Marina Graetzer

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.

“There was no physical exam record available for child #3, who had been in care for two months.”

Rule 8VAC20-800-100-A.

To safely perform medication administration practices listed in 8VAC20-800-710 whenever the family day home has agreed to administer prescription medications or nonprescription medications, the administration shall be performed by a caregiver who has satisfactorily completed a training program for this purpose.

“Child #4 (age 4 years), has a confirmed allergy that requires the use of emergency medication intended to be used in case of exposure. On August 17, 2026, for approximately 25 minutes, there were no caregivers on site with the certification to administer medication.”

Rule 8VAC20-800-220-A.

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, who had been in care for over 18 months, did not have a parent’s signature for an annual review of the emergency contact information.”

Rule 8VAC20-800-780-B.

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

“There was no documentation of immunizations for child #3, who was in care during the inspection and had been in care for two months.”

Rule 8VAC20-800-90-A.

The family day home shall obtain documentation of additional immunizations once every six months for children under the age of two years.

“Child #1 (age 23 months), last immunization record was dated over one year ago.”

Rule 8VAC20-800-90-C.

The license and any other documents required by the Superintendent shall be posted in a conspicuous place on the licensed premises.

“The new license was not posted at the family day home. The license posted at the family day home expired five months ago.”

Rule 22.1-289.011-F.

An assistant 18 years of age or older who is left alone with children in care shall have: Current certification in cardiopulmonary resuscitation (CPR).

“Caregiver #1s CPR certification expired over four months ago. Caregiver #1 was alone with two children for approximately 30 minutes at the time of inspection.”

Rule 8VAC20-800-150-D-1.

8VAC20-800-180-A

“Based on record review, the provider did not obtain for each caregiver and adult household member a current Report of Tuberculosis Screening form, every two years. Evidence: 1. The record for Caregiver #1 contained documentation of a tuberculosis screening dated 05/18/2022. 2. The record for Household Member #2 contained documentation of a tuberculosis screening dated 08/01/2022.”

Rule 8VAC20-800-180-A.

8VAC20-800-60-B

“Based on record review and interview, childrens records, did not contain all required information. Evidence: 1. The record for Child #1 (date of enrollment: 09/03/2024) did not contain emergency contact name, address and telephone number for two designated people, an immunization record or name, office address, and telephone number of the child’s physician. 2. Caregiver #1 acknowledged that the record for Child #1 did not contain all required information.”

Rule 8VAC20-800-60-B.

Based on record review, the family day home failed to ensure that 1 out of 2 caregivers obtained a Tuberculosis (TB) screening that was completed within the last 30 days of the time of hire.

“Evidence: Caregiver #2’s (start date: 03/28/2023) TB screening was dated 09/26/2022.”

Rule 8VAC20-800-170-B.

Based on observation, 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: The provider’s maximum licensed capacity is 7. At the start of the inspection, there were 8 children present.”

Rule 8VAC20-800-40-A.

Based on record review, the family day home failed to maintain documentation of emergency evacuation and shelter-in-place drills.

“Evidence: 1. At the time of inspection, the family day home only had documentation of 1 of 2 shelter-in-place drills for the year of 2023. 2. At the time of inspection, the family day home did not have documentation of an emergency evacuation drill for January 2024.”

Rule 8VAC20-800-830-C.

Based on record review, every applicant for licensure as a family day home and adult living in such family day home underwent background checks every five years.

“Evidence: Household Member #1?s most recent central registry search was dated 06/01/2017.”

Rule 22.1-289.036-A.

Based on record review, the provider did not obtain documentation of physical examination for each child prior to the child’s attendance or within 30 days after the first day of attendance.

“Evidence: Child #1 (start date:01/03/2023) did not have documentation of physical examination on file.”

Rule 8VAC20-800-100-A.

Based on record review, the provider did not obtain documentation that all children were adequately immunized, before a child may attend the family day home.

“Evidence: Child #1 (start date:01/03/2023) did not have documentation of immunizations on file.”

Rule 8VAC20-800-90-A.

Based on record review, every applicant for licensure as a family day home and adult living in such family day home underwent background checks every five years.

“Evidence: 1. Caregiver #1?s most recent central registry search was dated 06/01/2017. 2. Household Member #1?s most recent central registry search was dated 06/01/2017.”

Rule 22.1-289.036-A.

Based on record review, the provider did not obtain for each adult household member a current Report of Tuberculosis (TB) Screening form every two years from the date of the first screening.

“Evidence: Household Member #1 had a TB screening form dated 01/08/2020.”

Rule 8VAC20-800-180-A.

Based on observation, not all small electrical appliances were unplugged while not being used by the caregiver or with children under close supervision.

“Evidence: 1. In the basement kitchen, a kettle was plugged in while not being used. 2. In the upstairs kitchen, a toaster and toaster oven were plugged in while not being used.”

Rule 8VAC20-800-320-A.

Based on caregiver interview, the wood burning fireplace was not inspected annually by a knowledgeable inspector to verify that the device is properly installed, maintained and cleaned as needed.

“Evidence: Caregiver #1 stated that the wood burning fireplace had not been inspected.”

Rule 8VAC20-800-320-G.

Based on observation and record review, when topical skin products were used, not all requirements were met.

“Evidence: 1. Written parent authorization was not obtained for Child #1?s insect repellant. 2. The written parent authorization form for Child #2?s sunscreen was dated 05/26/2021. 3. There were two bottles of sunscreen that were not labeled with the child’s name. Caregiver #1 stated that she just received them and forgot to label them.”

Rule 8VAC20-800-750-A.

Based on observation, not all topical skin products were inaccessible to children.

“Evidence: There were two bottles of insect repellant and three bottles of sunscreen located at the bottom of the cubbies, within reach of children.”

Rule 8VAC20-800-750-B.

Based on record review, the provider did not obtain the parent’s signed acknowledgement of the review of the emergency contact information for each child.

“Evidence: 1. The parent’s signed acknowledgement of the review of the emergency contact information for Child #2 was dated 03/16/2021. 2. The parent’s signed acknowledgement of the review of the emergency contact information for Child #4 was dated 07/28/2020.”

Rule 8VAC20-800-780-B.

Based on record review, emergency evacuation procedures were not practiced monthly with all caregivers and children in care.

“Evidence: The most recent emergency evacuation was dated 05/27/2022.”

Rule 8VAC20-800-830-A.

Based on observation and caregiver interview, a menu for the current one-week period was not given to parents, posted or placed in an area accessible to parents when meals or snacks were provided by the family day home.

“Evidence: Caregiver #1 stated that she does not have a menu for the current one-week period.”

Rule 8VAC20-800-920.

8VAC20-800-180-A

“Based on a review of caregiver health records, it was determined that the provider did not obtain for each caregiver a current Report of Tuberculosis Screening form every two years from the date of the first screening. Evidence: The TB screening for caregiver A expired on 1/8/2022.”

Rule 8VAC20-800-180-A.

8VAC20-800-60-B

“Based on a review of children’s records, it was determined that one record does not contain all required information. Evidence: Child record B does not include documentation of the review of the child’s emergency contact information. The parent most recently reviewed this record on 2/28/2020.”

Rule 8VAC20-800-60-B.