Virginia Law

Article 7.2. Prescribed Pediatric Extended Care Center Licensing.

As used in this article, unless the context requires a different meaning:

"Center" means a prescribed pediatric extended care center.

"Parent" means the same as that term is defined in § 22.1-213.1.

2025, c. 451.

A. No person shall establish or operate a Center without a license issued by the Commissioner pursuant to this article.

B. No license issued under this article shall be assignable or transferable.

C. The Board shall adopt regulations for the implementation of this article.

2025, c. 451.

A. The Board is authorized to adopt regulations and schedules for fees to be charged for processing applications for licenses to operate Centers.

B. All fees received under the provisions of this article shall be paid into a special nonreverting fund of the Department and are appropriated to the Department solely for the operation of the Center licensure and inspection program. Any surplus of fees above actual program operating costs maintained in the special nonreverting fund in any state fiscal year shall be applied to the future program operating costs in the following state fiscal year.

2025, c. 451.

A. Every person that establishes or operates a Center shall obtain a license from the Commissioner, which may be renewed annually. Each application for a license shall be made to the Commissioner, in such form as he may prescribe and accompanied by an application fee. It shall contain the name and address of the applicant and, if the applicant is an association, partnership, limited liability company, or corporation, the names and addresses of its officers and agents. The application shall also contain a description of the activities proposed to be engaged in and the facilities and services to be employed, together with other pertinent information as the Board may require by regulation. The application shall also contain information regarding any complaints, enforcement actions, or sanctions against a license to operate a Center, or substantially similar facility, held by the applicant in another state.

B. Each license shall indicate the maximum number of children who may be cared for in the Center for which it is issued.

C. The license and any other documents required by the Commissioner shall be posted in a conspicuous place on the licensed premises.

D. Every person issued a license that has not been suspended or revoked shall renew such license prior to its expiration.

2025, c. 451.

Upon receipt of a completed application for initial licensure, the Commissioner shall cause an inspection to be made of the activities, services, and facilities of the applicant and of his character and reputation or, if the applicant is an association, partnership, limited liability company, or corporation, the character and reputation of its officers and agents, and upon receipt of the initial application, an investigation of the applicant's financial responsibility. The financial records of an applicant shall not be subject to inspection if the applicant submits an operating budget and at least one credit reference. The character and reputation investigation upon application shall include background checks pursuant to § 32.1-162.15:1.10 and include consideration of any complaints, enforcement actions, or sanctions against a license to operate a Center, or a substantially similar facility, held by the applicant in another state.

2025, c. 451.

A. Upon completion of the inspection pursuant to § 32.1-162.15:1.5, the Commissioner shall issue a license to the applicant if (i) the applicant has made adequate provision for such activities, services, and facilities as are reasonably conducive to the welfare of the children over whom he may have custody or control; (ii) at the time of initial application, the applicant has submitted an operating budget and at least one credit reference; (iii) he is, or the officers and agents of the applicant if it is an association, partnership, limited liability company, or corporation are, of good character and reputation; and (iv) the applicant and agents comply with the provisions of this article. Otherwise, the license shall be denied. Immediately upon taking final action, the Commissioner shall notify the applicant of such action.

B. When issuance of a license as a Center has been refused by the Commissioner, the applicant shall not apply again for such license for a period of one year unless the Commissioner in his sole discretion believes that there has been such a change in the conditions on account of which he refused the prior application as to justify considering the new application. If an applicant appeals a decision rendered pursuant to subsection A, the one-year period shall be extended until a final decision has been rendered on appeal.

C. Upon submission of a completed application for renewal of a license, the Commissioner may issue a provisional license to any applicant if the applicant is temporarily unable to comply with all of the licensure requirements. The provisional license may be renewed, but the issuance of a provisional license and any renewals thereof shall be for no longer than six successive months. A copy of the provisional license shall be prominently displayed by the provider at each public entrance of the Center. In addition, the Center shall be required to prominently display next to the posted provisional license a notice that a description of specific violations of licensing standards to be corrected and the deadline for completion of such corrections is available for inspection at the Center and on the Center's website, if applicable.

