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Ms. Maria Clark
1519 Moorman Avenue, NW
Roanoke, VA 24017
(540) 343-7810

Current Inspector: Rebecca Forestier (540) 309-2835

Inspection Date: Aug. 26, 2016

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 Medication Administration
22VAC40-111 Emergencies
22VAC40-111 Nutrition
22VAC40-111 Transportation
22VAC40-111 Nighttime Care
63.2 General Provisions.
63.2 Child Abuse and Neglect
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
63.2 Liability Insurance Disclosure
22VAC40-191 Background Checks for Child Welfare Agencies
54.1-3408 Provider must be MAT certified to administer prescription medication.

Technical Assistance:
Clarification was given to the Provider regarding approved documents to be used for verification of identity and age. The LI explained how to document verification on the child's identity on the registration form.

A Renewal inspection was conducted in the Family Day Home on August 26, 2016. The LI attempted an inspection in the morning but no one was at home. The LI returned to the home at approximately 2:15pm, 4 children were in care of the Provider. The children were napping. Based on the ages of the children, the total points were 8. The Provider reported that she had taken the children for an outing to a park and to lunch. After school, 5 additional children arrived, the points totaled 14 for the nine children in care. Prior to the school-age children's arrival, the Provider spoke on the phone with the Assistant and she came to the FDH. The Provider reported medications are not administered. The LI reviewed a sample of 9 records, 6 children's, two caregivers' and one household member. Observed activities included crafts, open play, and several children viewed a movie. The children were served a snack. Dismissal at the end of the day was also observed as the children were picked up. Findings of the inspection were reviewed at exit. The on site inspection concluded at 5:30pm. If you have questions, I may be reached at (540)309-2310 or via e-mail Thank you.

Standard #: 22VAC40-111-780-B
Description: Based on records reviewed, the Provide failed to review the emergency contact information for each child and obtain the parent's signed acknowledgment of the review. Evidence: The LI reviewed a sample of 6 children's records. Two of the six children had attended over one year. The records of children 4 and 5 were not documented to verify an annual review with the children's parents.

Plan of Correction: Records will be reviewed with each parent to verify that information is accurate and current. The form will be signed and dated at the time of the review.

Standard #: 22VAC40-111-800-C
Description: Based on review of a caregiver's record, the Provider failed to document that annual training was conducted regarding the emergency evacuation, emergency relocation, and shelter-in-place procedures. Evidence: The training log for caregiver 1 was not documented to support completion of an annual training on the FDH's emergency procedures for the current year. It was noted on the training log that response drill training was completed on 07/29/15.

Plan of Correction: The emergency procedures will be reviewed with the caregiver. The date of the training will be written on the training log.

Standard #: 22VAC40-111-980-B
Description: Based on reviewed children's records, the Provider failed to obtain written permission for a special field trip. Evidence: The record of one of four children taken on the August 26th field trip did not have the destination of the field trip listed for parental permission. The parent had given general written permission for field trips.

Plan of Correction: The Provider will add the information and will have the parent initial and date for permission.

Standard #: 22VAC40-111-990-B
Description: Based on Provider report, the name, address and phone number of the family day home was not located in the vehicle during transportation of children. Evidence: The Provider had transported a group of young children on a field trip on the date of the inspection. The Provider reported that she had not placed the information in the vehicle that is currently being driven.

Plan of Correction: The Provider will have complete information regarding the FDH's name, address, and phone number in the first aid kit located in the vehicle.

Standard #: 22VAC40-111-100-A
Description: Based on a sample review of children's records, the Provider failed to 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: Three of six reviewed children's records did not contain documentation of a physical examination. The records of children 1, 6 and 7 did not have documentation of a completed physical, the children have attended over 30 days.

Plan of Correction: Each parent will be informed and requested to provide a copy of their child's current physical.

Standard #: 22VAC40-111-80-B
Description: Based on documentation reviewed in children's records, the Provider failed to verify the identity and age of a child by viewing one of the following: certified birth certificate, birth registration card, notification of birth, passport, copy of the placement child agreement, record or report card from a VA public school, a child id card issued by VA Dept. of Motor Vehicles (DMV). Evidence: Two of six records (children 2 and 6) noted a school entrance health form was used for proof of identity and age.

Plan of Correction: The Provider will inform the parents and will ask to see the birth record of each child. Documentation will be in each record.


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.

Virginia Quality is a voluntary quality rating and improvement system for early care and education facilities serving children ages birth through pre-K. Eligible child care facilities must be fully licensed, licensed exempt and a VDSS subsidy vendor, or a voluntary registered day home and a VDSS subsidy vendor. Only programs enrolled in Virginia Quality will display a rating. Virginia Quality contact information for your region is available at the following link Regional Contacts.


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