Monica Alegre Munoz

8VAC20-800-90-A

“Based on a review of five children's records and interviews, the provider did not obtain documentation that one child had 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: The immunizations in the record of Child #2, date of attendance 04/14/23, were obtained on 06/03/23. During interview, Caregiver #1 reported the immunizations for Child #2 were requested prior to the child's attendance, but were not obtained until after the child attended the family day home.”

8VAC20-800-100-A

“Based on a review of five children's records and interviews, the provider did not obtain documentation that one child had a physical examination by or under the direction of a physician prior to the child's attendance or within 30 days after the first day of attendance. Evidence: The physical examination in the record of Child #2, date of attendance 04/14/23, was completed on 08/08/23. During interview, Caregiver #1 acknowledged the physical examination for Child #2 was not obtained within 30 days after the first day of attendance.”

8VAC20-800-830-A

“Based on a review of documentation and interviews, the provider did not ensure the emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care. Evidence: The emergency response drills for 2023 were reviewed. An emergency evacuation drill was not documented in November 2023. During interview, Caregiver #1 reported that an evacuation drill was not practiced in November as required.”

8VAC20-770-60-B

“Based on a review of four caregivers' records and interview, the provider did not ensure one caregiver had a completed sworn statement or affirmation prior to employment. Evidence: The sworn statement in the record of Caregiver #4, employed on 11/20/23, was completed on 12/01/23. During interview, Caregiver #1 acknowledged the sworn statement was completed after Caregiver #4 started employment.”

22.1-289.035-B-2

“Based on a review of four caregivers' records and interviews, the provider did not ensure one caregiver obtained a fingerprint-based national criminal background check prior to employment. Evidence: The results of the fingerprint-based national criminal background check in the record of Caregiver #4, employed on 11/20/23, were completed on 01/17/24. During interview, Caregiver #1 acknowledged the fingerprints were obtained after Caregiver #4 started employment.”

8VAC20-800-90-C

“Based on a review of five children's records, the provider did not obtain documentation of additional immunizations every six months for a child under the age of two years. Evidence: 1) The most recent immunization documentation in the record of Child #1 (22-months-old), enrolled on 08/28/22, was dated 08/24/22. 2) During interview, the provider confirmed the family day home has not obtained additional immunizations since the child was enrolled.”

8VAC20-800-90-C

“Based on a review of five children's records, the provider did not obtain documentation of additional immunizations every six months for a child under the age of two years. Evidence: 1) The most recent immunization documentation in the record of Child #1 (22-months-old), enrolled on 08/28/22, was dated 08/24/22. 2) During interview, the provider confirmed the family day home has not obtained additional immunizations since the child was enrolled.”

8VAC20-790-250-F

“Based on a review of four caregivers' records and interview, the vendor did not ensure two caregivers completed the department's health and safety update course. Evidence: 1) The record of Caregiver #1 did not contain the department's health and safety update course. 2) The record of Caregiver #4, date of employment 04/10/20, did not contain the department's health and safety update course. 3) During interview, Caregiver #1 reported Caregiver #1 and Caregiver #4 have not completed the health and safety update course. The department's health and safety update course should be completed annually.”

8VAC20-800-70-B

“Based on a review of five children's records and interview, the provider did not obtain the parent's written acknowledgement of the receipt of the family day home's policies for the administration of medications for five children. Evidence: 1) The records of Child #1 (DOA: 03/09/22), Child #2 (DOA: 08/12/21), Child #3 (DOA: 04/07/21), Child #4 (DOA: 12/20/19), and Child #5 (DOA: 05/23/21) did not contain written acknowledgement that their parents received the family day home's policies for the administration of medication. 2) During interview, Caregiver #1 acknowledged the written acknowledgement was missing from each file.”