D. At the discretion of the Commissioner, a conditional license may be issued to an applicant to operate a new facility in order to permit the applicant to demonstrate compliance with licensure requirements. Such conditional license may be renewed, but the issuance of a conditional license and any renewals thereof shall be for no longer than six successive months. A copy of the conditional license shall be prominently displayed by the provider at each public entrance of the Center. In addition, the Center shall be required to prominently display next to the posted conditional license a notice that a description of specific violations of licensing standards to be corrected and the deadline for completion of such corrections is available for inspection at the Center and on the Center's website, if applicable.

2025, c. 451.

Buildings licensed as Centers shall be classified by and meet the specifications for the proper Use Group as required by the Uniform Statewide Building Code (§ 36-97 et seq.).

2025, c. 451.

A. Applicants for licensure and licensees shall at all times afford the Commissioner or his representatives reasonable opportunity to inspect all of their facilities, books, and records and to interview their agents and employees and any person participating in such Centers or under their custody, control, direction, or supervision. Interviews conducted pursuant to this section with persons participating in a Center operated by or under the custody, control, direction, or supervision of an applicant for licensure or a licensee shall be (i) authorized by the person to be interviewed or his legally authorized representative and (ii) limited to discussion of issues related to the applicant's or licensee's compliance with applicable laws and regulations, including ascertaining if assessments and reassessments of children's cognitive and physical needs are performed as may be required under regulations of the Board.

B. The Commissioner shall cause each licensed Center to be subject to an unannounced inspection periodically, but not less often than biennially, in accordance with the provisions of this article and regulations of the Board.

C. The activities, services, and facilities of each applicant for renewal of his license as a Center may be subject to an inspection or examination by the Commissioner to determine if he is in compliance with current regulations of the Board.

D. For any Center, the Commissioner may authorize such other announced or unannounced inspections as the Commissioner considers appropriate.

2025, c. 451.

Every Center shall keep such records and make such reports to the Commissioner as the Board may require by regulation. The forms to be used in the making of such reports shall be prescribed and furnished by the Commissioner.

2025, c. 451.

A. Upon application for licensure as a Center, (i) all applicants and (ii) all agents at the time of application who are or will be involved in the day-to-day operations of the Center or who are or will be alone with, in control of, or supervising one or more children shall undergo a background check pursuant to subsection B.

B. Background checks pursuant to subsection A require:

1. A sworn statement or affirmation disclosing whether the person has a criminal conviction or is the subject of any pending criminal charges within or outside the Commonwealth and whether or not the person has been the subject of a founded complaint of child abuse or neglect within or outside the Commonwealth;

2. A criminal history records check through the Central Criminal Records Exchange pursuant to § 19.2-389; and

3. A search of the central registry maintained pursuant to § 63.2-1515 for any founded complaint of child abuse and neglect.

C. Each person required to have a background check pursuant to subsection A shall submit the background check information required in subsection B to the Commissioner's representative prior to issuance of a license. The applicant shall provide an original criminal record clearance with respect to any barrier crime as defined in § 19.2-392.02 or an original criminal history record from the Central Criminal Records Exchange.

D. Any person making a materially false statement regarding the sworn statement or affirmation provided pursuant to subdivision B 1 is guilty of a Class 1 misdemeanor.

E. If any person specified in subsection A required to have a background check (i) has been convicted of any barrier crime as defined in § 19.2-392.02 or (ii) is the subject of a founded complaint of child abuse or neglect within or outside the Commonwealth, the Commissioner shall not issue a license. For the purposes of this section, convictions for any barrier crime as defined in § 19.2-392.02 shall include prior adult convictions and juvenile convictions or adjudications of delinquency based on a crime that would be a felony if committed by an adult within or outside the Commonwealth.

F. No person specified in subsection A shall be (i) involved in the day-to-day operations of a Center; (ii) alone with, in control of, or supervising one or more children receiving services from a Center; or (iii) permitted to work in a position that involves direct contact with a person receiving services without first having completed background checks pursuant to subsection B unless such person is directly supervised by another person for whom a background check has been completed in accordance with the requirements of this section.

