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Source: VA State Licensing Agency
Type of inspection: ?Renewal? Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 02/24/2026, 10:15 a.m. to 2:00 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 8 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 2 Number of staff records reviewed: 2 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 1 Observations by licensing inspector: Activities and lunch. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of these inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Refer to General Procedures and Information for Licensure, 22VAC40-80-260-B for information on requesting a problem solving conference. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jacquelyn Kabiri, Licensing Inspector at (703) 397-3017 or by email at Jacquelyn.Kabiri@dss.virginia.gov
Based on record review and interview, the facility failed to ensure a method of written communication was utilized as a means of keeping direct care staff on all shifts informed of significant happenings experienced by residents including incidents related to mental conditions. Evidence: 1. During the onsite inspection on 02/24/2026, the LI received a self-report indicating Resident 1 was sent to the hospital on 02/23/2026. 2. During the onsite inspection on 02/24/2026, review of the facility?s written communication shift log showed entries for 02/11/2026 and 02/12/2026 only for the month of February 2026, with no documentation for 02/23/2026 indicating Resident 1?s hospitalization. 3. Staff 1 confirmed the LI?s findings.
Based on observation and interview, the facility failed to ensure that doors leading to the outside were not locked from the inside or secured from the inside in any manner that amounts to a lock. 1. On 02/24/202, LI observed the front door was equipped with multiple locking mechanisms, including: a. One lock that secures into the top of the door frame. b. One lock that secures into the floor. c. One thumb turn lock. 2. Staff 2 confirmed that the lock securing into the top of the door frame on the front door was locked when the LI began the inspection. 3. Photo evidence taken.
Based on observation and interview, the facility failed to ensure that the interior and exterior were maintained in good repair and kept clean and free of rubbish. Evidence: 1. Upon arrival at the facility on 02/24/2026 at approximately 10:15 a.m., the Licensing Inspector (LI) exited the vehicle and stepped onto the paved walkway. The first gray pathway paver was broken and cracked, causing the paver to shift underfoot when stepped on, creating an uneven walking surface. 2.Upon entry to the facility on 02/24/2026, the LI observed the following: a. The main level hallway carpet appeared aged and worn. b. The carpeted stairs had small red spots, a worn area, and one torn section in the carpet. c. At 10:51 a.m., the LI observed Resident 4?s bedroom carpet with multiple brown circular stains and noted that a section of the wooden window blinds was broken. d. The LI observed Resident 5?s bedroom carpet with brown stains present. e. The carpeted area in close proximity to the basement door had dark circular areas that appeared stained. 3.Staff 1 acknowledged the LI?s findings. 4. Photo evidence taken.
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 12/09/2025, 9:30 a.m. to 12:15 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 11/25/2025 regarding allegations in the area(s) of: Resident Care and Related Services, Buildings and Grounds. Number of residents present at the facility at the beginning of the inspection: 7 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 1 Number of staff records reviewed: 3 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: Lunch and Activities Additional Comments/Discussion: N/A An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported some, but not all of the allegation(s); area(s) of non-compliance with standard(s) or law were: 870.H and 870.F. A violation notice was issued; any violation(s) not related to the complaint but identified during the course of the investigation can also be found on the violation notice. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5)business days of the exit interview. Compliance with all applicable regulations and law shall be maintained, and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jacquelyn Kabiri, Licensing Inspector at (703) 397-3017 or by email at Jacquelyn.Kabiri@dss.virginia.gov
Based on observation and staff interview, the facility failed to ensure that handrails were provided on all stairs and ramps. Evidence: 1. The Licensing Inspector (LI) observed that the facility did not have appropriate handrails on the exterior stairs and ramp leading to the front door of the facility. 2. Staff 1 acknowledged the LI?s findings. 3. Photo evidence taken.
Based on record review and staff interviews, the facility failed to utilize written communication to inform all shifts of significant happenings or problems experienced by residents, including complaints, incidents, or injuries related to physical or mental conditions. Evidence: 1. On 06/08/2025, the facility submitted an incident report documenting a medical issue, and the physician was notified. 2. There was no written communication for this time period to document the resident?s condition, interventions, or preventive measures. 3. On 09/06/2025, the facility self-reported that resident 1 experienced a fall in the bathroom, was found non-responsive, and 911 was called. 4. There were no written communication for this time period to document the resident?s condition, interventions, or preventive measures. 5.Resident 1 died in the hospital on 09/06/2025, and there were no written communication indicating the incident or discharge from the facility.