8VAC20-790-250-F

“Based on a review of four caregivers' records and interview, the vendor did not ensure two caregivers completed the department's health and safety update course. Evidence: 1) The record of Caregiver #1 did not contain the department's health and safety update course. 2) The record of Caregiver #4, date of employment 04/10/20, did not contain the department's health and safety update course. 3) During interview, Caregiver #1 reported Caregiver #1 and Caregiver #4 have not completed the health and safety update course. The department's health and safety update course should be completed annually.”

8VAC20-800-70-B

“Based on a review of five children's records and interview, the provider did not obtain the parent's written acknowledgement of the receipt of the family day home's policies for the administration of medications for five children. Evidence: 1) The records of Child #1 (DOA: 03/09/22), Child #2 (DOA: 08/12/21), Child #3 (DOA: 04/07/21), Child #4 (DOA: 12/20/19), and Child #5 (DOA: 05/23/21) did not contain written acknowledgement that their parents received the family day home's policies for the administration of medication. 2) During interview, Caregiver #1 acknowledged the written acknowledgement was missing from each file.”

8VAC20-790-180-B

“Based on a review of records and interview on May 5, 2022, the vendor did not maintain a written hard copy record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: 1. The daily attendance sheet on May 4, 2022, did not reflect the departure time of two children. 2. The daily attendance sheet on May 5, 2022, did not reflect one child being signed in for the day. There were 12 observed in attendance and only 11 children signed in on the attendance sheet. 3. The provider acknowledged the child was not signed in and that the departure time was missing.”

8VAC20-790-430-A-3

“Based on a review of records and interview on May 5, 2022, the vendor did not ensure lockdown procedures are practiced at least annually. Evidence: There was no record of lockdown procedures to view. The vendor became a subsidy provider in November 2020. There was no documentation of a lockdown procedure practiced in 2021.”

8VAC20-800-170-B

“Based on a review of caregiver records on May 5, 2022, the provider did not ensure that the tuberculosis screening form shall have been completed within the last 30 days and be signed by a physician, physicians' designee, or an official of the local health department. Evidence: The record of caregiver #1 (hired 3/7/22) contained documentation of a tuberculosis screening dated 1/5/22.”

8VAC20-800-170-A

“Based on a review of caregiver records and interview, the provider did not obtain from one caregiver prior to coming into contact with children a current Report of Tuberculosis (TB) Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form. Evidence: 1. The record of caregiver #2 (hired 5/2/22) did not contain documentation of a tuberculosis screening. 2. Caregiver #2 was observed caring for children. 3. The provider confirmed she did not obtain a tuberculosis screening from caregiver #2.”

8VAC20-800-120-A

“Based on a review of caregiver records on May 5, 2022, the provider did not ensure to maintain a complete record for each caregiver as required. Evidence: 1. The record of caregiver #1 (hired 3/7/22) did not contain documentation of a name, address, and telephone number of a person to be notified in an emergency and did not contain documentation of one reference as to character and reputation, as well as, competency checked before employment. 2. There was no record for caregiver #2 (hired 5/2/22). 3. The provider confirmed she did not obtain the required information for the caregiver records.”

8VAC20-800-240-A

“Based on observation on May 5, 2022, 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: 1. There was a broken picnic table outside with approximately 13 nail pops creating cracks in the plastic that could snag children's clothing or skin. 2. There was a Little Tykes climber/slide that was cracked approximately 12x4 creating a hole that children's clothing or skin could get entangled or snagged. 3. There was a crack and hole approximately 4x2 in the plastic of a tunnel of the Little Tykes climber that could entangle or snag children's clothing and skin. 4. The provider acknowledged the broken equipment.”

8VAC20-800-250-A

“Based on observation and interview on May 5, 2022, the provider did not ensure hanging items including, but not limited to, window blinds or curtain cords, appliance cords, and ropes shall be out of the reach of children under five years of age. Evidence: 1. The cording to the back screen door came apart from the door leaving a cord hanging from the door. 2. There was a piece of string approximately 14 inches long hanging from the door knob of the back door leading to the outdoor play area. 3. Children under the age of five were using the back door to get to the play area. Both the cord and the string were in reach of children under the age of five. 4. The provider acknowledged the cording was broken and that the string was hanging from the knob.”