G. If an applicant is denied licensure because of information from the central registry or convictions appearing on his criminal history record, the Commissioner shall provide a copy of the information obtained from the central registry or the Central Criminal Records Exchange or both to the applicant.

H. Further dissemination of the background check information is prohibited other than to the Commissioner's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.

2025, c. 451.

A. A Center shall be a nonresidential health care service that provides a link in the continuum of care for medically dependent or technologically dependent children.

B. A Center shall provide services that promote and maintain the health and development of the children attending the Center and that assist with the training of the children's parents. Such services shall include:

1. Skilled nursing;

2. Physical therapy;

3. Respiratory therapy;

4. Occupational therapy;

5. Speech therapy;

6. Education;

7. Provision of meals and snacks;

8. Transportation; and

9. Family education.

C. No Center shall provide services other than those typically provided to medically dependent or technologically dependent children.

D. A Center shall develop an individualized plan of care for each child that attends the Center. Such plan shall be developed by the child's attending physician, the Center, any Center staff responsible for the child's care, a parent, and, when appropriate, the child.

E. No child shall attend a Center for more than 12 hours within a 24-hour period.

2025, c. 451.

A. Each Center shall have an administrator who oversees the operation of the Center. Such administrator shall be a physician with a current license, an advanced practice registered nurse, a licensed nursing home administrator, a child day center director, or a registered nurse with at least five years of experience in pediatric medicine.

B. Operation of the Center shall include:

1. Coordination of emergency transportation arrangements with the emergency medical services of the locality where the Center is located, including the provision of an adult staff member of the Center who accompanies any child who requires emergency transportation;

2. Creation of a documented preventative maintenance program that emphasizes ensuring that all durable medical equipment functions correctly and safely;

3. Maintenance of medical records, data, and information related to the children and programs in the Center for inspection by the Commissioner;

4. Provision of appropriate and readily available emergency services that include (i) an emergency drug kit and (ii) a crash cart with a defibrillator appropriate for children;

5. Creation of a written disaster plan that addresses natural disasters, weather emergencies, bomb threats, emergency drills, manufactured disasters, and financial disasters;

6. Documentation of all incidents and accidents;

7. A process for reporting to the Commissioner any incidents and accidents that affect the health, safety, or welfare of a child; and

8. Coordination and collaboration with other agencies that may serve the child.

C. Each Center shall have a medical director who is responsible for basic and supportive services, including medical, pharmaceutical, and nursing services. The medical director shall be responsible for (i) the prevention, reporting, and investigation of abuse; (ii) the delivery of medical and therapeutic services; (iii) the control and delivery of pharmaceutical services; (iv) infection control; and (v) policies for prevention of incidents and accidents. The medical director shall ensure compliance with any policies and procedures developed by the Board.

D. Each Center shall employ:

1. A supervisor that holds a valid relevant professional license issued by the Board of Medicine, Board of Nursing, Board of Pharmacy, Board of Physical Therapy, or Board of Audiology and Speech-Language Pathology.

2. At least one direct care staff member who is qualified as a licensed advanced practice registered nurse, registered nurse, physical therapist, respiratory therapist, occupational therapist, or speech-language pathologist.

E. Each Center shall abide by the following applicable staffing ratio:

1. For a Center with fewer than 13 children, the Center shall be staffed by two registered nurses and two other staff members.

2. For a Center with no less than 13 and no more than 18 children, the Center shall be staffed by two registered nurses, one licensed practical nurse, and three other staff members.

3. For a Center with no less than 19 and no more than 24 children, the Center shall be staffed by two registered nurses, two licensed practical nurses, and four other staff members.

4. For a Center with more than 24 children, the number of licensed practical nurses and other staff members shall increase by one each for up to six additional children enrolled.

2025, c. 451.