Based on observation and staff interview, the facility failed to have nonslip surfaces on ramps and stairways outside of the building. Evidence: 1. The ramp outside the entrance into the facility is missing a non-skid surface or strips. 2. Staff 1 acknowledged the LI?s findings 3. Photo evidence taken.
Based on facility incident report and record review, the facility failed to submit a written report of each incident specified in 22VAC40-73- 70-A to the regional licensing office within seven days from the date of the incident and shall be signed and dated by the administrator and include a description of the incident, the circumstances under which it happened, and, when applicable, extent of injury or damage. Evidence: 1. Staff 1 submitted an initial incident report on 09/07/25, stating that resident 1 was transported to the hospital for care. 2. On 12/09/2025, during an onsite inspection, resident 1?s record indicated the resident expired at the hospital on 09/06/2025. 3. Staff 1only submitted the initial incident report dated 09/08/2025, with no follow-up report submitted within seven days to disclose additional information regarding the incident and the resident's death.
Type of inspection: ?Monitoring? Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 03/20/2025, 09:30 a.m. through 3:00 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 7 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4, plus 1 partial review. Number of staff records reviewed: 2 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Lunch and card games Additional Comments/Discussion: none An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jacquelyn Kabiri, Licensing Inspector at (703) 397-3017 or by email at Jacquelyn.Kabiri@dss.virginia.gov
Based on observation and facility record review, the facility failed to ensure compliance with the facility?s own policies and procedures. Evidence: 1. During a tour of the facility on 03/20/2025, the licensing inspector (LI) observed a small electric icemaker in use in resident 1?s bedroom. 2. The facility?s policy states that residents may not have appliances in their bedrooms. 3. Staff 1 confirmed the LI?s findings during the inspection. 4. Photo evidence taken.
Based on staff interview and observation, the facility failed to implement their medication management plan, to include proper disposal of medication. Evidence: 1. During a medication cart audit on 03/20/2025, a box of liquid Lorazepam Intensol was noted in the refrigerated area; however, Resident 4 discharged from the facility on 03/15/2025. 2. Additionally, the facility?s medication management policy states, ?Medication disposal will occur when the following occurs: 4. Client for whom it was prescribed is discharged from the facility?. ?Disposal of controlled substances, schedule II-VI require Registered Nurse and a witness?. 3. Staff 1 and staff 2 confirmed the medication for resident 4 was not properly disposed of upon their discharge, per their medication management plan. 4. Photo evidence taken.
Based on observation, the facility failed to ensure that protective devices were on windows in common areas accessible to residents with serious cognitive impairments to prevent the windows from being opened wide enough for a resident to crawl through. Evidence: 1. LI observed a bathroom window on the main level, which faces the front yard, did not have a window stop to prevent the window from opening fully. 2. Photo evidence taken.
Based on observation, the facility failed to ensure that the interior was maintained in good repair and kept clean and free of rubbish. Evidence: 1. During the facility tour on 03/20/2025, the LI observed the following: a. A white trash bag was loacted in the corner of the dining room. b. The main level bathroom contained a white vanity cabinet with the veneer peeling off the top drawer. 2. At 10:00 a.m., the LI observed resident 4?s bathroom window with a cracked glass pane and a torn window screen. 3. LI observed resident 2?s bedroom carpet with multiple areas of stained and worn spots. 4. LI observed the hard wood floor area leading to the living room. The floor had one plank that was in disrepair and not flush with the other planks. 5. Staff 1 acknowledged the areas of the hardwood floors that were noted to be in need of repair. 6. Photo evidence taken.
Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: LI entered the facility at 8:45 am on 3/9/2023 and exited at 10:10 am on 3/9/2023. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 7 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4 Number of staff records reviewed: 3 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 0 Observations by licensing inspector: LI observed residents taking part in an activity. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined no violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website within five (5) business days of your receipt of the inspection summary. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Jamie Eddy, Licensing Inspector at (703) 479-5247 or by email at jamie.eddy@dss.virginia.gov
No deficiencies are reported in this inspection record.
The evidence gathered during the inspection determined no violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website should the facility be issued a license to operate. An unannounced monitoring inspection was conducted on 6/3/22. At the time of entrance 7 residents were in care. The sample size consisted of three resident records, and three staff records including a review of criminal background checks for new hires since the last mandated inspections. Additionally, residents were observed engaging in activities. Medication were reviewed, and no violations were issued today. Exit held with Administrator. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of a licensed facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Tammy Pruitt, Licensing Inspector at 703) 314-0604 or by email at tammy.pruitt@dss.virginia.gov
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