8VAC20-800-350-E

“Based on observation on May 5, 2022, the provider did not ensure that hot water taps available to children were maintained within a range of 105?F to 120?F. Evidence: The hot water temperature in the children's bathroom was obtained using a digital thermometer. The hot water temperature registered 130?F.”

8VAC20-800-830-C

“Based on a review of the fire drill log and interview on May 5, 2022, the provider did not ensure that documentation shall be maintained of emergency evacuation and shelter-in-place drills. Evidence: The fire drill log indicated the last fire drill documented was dated 11/22/21. The provider stated the drills are being conducted but not logged.”

8VAC20-770-60-C-2

“Based on a review of caregiver records and interview on May 5, 2022, the provider did not ensure to obtain results of a central registry search within 30 days of employment for each caregiver. Evidence: The record of caregiver #1 (hired 3/7/22) did not contain documentation of central registry results. The provider acknowledged the results were not received.”

8VAC20-770-60-B

“Based on a review of caregiver records and interview on May 5, 2022, the provider did not ensure to have a Sworn Statement or affirmation available for each caregiver. Evidence: 1. The records of caregiver #1 (hired 3/7/22) and caregiver #2 (hired 5/2/22) did not contain documentation of a sworn statement or affirmation. 2. The provider confirmed she did not obtain sworn statements from the caregivers.”

22.1-289.035-B-2

“Based on a review of records and interview on May 5, 2022, the provider did not ensure every person required to undergo a background check shall submit to fingerprinting and provide personal descriptive information. Evidence: 1. The record of caregiver #2 (hired 5/2/22) did not contain documentation of fingerprint results. 2. The provider confirmed she did not obtain fingerprint results for caregiver #2 prior to hire.”

8VAC20-800-90-A

“Based on a review of children's records on May 5, 2022, the provider did not ensure before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized. Evidence: 1. The record of child #1 (enrolled 2/25/22) contained documentation of immunizations dated 2/28/22. 2. The record of child #5 (enrolled 12/27/21) did not contain documentation of immunizations.”

8VAC20-790-180-B

“Based on a review of records and interview on May 5, 2022, the vendor did not maintain a written hard copy record of daily attendance that documents the arrival and departure of each child in care as it occurs. Evidence: 1. The daily attendance sheet on May 4, 2022, did not reflect the departure time of two children. 2. The daily attendance sheet on May 5, 2022, did not reflect one child being signed in for the day. There were 12 observed in attendance and only 11 children signed in on the attendance sheet. 3. The provider acknowledged the child was not signed in and that the departure time was missing.”

8VAC20-790-430-A-3

“Based on a review of records and interview on May 5, 2022, the vendor did not ensure lockdown procedures are practiced at least annually. Evidence: There was no record of lockdown procedures to view. The vendor became a subsidy provider in November 2020. There was no documentation of a lockdown procedure practiced in 2021.”

8VAC20-800-170-B

“Based on a review of caregiver records on May 5, 2022, the provider did not ensure that the tuberculosis screening form shall have been completed within the last 30 days and be signed by a physician, physicians' designee, or an official of the local health department. Evidence: The record of caregiver #1 (hired 3/7/22) contained documentation of a tuberculosis screening dated 1/5/22.”

8VAC20-800-170-A

“Based on a review of caregiver records and interview, the provider did not obtain from one caregiver prior to coming into contact with children a current Report of Tuberculosis (TB) Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form. Evidence: 1. The record of caregiver #2 (hired 5/2/22) did not contain documentation of a tuberculosis screening. 2. Caregiver #2 was observed caring for children. 3. The provider confirmed she did not obtain a tuberculosis screening from caregiver #2.”