A. The regulations promulgated by the Board to carry out the provisions of this article shall be in substantial conformity to the standards of health, hygiene, sanitation, construction, and safety as established and recognized by medical and health care professionals and by specialists in matters of public health and safety, including the regulations of the Board of Education for child day centers, and as deemed relevant to Centers by the Board.

B. The Board shall adopt regulations for facility standards that prioritize:

1. The adoption and implementation of policies and procedures that ensure the health and safety of children attending a Center;

2. Maintenance based upon the size of the facility and the number of children as related to plumbing, heating, lighting, ventilation, and other applicable building conditions;

3. Sanitary conditions, including the water supply, sewage disposal, food handling, and general hygiene; and

4. Any operational or transportation concerns specific to children attending a Center.

2025, c. 451.

Whenever the Department conducts inspections or investigations in response to complaints received from the public, the identity of the complainant and the identity of any child who is the subject of the complaint, or identified therein, shall be confidential and shall not be open to inspection by members of the public. Identities of the complainant and child who is the subject of the complaint shall be revealed only if a court order so requires. Nothing contained herein shall prevent the Department, in its discretion, from disclosing to the Center the nature of the complaint or the identity of the child who is the subject of the complaint. Nothing contained herein shall prevent the Department or its employees from making reports under Chapter 15 (§ 63.2-1501 et seq.) or Article 2 (§ 63.2-1603 et seq.) of Chapter 16 of Title 63.2. If the Department intends to rely, in whole or in part, on any statements made by the complainant at any administrative proceeding brought against the Center, the Department shall disclose the identity of the complainant to the Center a reasonable time in advance of such proceeding.

2025, c. 451.

No Center may retaliate or discriminate in any manner against any person who (i) in good faith complains or provides information to, or otherwise cooperates with, the Department or any other agency of government or any person or entity operating under contract with an agency of government having responsibility for protecting the rights of children in Centers; (ii) attempts to assert any right protected by state or federal law; or (iii) assists any person in asserting such right.

2025, c. 451.

No Center may retaliate in any manner against any person who in good faith reports adult or child abuse or neglect pursuant to Chapter 15 (§ 63.2-1501 et seq.) or Article 2 (§ 63.2-1603 et seq.) of Chapter 16 of Title 63.2.

2025, c. 451.

A. No Center may hire for compensated employment, continue to employ persons, or permit persons to serve as volunteers who (i) have been convicted of any barrier crime as defined in § 19.2-392.02 or (ii) are the subject of a founded complaint of child abuse or neglect within or outside the Commonwealth. All persons interested in volunteering at a Center and all applicants for employment at a Center shall undergo background checks pursuant to subsection B. For the purposes of this section, convictions for any barrier crime as defined in § 19.2-392.02 shall include prior adult convictions and juvenile convictions or adjudications of delinquency based on a crime that would be a felony if committed by an adult within or outside the Commonwealth.

B. Background checks pursuant to subsection A require:

1. A sworn statement or affirmation disclosing whether the person has a criminal conviction or is the subject of any pending criminal charges within or outside the Commonwealth and whether or not the person has been the subject of a founded complaint of child abuse or neglect within or outside the Commonwealth;

2. A criminal history records check through the Central Criminal Records Exchange pursuant to § 19.2-389; and

3. A search of the central registry maintained pursuant to § 63.2-1515 for any founded complaint of child abuse and neglect.

C. Any person making a materially false statement regarding the sworn statement or affirmation provided pursuant to subdivision B 1 is guilty of a Class 1 misdemeanor.

D. A Center shall obtain (i) an original criminal record clearance with respect to any barrier crime as defined in § 19.2-392.02 or an original criminal history record from the Central Criminal Records Exchange for any compensated employees within 30 days of employment and any volunteer within 30 days of commencement of volunteer service and (ii) a copy of the information from the central registry for any compensated employee within 30 days of employment. However, no employee or volunteer may be permitted to work in a position that involves direct contact with a child receiving services until an original criminal record clearance or original criminal history record has been received, unless such person works under the direct supervision of an employee for whom a background check has been completed in accordance with the requirements of this section. If an applicant is denied employment or if a volunteer is denied service because of information from the central registry or convictions appearing on his criminal history record, the Center shall provide a copy of the information obtained from the central registry or the Central Criminal Records Exchange or both to the applicant or volunteer.

