Anju Thapa

Assistant’s records shall contain documentation that two or more references as to character and reputation were checked before employment.

“The record for Assistant Caregiver #2 was missing two objective references and has been employed for over six months.”

Rule 8VAC20-800-120-B.

The provider shall obtain a current report of Tuberculosis Screening form for each adult household member.

“At the time of the inspection, the Tuberculosis Screening form for household member #1 was not available for review.”

Rule 8VAC20-800-170-A.

The provider must orient assistants by the end of their first week of assuming job responsibilities.

“Assistant Caregiver #2 provided care for children for six months without receiving orientation.”

Rule 8VAC20-800-200-A.

Child-resistant protective covers larger than 1-1/4 inches in diameter shall be installed on all unused electrical outlets and surge protectors accessible to children under five years of age.

“Two unused electrical outlets, accessible to children, were missing a child-resistant protective cover.”

Rule 8VAC20-800-320-B.

Annually, the provider shall review with the parent the emergency contact information required in each child’s record to ensure the information is correct and shall obtain the parents signed acknowledgment of the review.

“The record for Child #2, in care for over a year, did not have a parent’s signature for annual review of the emergency contact information.”

Rule 8VAC20-800-780-B.

Children shall not be allowed to drink while lying down.

“Two children were observed laying down in their crib while drinking a bottle.”

Rule 8VAC20-800-900-B.

Providers must obtain a completed national criminal background check prior to the employee’s first day of employment.

“Caregiver #2’s completed national criminal background check was received one month after the first day of employment.”

Rule 22.1-289.035-B-2.

Documentation of a negative tuberculosis (TB) screening must be submitted at the time of employment, before coming into contact with children, and shall have been completed within the last 30 days of the date of employment.

“Caregiver #2’s TB was dated 1 year, seven months prior to the date of employment and has been employed for three months.”

Rule 8VAC20-800-170-A.

Children’s records are required to contain the address of two designated persons to contact in case of an emergency if the parent cannot be reached and the name of the child’s medical insurance.

“The record for Child #1 (in care for almost one month) was missing the address of the second emergency contact. The record for Child #4 (in care for over two years) was missing the medical insurance name.”

Rule 8VAC20-800-60-B.

Documentation of additional immunizations is required once every six months for children under the age of two years. ’

“Child #2, 21 months old, last documented immunization was over 12 months ago.”

Rule 8VAC20-800-90-C.

22.1-289.035-B-1

“The family day home is required to obtain a completed sworn statement prior to the employee’s first day of employment. The sworn statements for Caregiver #3 and Caregiver #4 were dated after their first day of employment.”

Rule 22.1-289.035-B-1.

22.1-289.035-B-2

“Providers must obtain a completed national criminal background check prior to the employee’s first day of employment. The national criminal background check in the record for Caregiver #3 was obtained a month after the employee’s first date of employment. The national criminal background check in the record for Caregiver #4 was obtained two months after the employee’s first date of employment.”

Rule 22.1-289.035-B-2.

22.1-289.035-B-3

“The family day home must request a search of the central registry prior to the employee’s first day of employment. Caregiver #3, who had been employed for two weeks, did not have a central registry search requested. Caregiver #3 does not work in the family day home, but has worked ?a few times? since beginning employment two months ago. The central registry search results for Caregiver #4 was obtained two months after beginning employment.”

Rule 22.1-289.035-B-3.

8VAC20-800-120-B

“Providers must maintain a record for each caregiver which includes all required information. The record for Caregiver #3 did not contain the date of employment and documentation that two or more references as to character and reputation as well as competency were checked before employment. The record for Caregiver #4 did not contain the date of employment. Caregiver #4 has been employed for approximately two months. One reference obtained for Caregiver #4 was not dated as required.”

Rule 8VAC20-800-120-B.

8VAC20-800-510-C

“Occupied cribs shall be atleast 12 inches from each other. Two occupied cribs were observed side by side, closer than 12 inches apart. The children, one in each crib, were holding hands.”

Rule 8VAC20-800-510-C.

8VAC20-800-600-B

“Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours confined in a crib. 6 children were observed awake in cribs for 55 consecutive minutes.”

Rule 8VAC20-800-600-B.

8VAC20-800-800-B

“The provider is required to review the emergency plan at least annually and update the plan as needed. The provider is required to document in writing each review and update to the emergency plan. The annual review of the emergency plan was overdue by more than three months.”

Rule 8VAC20-800-800-B.

8VAC20-800-90-A

“Before attendance, documentation of immunizations is to be obtained for each child. The documentation of immunizations for child #3 was overdue by three days.”

Rule 8VAC20-800-90-A.

