Hilda Bustamante

Assistants’ and substitute providers’ records shall be maintained with required information.

“Caregiver 2’s record did not contain: date of hire, address, emergency contact information, or documentation that two references were completed.”

Rule 8VAC20-800-120-B.

The family day home shall keep a written record of children in attendance each day.

“There was no record of children in attendance on the date of inspection.”

Rule 8VAC20-800-50-A.

Repeat violation

“A child’s record shall be maintained with required information. Child 3’s record did not contain a health insurance policy number.”

Rule 8VAC20-800-60-B.

The family day home shall obtain documentation of additional immunizations for a child who is not exempt from the immunization requirements every six months until the child reaches the age of two.

“Child 1’s immunizations are overdue by two months. Child 2’s immunizations are overdue by twelve months.”

Rule 8VAC20-800-90-C.

A tuberculosis (TB) screening is required every two years from the last screening.

“An updated TB screening for Caregiver #3 was not completed and was overdue by two months.”

Rule 8VAC20-800-180-A.

Wood burning fireplaces shall be inspected annually by a knowledgeable inspector to verify that the devices are properly installed, maintained, and cleaned as needed. Documentation of the inspection and cleaning shall be maintained by the provider.

“At the time of the inspection, the home’s wood-burning fireplace inspection was overdue by 11 months.”

Rule 8VAC20-800-320-G.

Repeat violation

“Children’s records are required to contain the name and policy number of the child’s medical insurance. The records for Child #1 and Child# 5 were missing the name and policy number of the child’s medical insurance.”

Rule 8VAC20-800-60-A.

Before the child’s first day of attendance, parents shall be provided required information in writing.’

“The parents of Child #2 were not provided in writing the following required information: Policies for the administration of medications. Child #2 had been in care for three months.”

Rule 8VAC20-800-70-A.

Repeat violation

“The family day home is required to have employees undergo a background check every five years. The most recent central registry check for Staff #3 is overdue by nine months.”

Rule 22.1-289.035-A.

The physical examination and immunizations received shall be signed by a licensed physician, the physician’s designee, or an official of a local health department.

“The physical exam and immunization records available for Child #1 were missing a physician’s signature. Child #1 has been in care for seven months. The physical exam available for Child #2 was missing a physician’s signature. Child #2 has been in care for over 14 months.”

Rule 8VAC20-800-110-B.

Cribs when being used by infants shall have a tight-fitting bottom cover.

“Six cribs did not have a tight-fitting bottom cover.”

Rule 8VAC20-800-530-B.

A child’s record shall contain the name and policy number of the child’s medical insurance.

“Child #4?s record is missing the policy number of the child’s medical insurance. Child #4 has been in care for over four months. Child #5?s record is missing the name and policy number of the child’s medical insurance. Child #5 has been in care for a month.”

Rule 8VAC20-800-60-B.

Repeat violation

“The menu for the current one-week period shall be dated. The menu posted was dated July 1- 11, 2025.”

Rule 8VAC20-800-920.

The center is required to have employees undergo a background check every five years.

“The most recent central registry check for Staff #2 was overdue by three months.”

Rule 22.1-289.035-A.

Repeat violation

“The provider shall obtain documentation of a physical examination prior to a child’s attendance or within 30 days after the first day of attendance. No physical exam records were available for Child #2, who had been in care for over one month. No physical exam records were available for Child #4, who had been in care for over eight months.”

Rule 8VAC20-800-100-A.

Providers must keep a written record of children in attendance each day.

“The provider did not take written attendance on February 12-13, 2025.”

Rule 8VAC20-800-50-A.

Repeat violation

“The provider did not ensure that documentation of verifying children’s proof of identity was completed. There was no documentation of the date documentation viewed and the person viewing documentation for Child #1 record.”

Rule 8VAC20-800-80-A.

Documentation shall be maintained for emergency evacuation drills.

“The emergency evacuation drill was not documented for January 2025.”

Rule 8VAC20-800-830-C.

Before attendance, documentation of immunizations is to be obtained for each child.

“There was no documentation of immunizations for Child #2, who had been in care for over one month.”

Rule 8VAC20-800-90-A.

The menu for the current one-week period shall be dated.

“The menu for the current one-week period was not dated for the current week. The menu that was posted was dated September 2024.”

Rule 8VAC20-800-920.

Based on record review and interview, the provider did not obtain documentation of a physical examination by or under the direction of a physician prior to a child’s attendance or within 30 days after the first day of attendance.

“Evidence: Child #1 has a physical examination, but it is not complete.”

Rule 8VAC20-800-100-A.

Based on observation, infant walkers were in use.

“Evidence: Child A was observed sitting in an infant walker during the inspection.”

Rule 8VAC20-800-540-B.

Based on record review and interview, proof of identity was not obtained within 7 days.

“Evidence: Child #2 does not have signed documentation of viewing the proof of identity for the child.”