E. Further dissemination of the background check information is prohibited other than to the Commissioner's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.

F. No person who complies in good faith with the provisions of this section shall be liable for any civil damages for any act or omission in the performance of duties under this section unless the act or omission was the result of gross negligence or willful misconduct.

2025, c. 451.

A. The Commissioner may revoke or deny renewal of the license of a Center if the Center has knowledge that a person specified in § 32.1-162.15:1.17 required to have a background check (i) has been convicted of any barrier crime as defined in § 19.2-392.02 or (ii) is the subject of a founded complaint of child abuse or neglect within or outside the Commonwealth, and the Center refuses to separate such person from employment or volunteer service.

B. Failure to obtain background checks pursuant to § 32.1-162.15:1.17 shall be grounds for denial, revocation, or termination of a license. No violation shall occur if the Center has applied for the background check timely and it has not been obtained due to administrative delay. The provisions of this section shall be enforced by the Department.

2025, c. 451.

Any person, and each officer and each member of the governing board of any association or corporation that operates a Center, is guilty of a Class 1 misdemeanor if he:

1. Interferes with any representative of the Commissioner in the discharge of his duties under this article;

2. Makes to the Commissioner or any representative of the Commissioner any report or statement, with respect to the operation of any Center, that is known by such person to be false;

3. Operates or engages in the conduct of a Center without first obtaining a license as required by this article or after such license has been revoked or suspended or has expired and not been renewed. No violation shall occur if the Center applied to the Department for renewal prior to the expiration date of the license. Each day's violation of this subdivision shall constitute a separate offense; or

4. Operates or engages in the conduct of a Center serving more persons than the maximum stipulated in the license.

2025, c. 451.

A. The Commissioner may impose disciplinary action (i) for violation of any of the provisions of this article or any regulation adopted under any provision of this article for which that violation adversely affects, or is an imminent and substantial threat to, the health, safety, or welfare of the person cared for therein or (ii) for permitting, aiding, or abetting the commission of any illegal act in a Center.

B. The disciplinary action that the Commissioner may impose includes:

1. Revoking or refusing to renew a license;

2. Suspending or refusing to reinstate a license;

3. Placing a licensee on probation upon finding that the licensee is substantially out of compliance with the terms of its license and that the health and safety of children are at risk;

4. Reducing licensed capacity or prohibiting new admissions or enrollments when the Commissioner concludes that the licensee cannot make necessary corrections to achieve compliance with regulations except by a temporary restriction of its scope of service;

5. Mandating training for the licensee or licensee's employees or volunteers, with any costs to be borne by the licensee, when the Commissioner concludes that the lack of such training has led directly to violations of regulations;

6. Assessing monetary penalties of not more than $1,000 per violation per day, not to exceed $100,000 for a series of related incidents of noncompliance, upon finding that the Center is substantially out of compliance with the terms of its license and the health and safety of children are at risk; however, no monetary penalty shall be imposed pursuant to this subdivision on any Center operated by an agency of the Commonwealth;

7. Requiring licensees to contact parents, guardians, or other responsible persons in writing regarding health and safety violations; and

8. Requiring submission of and compliance with plans of corrective action, with or without actions directed by the Commissioner.

C. Any monetary penalties collected under this section shall be paid in equal portions to the Physician Loan Repayment Program established in § 32.1-122.6:1, the Nurse Loan Repayment Program established in § 32.1-122.6:04, and the Nursing Scholarship and Loan Repayment Fund established in § 54.1-3011.2 after deduction of the administrative costs of the Commissioner and the Department in furtherance of this section.

D. Except as provided in § 32.1-162.15:1.21, the Commissioner shall take no action to impose disciplinary action against a Center that is not operated by an agency of the Commonwealth except after reasonable notice and an opportunity to be heard in no fewer than 30 days by the Commissioner's presiding officer in accordance with § 2.2-4019. Such disciplinary action may be in addition to any penalty imposed by law for the violation.

