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Jayanthi Samarasekara
14725 Calvary Place
Centreville, VA 20121
(571) 565-1686

Current Inspector: Charles Perkins (703) 309-3963

Inspection Date: Nov. 7, 2017

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
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

Technical Assistance:
Discussion was held on the topics of current enrollment, current staffing, the new definition of a serious injury, and a review of changes to background checks with regards to expiration dates, new sworn disclosure statements, and to obtain CPS checks from other states as listed from the past five years. Discussion that the Provider has 3 more hours to take of training before completing her total of 16 hours by the end of the year.

The following inspection took place between the hours of 12pm noon through 2:30 pm. Today, I met with the Provider on site at the Family Day Home (FDH) located in Centreville, Virginia. At the start of this unannounced monitoring inspection there were a total of 5 children (12 points) (1 child was a resident) with 1 caregiver. A total of 4 children?s files and 5 staff/household member?s files were reviewed. The children were engaged in the following: nap time, quiet activities, music, games, books, hand washing, and other organized activities. If you should have any future questions, please call. Thank you. Charlie Perkins, Licensing Inspector (703) 309-3963

Standard #: 22VAC40-111-790
Description: Based on observation and interview, none of the required emergency telephone numbers were posted. Evidence - 1. On the date of inspection (11/07/2017), the number for poison control, 911, and the number of a responsible person for emergency back up care were all not posted. 2. The Provider stated (during an interview conducted on the date of inspection) that she had just taken these numbers down, but will re-post them.

Plan of Correction: All required emergency numbers shall be posted by the telephone.

Standard #: 22VAC40-111-920
Description: Based on observation and interview, the menu for the current one-week period was not posted. Evidence - 1. On the date of inspection (11/07/2017), the menu was not posted. 2. The Provider stated (during an interview conducted on the date of inspection) that she had trouble printing a hard copy out.

Plan of Correction: Will post a hard copy.

Standard #: 22VAC40-111-60-B
Description: Based on review, 1 of 4 children's files reviewed indicated that not all of the required information was contained within each child's record. Evidence - 1. On the date of inspection (11/07/2017), 1 of 2 emergency contacts were listed for Child #4. 2. While all of the information was listed for the first emergency contact for Child #4, the second area was listed as "N/A." 3. However, this area does apply and all enrolled children must have 2 completed emergency contact information listed.

Plan of Correction: Will obtain all missing information.

Standard #: 22VAC40-111-90-C
Description: Based on review, 1 of 4 children's files reviewed indicated that the Family Day Home (FDH) did not obtain documentation of additional immunizations for a child (who was not exempt from the immunization requirements according to subsection B of this section) once every six months for children under the age of two years. Evidence - 1. On the date of inspection (11/07/2017), the most current immunization documentation on file for Child #3 was dated - 01/18/2017. 2. Based on the information on file, Child #3 was currently under 2 years of age.

Plan of Correction: A current immunization page shall be obtained for Child #3.

Standard #: 22VAC40-111-520-C
Description: Based on observation, two cribs being used during nap time had mesh sides. Evidence - 1. On the date of inspection, starting at 12 noon, the LI observed Child #3 and Child #2 sleeping in two separate mesh cribs. 2. Child #1 was observed sleeping in a crib with an acceptable manufacture date of July 2016.

Plan of Correction: Children will now sleep either in an acceptable crib or transition to a mat or cot.


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.