Ms. Ghazala Shah

The diapering surface shall be nonabsorbent.

“During inspection, a rip was noticed in the diaper changing pad preventing it from being nonabsorbent.”

Rule 8VAC20-800-690-D.

Based on observation and Provider interview, the Provider did not ensure that areas and furnishings of the family day home, inside and outside were maintained in a clean, safe and operable condition.

“Evidence: There is a closet in the infant crib room that is unlocked and contains items piled as high as 5 feet from the ground that fall forward as soon as the door is opened.”

Rule 8VAC20-800-240-A.

Based on Provider interview, the Provider did not ensure that accordion expansion gates or pressure mounted gates were not used as protective barriers at stair openings.

“Evidence: The Provider stated that they use a pressure mounted gate as a barrier to block the top of the stairs on the deck where the children play with bubbles.”

Rule 8VAC20-800-430-B.

(Repeat Violation) Based on review of 5 children’s records, the Provider did not obtain all of the required documentation for child records.

“Evidence: 1)The record for Child #1 and Child #5 did not contain written authorization for emergency medical care. 2)The record for Child #4 did not contain the medical insurance policy number as required.”

Rule 8VAC20-800-60-B.

(Repeat Violation) Based on observation and interview with staff, the Provider did not ensure that medications, including refrigerated medication and medication for caregivers and household members, was kept in a locked place using a safe locking method that prevents access by children.

“Evidence: The Provider had a triple antibiotic medication stored unlocked on the shelves in the infant crib room.”

Rule 8VAC20-800-730-D.

Based on review of 3 household records, the Provider did not obtain for each Household member or caregiver a current report of Tuberculosis screening every 2 years from the date of the first screening.

“Evidence: The record for Household member #1 contained a Tuberculosis screening that was last completed on 10/7/21.”

Rule 8VAC20-800-180-A.

(Repeat Violation) Based on review of 5 child records, the Provider did not obtain information on allergies and intolerance to food, medication, or any other substances, and actions to take in an emergency situation.

“Evidence: The record for Child #1 did not contain the action to take in an emergency situation for the physician diagnosed food allergies and parent indicated food intolerances.”

Rule 8VAC20-800-60-B.

8VAC20-800-730-D

“(Repeat Violation) Based on observation and staff interview, the provider did not ensure that medication was kept in a locked place using a safe locking method that prevents access by children. Evidence: A medication was stored unlocked on top of a table in the front hall where children enter the home and have access.”

Rule 8VAC20-800-730-D.

Based on review of 5 child records, the Provider did not ensure they obtained documentation of additional immunizations for a child who is not exempt from the immunization requirements once every 6 months for children under the age of two years.

“Evidence: 1)The record for Child #1 (age 2) did not contain immunizations once every 6 months for a child under the age of 2 years. The last immunization documentation contained in the record was dated 8/5/22 when the child was 15 months old. 2)The record for Child #5 (age 3) did not contain immunizations once every 6 months for a child under the age of 2 years. The last immunization documentation contained in the record was dated 11/22/21 when the child was 18 months old.”

Rule 8VAC20-800-90-C.

Description: Based on review of the written attendance record and interview with the Provider, the Provider did not ensure they maintained a written record of children in attendance each day.

“Evidence: During the inspection in was determined there were 7 children present, but the written record reflected there were 5 children present.”

Rule 8VAC20-800-50-A.

Based on review of 2 child records, the provider did not ensure that that the record for each enrolled child included the name, address and telephone number of two designated persons to contact in case of emergency if the parent cannot be reached.

“Evidence: The record for Child #1 did not contain a 2nd designated person, address, and telephone number to contact in case of emergency.”

Rule 8VAC20-800-60-A.

Based on observation and staff interview, the provider did not ensure that medication was kept in a locked place using a safe locking method that prevents access by children.

“Evidence: A medication was stored on the edge of the counter in the kitchen.”

Rule 8VAC20-800-730-D.

Based on review of 2 staff records, the provider did not obtain documentation of the results of a national fingerprint background check prior to date of hire.

“Evidence: The record for Staff #2 (Date of Hire 8/1/22), did not contain documentation of a fingerprint background check completed prior to their date of hire.”

Rule 22.1-289.035-B-2.

Based on observation, the provider did not ensure that small electrical appliances were unplugged when not being used.

“Evidence: During an inspection of the kitchen, a toaster, air fryer and coffee maker were all plugged in and not in use.”

Rule 8VAC20-800-320-A.

Based on observation and staff interview, the provider did not ensure that rest mats were cleaned and sanitized on all sides weekly or as needed.

“Evidence: During an inspection of the programming space, 4 nap mats were observed with tears at the corners and seams preventing them from being sanitized properly. The staff indicated the 4 nap mats were being used for nap time.”

Rule 8VAC20-800-510-E.

Based on observation and staff interview, the provider did not ensure that medication was kept in a locked place using a safe locking method that prevents access by children.

“Evidence: A medication was stored on the bottom shelf of the unlocked medicine cabinet located in the bathroom that the children use in the programmatic space.”

Rule 8VAC20-800-730-D.

22VAC40-665-230-E-1

“Based on review of documentation, it was determined that not all caregivers have current certification in cardiopulmonary resuscitation (CPR) appropriate to the ages of children in care with training that included an in-person competency demonstration. Evidence: the record for caregiver #2 (date of hire: 9/14/21) had documentation of CPR from the National CPR Foundation which doesn’t include an in-person competency demonstration.”

Rule 22VAC40-665-230-E-1.

22.1-289.035-B-2

“Based on review of two caregiver records, the provider did not have an Office of Background Investigations (OBI) fingerprinting-based criminal history record determination letter prior to a caregiver beginning employment. Evidence: The record for caregiver #2 (date of hire: 9/14/22) had a determination letter dated: 9/29/22.”

Rule 22.1-289.035-B-2.

8VAC20-800-120-A

“Based on review of two caregiver records, it was determined that not all records contained all required information. Evidence: the record for caregiver #2 did not contain documentation that two or more references as to character and reputation as well as competency were checked before employment.”

Rule 8VAC20-800-120-A.

8VAC20-800-170-B

“Based on review of documentation, it was determined that not all caregivers had a Tuberculosis (TB) test/screening completed within the last 30 days and signed by a physician, physicians’ designee, or an official of the local health department. Evidence: the record for caregiver #2 (date of hire: 9/14/22) had a TB test/screening dated: 7/23/21 that was not signed by a physician, the physicians’ designee or an official of the local health department.”

Rule 8VAC20-800-170-B.

8VAC20-800-50-A

“Based on review of the written attendance record, and an interview with the provider, it was determined that the provider did not ensure all children were included on the written attendance record. Evidence: there was no written record of attendance for March 7, 8 or 9, that listed the children in attendance. On March 9, the LI observed 12 children in attendance.”

Rule 8VAC20-800-50-A.

8VAC20-800-920

“Based on review of documentation and an interview with the provider, it was determined that their was no menu for the current week. Evidence: the posted menu was not dated, the foods listed were not served to the children, and no substituted foods were listed.”

Rule 8VAC20-800-920.