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Shazia Zabair
2958 Ashdown Forest Drive
Herndon, VA 20171
(703) 218-2420

Current Inspector: Nancy Radcliffe (703) 268-3728

Inspection Date: May 1, 2024

Complaint Related: No

Areas Reviewed:
8 VAC 20-800 Administration
8 VAC 20-800 Personnel
8 VAC 20-800 Household Members
8 VAC 20-800 Physical Health of Caregivers and Household members
8 VAC 20-800 Caregiver Training
8 VAC 20-800 Physical Equipment and Environment
8 VAC 20-800 Care of Children
8 VAC 20-800 Preventing the Spread of Disease
8 VAC 20-800 Emergencies
8 VAC 20-800 Nutrition
8 VAC2 0-820 THE LICENSE
8 VAC 20-820 THE LICENSING PROCESS
8 VAC 20-770 Background Checks
20 Access to minor?s records
22.1 Background Checks Code, Carbon Monoxide
63.2 Child abuse and neglect

Technical Assistance:
Discussion that the LI will send to the Provider digital copies of the Provisional form, the staff orientation form, and the Assistant and Substitute Provider Record.

Comments:
This monitoring inspection was initiated by licensing staff and concluded on 05/01/2024, between the hours of 1:30 pm to 3:30 pm. There were 4 children present (13 points), ranging from infant to preschool-age, with 2 caregivers supervising. The children were engaged in the following: nap time and other organized activities. The inspector reviewed compliance in the areas of administration; physical plant; staffing and supervision; programming; special care and emergencies; and nutrition. A total of 5 children files, 4 household records, and 2 staff files were reviewed.

Information gathered during the inspection determined that there were (4) non-compliances. These violations were documented on the Violation Notice issued to the home.

If you should have any questions, please call or send an email to charlie.perkins@doe.virginia.gov. Thank you.

Charlie Perkins,
Licensing Inspector
(703) 309-3963

Violations:
Standard #: 8VAC20-800-780-B
Description: Based on review, 1 of 4 children files indicated that annually, the Provider did not review with the parent - the emergency contact information (required in 8VAC20-800-60 B 2) to ensure that the information is correct, and obtain the parent's signed acknowledgment of this review.

Evidence -
1. On the date of inspection (05/01/2024), the most recent signed and dated review of the emergency information on file for Child #5 was dated - 11/07/22).
2. This finding was confirmed on the date of inspection by the Provider.

Plan of Correction: Annual review will be conducted with the Parent of Child #5.

Standard #: 8VAC20-800-70-A
Description: Based on review, 3 of 5 children files indicated that not all of the required documentation was on file.

Evidence -
1. On the date of inspection (05/01/2024), the Emergency Preparedness and Response Plan (EP&RP) was not available for review for: Child #1, #4, and #5.
2. Their start dates were listed as - Child #1 (sd - 03/21/20), #4 (sd - 02/26/24), and #5 (sd - 02/05/24).

Plan of Correction: Missing documentation will be obtained.

Standard #: 8VAC20-800-180-A
Description: Based on review, 1 of 4 household records indicated that the Provider did not obtain for each adult household member a current Report of Tuberculosis Screening (TB) form every two years.

Evidence -
1. On the date of inspection (05/01/2024), Household Member #4 had TB documentation on file that was dated - 11/21/2021.
2. This finding was confirmed on the date of inspection by the Provider.

Plan of Correction: Missing documentation will be obtained.

Standard #: 8VAC20-800-200-C
Description: Based on review and interview, documentation of the orientation training was not signed and dated by the provider and assistant.

Evidence -
1. On the date of inspection (05/01/2024), the documentation of an orientation training conducted by the Provider and for Staff #2 was not available for review.
2. The Provider stated that she did go over the areas of the orientation for her assistant.

Plan of Correction: Documentation of an orientation will be created and signed off by both the Provider and Assistant.

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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