8VAC20-800-120-A

“Based on a review of caregiver records on May 5, 2022, the provider did not ensure to maintain a complete record for each caregiver as required. Evidence: 1. The record of caregiver #1 (hired 3/7/22) did not contain documentation of a name, address, and telephone number of a person to be notified in an emergency and did not contain documentation of one reference as to character and reputation, as well as, competency checked before employment. 2. There was no record for caregiver #2 (hired 5/2/22). 3. The provider confirmed she did not obtain the required information for the caregiver records.”

8VAC20-800-240-A

“Based on observation on May 5, 2022, 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: 1. There was a broken picnic table outside with approximately 13 nail pops creating cracks in the plastic that could snag children's clothing or skin. 2. There was a Little Tykes climber/slide that was cracked approximately 12x4 creating a hole that children's clothing or skin could get entangled or snagged. 3. There was a crack and hole approximately 4x2 in the plastic of a tunnel of the Little Tykes climber that could entangle or snag children's clothing and skin. 4. The provider acknowledged the broken equipment.”

8VAC20-800-250-A

“Based on observation and interview on May 5, 2022, the provider did not ensure hanging items including, but not limited to, window blinds or curtain cords, appliance cords, and ropes shall be out of the reach of children under five years of age. Evidence: 1. The cording to the back screen door came apart from the door leaving a cord hanging from the door. 2. There was a piece of string approximately 14 inches long hanging from the door knob of the back door leading to the outdoor play area. 3. Children under the age of five were using the back door to get to the play area. Both the cord and the string were in reach of children under the age of five. 4. The provider acknowledged the cording was broken and that the string was hanging from the knob.”

8VAC20-800-350-E

“Based on observation on May 5, 2022, the provider did not ensure that hot water taps available to children were maintained within a range of 105?F to 120?F. Evidence: The hot water temperature in the children's bathroom was obtained using a digital thermometer. The hot water temperature registered 130?F.”

8VAC20-800-830-C

“Based on a review of the fire drill log and interview on May 5, 2022, the provider did not ensure that documentation shall be maintained of emergency evacuation and shelter-in-place drills. Evidence: The fire drill log indicated the last fire drill documented was dated 11/22/21. The provider stated the drills are being conducted but not logged.”

8VAC20-770-60-C-2

“Based on a review of caregiver records and interview on May 5, 2022, the provider did not ensure to obtain results of a central registry search within 30 days of employment for each caregiver. Evidence: The record of caregiver #1 (hired 3/7/22) did not contain documentation of central registry results. The provider acknowledged the results were not received.”

8VAC20-770-60-B

“Based on a review of caregiver records and interview on May 5, 2022, the provider did not ensure to have a Sworn Statement or affirmation available for each caregiver. Evidence: 1. The records of caregiver #1 (hired 3/7/22) and caregiver #2 (hired 5/2/22) did not contain documentation of a sworn statement or affirmation. 2. The provider confirmed she did not obtain sworn statements from the caregivers.”

22.1-289.035-B-2

“Based on a review of records and interview on May 5, 2022, the provider did not ensure every person required to undergo a background check shall submit to fingerprinting and provide personal descriptive information. Evidence: 1. The record of caregiver #2 (hired 5/2/22) did not contain documentation of fingerprint results. 2. The provider confirmed she did not obtain fingerprint results for caregiver #2 prior to hire.”

8VAC20-800-90-A

“Based on a review of children's records on May 5, 2022, the provider did not ensure before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized. Evidence: 1. The record of child #1 (enrolled 2/25/22) contained documentation of immunizations dated 2/28/22. 2. The record of child #5 (enrolled 12/27/21) did not contain documentation of immunizations.”

8VAC20-790-210-A

“Based on a review of caregiver records, the vendor did not ensure to obtain a current report of tuberculosis screening at the time of employment and before coming in contact with children. Evidence: 1. The record of caregiver #2 (DOH 11/3/21) contained documentation of a tuberculosis screening dated 11/11/21.”

