Inspection · 2023-06-08

Based on record review, 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 by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance for child #5 (Start Date: 10/8/2020).

Based on record review and interview, documentation that two or more references as to character and reputation as well as competency were checked before employment.

Evidence: Caregiver #3 is missing 1 of 2 references as to character and reputation as well as competency were checked before employment. The date of employment for Caregiver #3 is 5/11/2023.

Based on observation and interview, the provider failed to ensure compliance with these standards and the terms of the current license issued by the department and with relevant federal, state or local laws, and other relevant regulations.

Evidence: The Inspector was unable to enter a storage space at the family day home due to the door being locked. The provider confirmed that the door was locked and they did not have a key to unlock it during the inspection.

Based on observation, small appliances were not unplugged when not in use.

Evidence: An electric kettle and a toaster oven were found to be plugged in while not in use.

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

Evidence:
1. Child #1 is missing a second emergency contact
2. Child #2 is missing two emergency contact addresses and phone numbers.
3. Child #3 is missing two emergency contact addresses.
4. Children #2, 3, 4, and 5 are missing two parent work phone numbers.

Based on record review, the provider did not provide all the required family day home policies in writing prior to the child's first day of attendance.

Evidence:
1. Child #3 and Child #4 record did not contain the family day homes policies for medication.
2. Child #1 and Child #3 record did not contain information on whether or not the family day home has liability insurance.
3. Child #1, #2, #3, #4 record did not contain the family day home's emergency preparedness and response plan
4. Child #2 and Child #3 record did not contain the requirement for the family day home to notify the parent when the child becomes ill and for the parent to arrange to have the child picked up as soon as possible if so requested by the home.
5. Child #2 and Child #3 record did not contain the requirements for the parent to inform the family day home within 24
hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life- threatening diseases, which must be reported immediately.

Based on medication review and inteview, the provider failed to obtain a written authorization from a parent to administer a medication for a child in care.

Evidence: There was no written authorization from a parent to administer medication for Child #3 who has emergency medication at the family day home.

Based on record review and interview, the provider did not annually review with the parent the emergency contact information to ensure the information is correct and obtain the parent?s signed acknowledgment of the review.

Evidence:
1. Child #5's last annual emergency contact review was on 6/4/2020.

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

Evidence: Child #2 and Child #3 do not have signed documentation of viewing the proof of identity for the child. The start date for child #2 is 5/30/2023 and the start date for child #3 is 3/2023.

Based on record review and interview, before a child's first day of attendance, the provider did not obtain documentation that a child has been adequately immunized according to the requirements of ? 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations.

Evidence: There was no documentation that child #3 had been adequately immunized prior to their first day of attendance, as required by Virginia Code ? 32.1-46 A. The start date for child #3 is 3/2022.