1. All requests for an opportunity to be heard following a notice of imposition of disciplinary action shall be received in writing within 15 days of the date of receipt of such notice.

2. All administrative proceedings under this section shall be separate from the regulatory office of the Department that conducted the inspection, investigation, examination, or review.

3. The presiding officer shall provide a recommendation to the Commissioner, including findings of fact, conclusions, and appropriate disciplinary action.

4. The Commissioner may affirm, modify, or reverse such recommendation and shall issue a final case decision.

E. Whenever the Commissioner refuses to issue a license or to renew a license or revokes a license for a Center other than a Center operated by an agency of the Commonwealth, the provisions of the Administrative Process Act (§ 2.2-4000 et seq.) shall apply.

F. Except as provided in § 32.1-162.15:1.22, the Commissioner shall take no action to impose disciplinary action against a Center operated by an agency of the Commonwealth except after reasonable notice and an opportunity to be heard in accordance with § 32.1-162.15:1.23.

G. An appeal, taken as provided in this section, shall operate to stay any criminal prosecution for operation without a license.

H. A monetary penalty that is not appealed becomes due on the first day after the appeal period expires. The license of a Center that has failed to pay a civil penalty due under this section shall not be renewed until the civil penalty has been paid in full, with interest, provided that the Commissioner may renew a license when an unpaid monetary penalty is the subject of a pending appeal.

I. If a license is revoked or refused renewal, a new license may be issued by the Commissioner after:

1. Satisfactory evidence is submitted to him that the conditions upon which the revocation or refusal was based have been corrected; and

2. Proper inspection has been made and compliance with all provisions of this article, regulations promulgated pursuant to this article, and applicable state and federal law and regulations hereunder has been obtained.

J. The Board shall promulgate regulations to implement the provisions of this section that include:

1. Criteria for when the imposition of disciplinary action or initiation of court proceedings as specified in § 32.1-27, or a combination thereof, are appropriate in order to ensure prompt correction of violations involving noncompliance with requirements of any order of the Board or Commissioner or any provision of or regulation promulgated pursuant to this article;

2. Criteria for the imposition of disciplinary action based upon the severity, pervasiveness, duration, and degree of risk to the health, safety, or welfare of children;

3. Provisions allowing the Commissioner (i) to accept a plan of correction, including a schedule of compliance, from a Center prior to assessing a monetary penalty pursuant to subdivision B 6 or (ii) to reduce or abate the monetary penalty amount if the Center complies with the plan of correction within its terms; and

4. Procedures for imposition of disciplinary action consistent with the Administrative Process Act (§ 2.2-4000 et seq.).

2025, c. 451.

A. Pursuant to the procedures set forth in this section and in addition to the authority for other disciplinary actions provided in this title, the Commissioner may issue a notice of summary suspension of the license of any Center in conjunction with any proceeding for revocation, denial, or other action when conditions or practices exist in the Center that pose an immediate and substantial threat to the health, safety, and welfare of the children receiving care and the Commissioner believes the operation of the Center should be suspended during the pendency of such proceeding.

B. A notice of summary suspension issued by the Commissioner to a Center shall set forth (i) the summary suspension procedures; (ii) hearing and appeal rights as provided in this section; (iii) facts and evidence that formed the basis for the summary suspension; and (iv) the time, date, and location of a hearing to determine whether the summary suspension is appropriate. Such notice shall be served on the Center or its designee as soon as practicable thereafter by personal service or certified mail, return receipt requested, to the address of record of the Center.

C. The summary suspension hearing shall be presided over by a hearing officer selected by the Commissioner from a list prepared by the Executive Secretary of the Supreme Court of Virginia and shall be held as soon as practicable, but in no event later than 15 business days following service of the notice of summary suspension; however, the hearing officer may grant a written request for a continuance, not to exceed an additional 10 business days, for good cause shown. Within 10 business days after such hearing, the hearing officer shall provide to the Commissioner written findings and conclusions, together with a recommendation as to whether the license should be summarily suspended.