8VAC20-800-60-B

“Children’s records are required to contain the name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached. The record for Child #3 and 4 were missing the addresses for both emergency contacts. Child #3 and 4 were present during the inspection and had been in care for five months.”

Rule 8VAC20-800-60-B.

Repeat Violation

“Based on record review, the provider did not obtain documentation of a physical examination within 30 days after the first day of attendance for 1 of 4 children reviewed. Evidence: The record for Child #1 (start date 2/26/2024) did not contain documentation of a physical examination.”

Rule 8VAC20-800-100-A.

Repeat Violation

“Based on record review, 1 caregiver record did not contain all required documentation. Evidence: 1. The record for Caregiver #2 did not contain the caregiver’s date of hire and name, address, and telephone number of a person to be notified in an emergency.”

Rule 8VAC20-800-120-B.

Repeat Violation

“Based on record review, the provider did not maintain written documentation of orientation for 1 caregiver. Evidence: 1. The record for Caregiver #2 did not contain documentation of orientation.”

Rule 8VAC20-800-230-A.

Based on record review, 1 of 4 records did not contain all required information.

“Evidence: 1. The record for Child #1 did not contain documentation of the address of the place of employment for both parents. 2. The record for Child #2 did not contain Written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately.”

Rule 8VAC20-800-60-B.

Based on record review, the provider did not obtain the parent’s written acknowledgement of the receipt of information as required.

Rule 8VAC20-800-70-B.

Repeat Violation

“Based on record review, 2 of 4 children’s records did not contain complete documentation of proof of identification for each child in care. Evidence: 1. The records for Child #1 and #2 did not contain documentation of date and person verifying original proof of identification.”

Rule 8VAC20-800-80-C.

Repeat Violation

“Based on record review, the provider did not obtain documentation that 1 of 4 children reviewed has been adequately immunized. Evidence: 1. The record for Child #1 (start date 02/26/2024) did not contain documentation of immunizations.”

Rule 8VAC20-800-90-A.

Based on record review, the provider did not obtain fingerprint-based criminal history record results for 1 caregiver prior to employment.

“Evidence: 1. The provider stated Caregiver #2 began employment in January 2023. The record for Caregiver #2 did not contain a Fingerprint Eligibility Letter issued by the Office of Background Investigations.”

Rule 22.1-289.035-B-2.

Based on record review, the provider did not obtain repeat background checks every five years as required for 2 of 4 Caregiver/household members reviewed.

“Evidence: 1. The repeat fingerprint check in the record for Caregiver #1 was obtained on 12/11/2023, more than 5 years after the previous results obtained on 7/24/18. 2. The repeat central registry check results in the record for Household member #1 were obtained on 1/10/2024, more than 5 years after the previous results obtained on 8/24/2018.”

Rule 22.1-289.036-A.

Based on record review, the provider did not obtain fingerprints for a household member over the age of 18.

“Evidence: 1. The record for Household Member #1 did not contain documentation of the results of a fingerprint-based criminal history record check.”

Rule 22.1-289.036-B-2.

Based on record review, the provider did not obtain documentation of a physical examination within 30 days after the first day of attendance for 1 of 3 children reviewed.

“Evidence: The record for Child #3 (start date 12/27/2023) did not contain documentation of a physical examination.”

Rule 8VAC20-800-100-A.

Based on record review, 1 caregiver record did not contain all required documentation.

“Evidence: 1. The record for Caregiver #2 did not contain the caregiver’s date of hire and name, address, and telephone number of a person to be notified in an emergency.”

Rule 8VAC20-800-120-B.

Based on record review, the provider did not maintain written documentation of orientation for 1 caregiver.

“Evidence: 1. The record for Caregiver #2 did not contain documentation of orientation.”

Rule 8VAC20-800-230-A.

Based on record review, 1 of 3 children’s records did not contain all required information.

“Evidence: 1. The record for Child #1 did not contain documentation of the name and policy number of the child’s medical insurance. 2. The record for Child #1 does not contain signed confirmation that the information provided in the record for Child #1 is correct.”

Rule 8VAC20-800-60-B.

Based on observation, the diapering surface was not cleaned after each use.

“Evidence: 1. The provider was observed during diaper changing using a spray sanitizer after each use. The surface was not cleaned by washing with soap and water or detergent solution and rinsing with water, prior to being sanitized as required.”

Rule 8VAC20-800-690-D.

Based on record review, the provider did not obtain the parent’s written acknowledgement of the receipt of information required to be provided to parents by the child’s first day.

“Evidence: 1. The records for Child #1 and Child #2 did not contain written confirmation of the receipt of the provisions of the family day home’s emergency preparedness and response plan.”