Rule 8VAC20-800-80-A.

Based on record review and interview, the provider did not obtain all information required for a child’s record.

“Evidence: Child #2 and Child #3 are missing a second emergency contact.”

Rule 8VAC20-800-60-B.

Repeat violation

“Based on record review and caregiver interview, proof of identity was not obtained within 7 days. Evidence: Child #2 does not have signed documentation of viewing the proof of identity for the child. The start date for child #1 is 1/29/2024.”

Rule 8VAC20-800-80-A.

Based on record review and interview, the provider did not obtain documentation of a physical examination by or under the direction of a physician prior to a child’s attendance or within 30 days after the first day of attendance.

“Evidence: There was no documentation of a physical examination completed by or under the direction of a physician prior to or within 30 days of child #1’s first day of attendance. The start date for child #1 is 7/19/2021.”

Rule 8VAC20-800-100-A.

Repeat violation

“Based on record review and interview, the provider did not obtain updated tuberculosis (TB) tests or screenings for each household member every two years. Evidence: Caregiver #2 tuberculosis test expired on 10/22/2023.”

Rule 8VAC20-800-180-A.

Based on documentation review and interview, the provider did not ensure that wood-burning fireplaces and associated chimneys were inspected annually by a knowledgeable inspector to verify that the devices were properly installed, maintained, and cleaned as needed.

“Evidence: The provider has not had its wood-burning fireplace inspected on an annual basis.”

Rule 8VAC20-800-320-G.

Based on observation and interview, the provider did not ensure that the total number of children receiving care at any one time does not exceed the maximum licensed capacity of the home.

“Evidence: 1. On 3/23/2023, at 9:45 am, there were 13 children present in the direct care of 3 staff members. 2. The license allows for a capacity of 12.”

Rule 8VAC20-800-40-A.

Based on record review and interview, the family day home did not keep a written record of children in attendance each day.

“Evidence: 1. Attendance sheets were reviewed at 9:53 am during the time of the inspection. 2. There were 13 children present but only 12 were checked in on the attendance sheet. 3. Child #1 was not checked in on the attendance sheet at the time the inspector reviewed it.”

Rule 8VAC20-800-50-A.

Based on record review and interview, proof of identity was not obtained within 7 days.

“Evidence: Child #1 does not have signed documentation of viewing the proof of identity for the child. The start date for child #1 is 2/13/2023.”

Rule 8VAC20-800-80-A.

Based on record review and interview, the family day home evacuation procedures did not include a designated relocation site.

“Evidence: A designated relocation site was not included in the family day home’s emergency preparedness and response plan.”

Rule 8VAC20-800-810.

Based on record review and interview, documentation was not maintained of emergency evacuation drills.

“Evidence: There was no documentation of emergency evacuation drills from 9/2022-12/2022.”

Rule 8VAC20-800-830-C.

Based on observation and interview, the provider failed to post on the premises the most recent inspection of the home.

“Evidence: The provider did not post all required pages of the most recent home inspection. The inspection summary was posted, but the violation notice was not.”

Rule 8VAC20-820-120-E-2.

Based on record review and interview, the provider did not obtain for each caregiver a current report of tuberculosis screening, every two years from the date of the first screening.

“Evidence: Caregiver #3 tuberculosis screening expired on 8/24/2022.”

Rule 8VAC20-800-180-A.

Based on observation, not all small electrical appliances were unplugged while not in use.

“Evidence: A toaster machine was plugged in and unattended in the kitchen area.”

Rule 8VAC20-800-320-A.

Based on record review and interview, the provider did not review the emergency plan at least annually and update the plan as needed.

“Evidence: The emergency plan was last reviewed on 6/20/2020.”

Rule 8VAC20-800-800-B.

Based on record review, the provider did not obtain repeat background checks every five years.

“Evidence: The records of Staff #1 and HH #2 contain central registry checks that were completed on 2/13/2017.”

Rule 22.1-289.036-A.

Based on observation and interviews, the home was not equipped with a least one carbon monoxide detector.

“Evidence: The Provider did not have a working carbon monoxide detector in the Family Day Home.”

Rule 22.1-289.058.

Based on record review, the provider did not obtain documentation of a physical examination by or under the direction of a physician within 30 days of their first day of attendance.

“Evidence: 1. The records of Child #2 and Child #3 do not contain documentation of their physical examination. 2. Child #2’s first day of attendance was documented as 7/19/2021. 3. Child #3’s first day of attendance was documented as 8/12/2019”

Rule 8VAC20-800-100-A.

Based on record review, the provider did not obtain documentation of additional immunizations once every six months for children under the age of two years.

“Evidence: 1. Child #2’s record contains an immunization record that was last updated on 8/3/2021. 2. Child #3’s record contains an immunization record that was last updated on 12/10/2020”

Rule 8VAC20-800-90-C.