D. Within 10 business days of the receipt of the hearing officer's findings, conclusions, and recommendation, the Commissioner may issue a final order of summary suspension or an order that such summary suspension is not warranted by the facts and circumstances presented. The Commissioner shall adopt the hearing officer's recommended decision unless to do so would be an error of law or Department policy. If the Commissioner rejects the hearing officer's findings, conclusions, or recommendation, the Commissioner shall state with particularity the basis for rejection. In issuing a final order of summary suspension, the Commissioner may choose to suspend the license of the Center or to suspend only certain authority of the Center to operate, including the authority to provide certain services or perform certain functions that the Commissioner determines should be restricted or modified in order to protect the health, safety, or welfare of the children receiving care. A final order of summary suspension shall include notice that the licensee may appeal the Commissioner's decision to the appropriate circuit court no later than 10 business days following service of the order. The sole issue before the court shall be whether the Commissioner had reasonable grounds to require the licensee to cease operations during the pendency of the concurrent revocation, denial, or other proceeding. The concurrent revocation, denial, or other proceeding shall not be affected by the outcome of any hearing on the appropriateness of the summary suspension.

E. A copy of any final order of summary suspension shall be prominently displayed by the Center at each public entrance of the facility, or in lieu thereof, the Center may display a written statement summarizing the terms of the order in a prominent location, printed in a clear and legible size and typeface, and identifying the location within the facility where the final order of summary suspension may be reviewed.

F. The provisions of this subsection shall not apply to any Center operated by an agency of the Commonwealth, which shall instead be governed by the provisions of § 32.1-162.15:1.22.

2025, c. 451.

Whenever the Commissioner issues a summary order of suspension of the license to operate a Center operated by an agency of the Commonwealth:

1. Before such summary order of suspension shall take effect, the Commissioner shall issue to the Center a notice of summary order of suspension setting forth (i) the procedures for a hearing and right of review as provided in this section and (ii) the facts and evidence that formed the basis on which the summary order of suspension is sought. Such notice shall be served on the licensee or its designee as soon as practicable thereafter by personal service or certified mail, return receipt requested, to the address of record of the licensee. The notice shall state the time, date, and location of a hearing to determine whether the suspension is appropriate. Such hearing shall be held no later than three business days after the issuance of the notice of the summary order of suspension and shall be convened by the Commissioner or his designee. After such hearing, the Commissioner may issue a final order of summary suspension or may find that such summary suspension is not warranted by the facts and circumstances presented.

2. A final order of summary suspension shall include notice that the licensee may request, in writing and within three business days after receiving the Commissioner's decision, that the Commissioner refer the matter to the Secretary of Health and Human Resources for resolution within three business days of the referral. Any determination by the Secretary shall be final and not subject to judicial review. If the final order of summary suspension is upheld, it shall take effect immediately, and a copy of the final order of summary suspension shall be prominently displayed by the licensee at each public entrance of the Center. Any concurrent revocation, denial, or other proceedings shall not be affected by the outcome of any determination by the Secretary.

2025, c. 451.

A Center operated by an agency of the Commonwealth shall have the right to appeal any notice of imposition of disciplinary action as follows:

1. Within 30 days after receiving a notice of imposition of disciplinary action, the licensee shall request in writing that the Commissioner review the intended disciplinary action and may submit, together with such request, relevant information, documentation, or other pertinent data supporting its appeal. The Commissioner shall issue a decision within 60 days after receiving the request and shall have the authority to uphold the disciplinary action or take whatever action he deems appropriate to resolve the controversy.

2. If the Center disputes the Commissioner's decision, the licensee shall request, within 30 days of receiving the Commissioner's decision, that the Commissioner refer the matter to the Secretary of Health and Human Resources. The Secretary shall issue a decision within 60 days of receiving the request for review. The Secretary's decision shall be final and shall not be subject to judicial review.

2025, c. 451.