of an annual review for year one and year two.
3. Staff #1 confirmed that Child #1 and Child #2's parents had not reviewed the records.

Plan of Correction: The provider will have each parent to review the record and sign the record as acknowledgment of review.

Standard #: 22VAC40-111-70-A
Description: Based on record review, children's records did not contain required information.
Evidence:
1. Child #1's and Child #2's record did not contain policies for the administration of medications.
2. Child #1's and Child #2's record did not contain Liability Insurance Declaration forms.
3. Child #2's record did not contain Provisions of the Emergency Plan.

Plan of Correction: The provider will print all required forms and have the parents to sign the forms. The forms will be placed into the record.

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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