Rule 8VAC20-800-70-B.

Based on record review, 2 of 3 children’s records did not contain complete documentation of proof of identification for each child in care.

“Evidence: 1. The records for Child #1 and #3 did not contain documentation of date and person verifying original proof of identification.”

Rule 8VAC20-800-80-C.

Based on record review, the provider did not review the emergency plan at least annually.

“Evidence: 1. There is documentation of one review of the emergency plan which was created on 11/08/2021. The signature of the review of the plan was not dated.”

Rule 8VAC20-800-800-B.

Based on record review, the provider did not obtain documentation that 1 of 3 children reviewed has been adequately immunized.

“Evidence: 1. The record for Child #3 (start date 12/27/2023) did not contain documentation of immunizations.”

Rule 8VAC20-800-90-A.

8VAC20-800-120-B

“Based on the review of the providers staff paperwork, the provider failed to get some of the required information to make the record complete. Evidence: Based on the review of three staff files, one staff, staff 2 is missing a second reference.”

Rule 8VAC20-800-120-B.

8VAC20-800-200-A

“Based on the review of three staff records, the provider failed to orient the caregivers within the first week of employment. Evidence: Staff 2 and Staff 3 are missing the orientation and both have been employed for more than a week.”

Rule 8VAC20-800-200-A.

Based on record review, the provider did not obtain fingerprint-based criminal history record reports for 1 caregiver prior to employment.

“Evidence: The record for Caregiver #1 did not contain a Fingerprint Eligibility Letter issued by the Office of Background Investigations.”

Rule 22.1-289.035-B-2.

Based on record review, the provider did not obtain central registry check results every five years for 1 caregiver.

“Evidence: 1. The most recent central registry check results in the record for Caregiver #2 were dated 9/27/2017.”

Rule 22.1-289.036-A.

Based on record review, 1 caregiver record did not contain all required information.

“Evidence: The record for Caregiver #1 did not contain the following: -Date of employment -Name address and telephone number of a person to be notified in an emergency -Documentation that two or more references as to character and reputation as well as competency were checked before employment. The record only contained one reference.”

Rule 8VAC20-800-120-B.

Based on record review and provider interview, the provider did not provide orientation to 1 assistant by the end of their first week of assuming job responsibilities.

“Evidence: 1. The provider stated caregiver #1’s date of employment was 1/12/2023. 2. There was no documentation of orientation training in the record for Caregiver #1.”

Rule 8VAC20-800-200-A.

Based on observation, sleeping mats were not atleast 12 inches from each other.

“Evidence: Four children were observed sleeping on sleeping mats in the floor of the family day home. The sleeping mats were positioned next to each other and touching.”

Rule 8VAC20-800-510-C.

Based on record review, 3 of 3 children’s records reviewed did not contain all required information.

“Evidence: 1. The record for Child #2 did not contain documentation of the name, address and telephone number of one of two required designated persons to contact in case of an emergency if the parent cannot be reached 2. The records for Child #1 and Child #3 did not contain written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately.”

Rule 8VAC20-800-60-B.

Based on record review, the provider did not provide all required information in writing to the parents prior to the child’s first day.

“Evidence: The records for Child #1, Child #2, and Child #3 did not contain written acknowledgement that the parents received the provisions of the family day home’s emergency preparedness and response plan.”

Rule 8VAC20-800-70-A.

Based on observation, the provider did not ensure required phone numbers were posted.

“Evidence: The provider did not have the following numbers posted: A 911 or local dial number for police, fire, and emergency medical responders The regional poison control center”

Rule 8VAC20-800-790.

Based on record review and caregiver interview, the provider did not provide all required information in writing to the parents prior to the child’s first day.

“Evidence: The records for Child #1 and Child #2 did not contain written acknowledgement that the parents received the provisions of the family day home’s emergency preparedness and response plan. The provider stated information was not provided to the parents.”

Rule 8VAC20-800-70-A.

Based on observation, the provider did not ensure required phone numbers were posted.

“Evidence: The provider did not have the following numbers posted: A 911 or local dial number for police, fire, and emergency medical responders The responsible person for emergency backup care The regional poison control center”

Rule 8VAC20-800-790.

Based on record review, the provider did not obtain documentation that the child has been adequately immunized prior to the child’s first day.

“Evidence: 1. Child #1 began attending the family day home on 08/16/2021. The documentation of immunizations in the record for Child #1 were dated 08/20/2021.”

Rule 8VAC20-800-90-A.

Based on observation, the first aid kit did not contain all required items.

“Evidence: The first aid kit did not contain adhesive tape.”

Rule 22VAC40-111-760-A-1.