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(Under the authority of Executive Order 51, the Commissioner of Department of Social Services is waiving regulation 22VAC40-665-40.N which references the period of time for a redetermination of eligibility for the subsidy program. )

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Lucia Martinez
5646 Kathryn Street
Alexandria, VA 22303
(703) 960-6438

Current Inspector: Jessica Willis (571) 352-1453

Inspection Date: Dec. 6, 2018

Complaint Related: No

Areas Reviewed:
22VAC40-111 Administration
22VAC40-111 Personnel
22VAC40-111 Household Members
22VAC40-111 Physical Health of Caregivers and Household Members
22VAC40-111 Caregiver Training
22VAC40-111 Physical Environment and Equipment
22VAC40-111 Care of Children
22VAC40-111 Preventing the Spread of Disease
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.
63.2 Licensure and Registration Procedures

Technical Assistance:
Obtain training documents from Caregiver #2 and maintain in the file. Out of State CPS checks are required for any household member/employee when they have lived out of the Commonwealth within the last five years.

An unannounced renewal was conducted from 940-11:10 AM. There were 8 children ( infant- 4 years) with the Provider and an assistant for a total of 22 points. The children were observed using play dough, coloring, and in group play. The backyard was free of hazards but children were inside due to the weather. The Provider has documentation of over 30 hours in annual training and she stated she is updating her CDA. Provider is MAT certified but stated that no one is on medication at this time. Caregiver #2 was a Substitute in the last year but Provider stated she is now her only assistant. The application cannot be submitted for renewal until the Provider obtains the Fingerprints and Sworn Disclosure statement for Caregiver #2. Please call with questions 703-479-4679

Standard #: 22VAC40-111-60-A
Description: Based on interview and record review, the Provider did not maintain a record for an enrollled child. Evidence: 1. Child #2 was observed in the home and recorded in the attendance book. The Provider stated she has a file but after the inspection was concluded, she was unable to locate the file.

Plan of Correction: I will find the file and keep all records together.

Standard #: 22VAC40-111-60-B
Description: Based on record review, the Provider did not maintain complete children's files. Evidence: 1. Child #1 and Child #3 had files available for review. Both files did not contain Parent's signed acknowledgement of the receipt of the information including operating information (hours and days of operation), the telephone number where a message can be left for a caregiver, fees, open door policy, check in and out procedures, medication policies, and general daily schedule that is appropriate for the age of the enrolling child. 2. Child #1's file also did not include parent's annual acknowledgement of enrollment info is current. 3. Child #3's file did not include start date, completed emergency care authorization, and proof of ID verification.

Plan of Correction: I will complete the paperwork.

Standard #: 22VAC40-111-240-A
Description: Based on observation, the Provider did not maintain items in the home in a safe manner. Evidence: 1. In the back room there are items stacked that a child can pull down on himself/herself. The kitchen has items stacked on the counters and the furnace is accessible to a child's touch. 2. The children have to walk through the kitchen and then the back room to access the back yard which is where they have outside time.

Plan of Correction: I will work on moving items as I have been throwing out items. I will also place a gate to prevent children's access of furnace.

Standard #: 22VAC40-191-40-D-1-b
Description: Based on record review, the Provider did not obtain a Sworn Disclosure Statement for Caregiver #1. Evidence: 1. Provider has a file for caregiver #2 but file did not contain Sworn Disclosure Statement. 2. Provider said she would look for the statement because it had been filled out.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-191-60-G-1
Description: Based on record review, the Provider did not adhere to the requirements for obtaining fingerprints for caregiver #2. Evidence; 1. Caregiver #2 was the assistant over a year ago and has the older background check and a CPS Clearance. There is a fingerprint eligibility letter in the file, but the check was conducted by the caregiver. Caregiver #2 stated she was a Provider but closed in August when she moved. The fingerprints registry check is not transferable from another licensed home and it needs to be conducted through the Provider.

Plan of Correction: I will obtain one for the caregiver.

A compliance history is in no way a rating for a facility.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.


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