8VAC20-770-40-D-5-a

“Based on a review of records, the provider failed to ensure that each household member obtained a central registry check within 30 days of turning 14 years of age. Evidence: 1. The record of household member #2 (DOB 11/9/06) contained documentation of central registry results dated 4/15/21.”

22.1-289.036-B-4

“Based on a review of records and interview, the provider did not obtain results of a check of the out-of-state sex offender registry by 12/31/2020 for each caregiver or household member over the age of 18 that was residing in the home prior to July 1, 2020, and has resided in any state in the preceding five years. Evidence: 1. The record of caregiver #1 did not contain results of an out-of-state sex offender check. Caregiver #1 identified living in another state in the past 5 years on the caregiver's sworn disclosure statement dated 06/10/20. 2. The record of household member #1 did not contain results of an out-of-state sex offender check. Household member #1 identified living in another state in the past 5 years on the household member's sworn disclosure statement dated 6/10/20. 3. The provider acknowledged the out-of-state sex offender checks were not completed.”

8VAC20-800-120-A

“Based on record review and interview, the provider did not ensure to maintain a complete record for each caregiver as required. Evidence: 1. The record of caregiver #2 (DOH 11/3/21) did not contain documentation that two or more references as to character and reputation, as well as, competency were checked before employment. 2. The provider acknowledged that the references were not obtained.”

8VAC20-800-830-A

“Based on a review of the fire drill log and interview, the provider did not ensure the emergency evacuation procedures were practiced monthly with all caregivers and children during all shifts that children are in care. Evidence: 1. There was no documentation of a fire drill in September 2020. 2. The provider stated she conducted a shelter-in-place that month and didn't know she had to do a fire drill if she did a shelter-in-place.”

8VAC20-790-210-A

“Based on a review of caregiver records, the vendor did not ensure to obtain a current report of tuberculosis screening at the time of employment and before coming in contact with children. Evidence: 1. The record of caregiver #2 (DOH 11/3/21) contained documentation of a tuberculosis screening dated 11/11/21.”

8VAC20-770-40-D-5-a

“Based on a review of records, the provider failed to ensure that each household member obtained a central registry check within 30 days of turning 14 years of age. Evidence: 1. The record of household member #2 (DOB 11/9/06) contained documentation of central registry results dated 4/15/21.”

22.1-289.036-B-4

“Based on a review of records and interview, the provider did not obtain results of a check of the out-of-state sex offender registry by 12/31/2020 for each caregiver or household member over the age of 18 that was residing in the home prior to July 1, 2020, and has resided in any state in the preceding five years. Evidence: 1. The record of caregiver #1 did not contain results of an out-of-state sex offender check. Caregiver #1 identified living in another state in the past 5 years on the caregiver's sworn disclosure statement dated 06/10/20. 2. The record of household member #1 did not contain results of an out-of-state sex offender check. Household member #1 identified living in another state in the past 5 years on the household member's sworn disclosure statement dated 6/10/20. 3. The provider acknowledged the out-of-state sex offender checks were not completed.”

8VAC20-800-120-A

“Based on record review and interview, the provider did not ensure to maintain a complete record for each caregiver as required. Evidence: 1. The record of caregiver #2 (DOH 11/3/21) did not contain documentation that two or more references as to character and reputation, as well as, competency were checked before employment. 2. The provider acknowledged that the references were not obtained.”

8VAC20-800-830-A

“Based on a review of the fire drill log and interview, the provider did not ensure the emergency evacuation procedures were practiced monthly with all caregivers and children during all shifts that children are in care. Evidence: 1. There was no documentation of a fire drill in September 2020. 2. The provider stated she conducted a shelter-in-place that month and didn't know she had to do a fire drill if she did a shelter-in-place.”