Candle Light Senior Manor

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: 12/4/2025 10:20 a.m.-12:00p.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: 3 Observations by licensing inspector: All required postings, physician's orders, medication administration records, emergency supplies, lunch meal Additional Comments/Discussion: Staff members were given the opportunity to ask questions. Inspection completed by 2 Licensing Inspectors. An exit meeting was 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 Belinda Dyson, Licensing Inspector at (804) 840-8313 or by email at Belinda.Dyson@dss.virginia.gov

Type of inspection: Complaint. Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 08/29/2029 10a.m.-11:00 a.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint/self-reported incident was received by VDSS Division of Licensing on regarding allegations in the area(s) PERSONNEL, STAFFING AND SUPERVISION, RESIDENT CARE AND RELATED SERVICES 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 residents interviewed: 4 Number of staff interviewed: 2: Additional Comments/Discussion/Observations: All residents were observed to be neat clean and well groomed. They did not express any concerns or complaints. Investigated by 2 Licensing Inspectors. All required postings. An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support the (allegation(s)/self-report) of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 Belinda Dyson, Licensing Inspector at (804) 840-8313 or by email at Belinda.Dyson@dss.virginia.gov

Type of inspection: Complaint. Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/25/2025 10:10 a.m.-11:30 a.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 4/18/2025 regarding allegations in the area(s) of: GENERAL PROVISIONS, ADMINISTRATION AND ADMINISTRATIVE SERVICES PERSONNEL, RESIDENT CARE AND RELATED SERVICES, RESIDENT ACCOMMODATIONS AND RELATED PROVISIONS, BUILDINGS AND GROUNDS Number of residents present at the facility at the beginning of the inspection: 4 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: NA Number of staff records reviewed: 3 Number of interviews conducted with residents: 3 Number of interviews conducted with staff: 2 Observations by licensing inspector: Medication Administration records, fire drills logs, pest control information, food supplies and emergency supplies for census, observation of residents Additional Comments/Discussion: Staff members were given the opportunity to ask questions. All required postings. Inspector was accompanied by Licensing Administrator. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the allegations of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 Belinda Dyson, Licensing Inspector at (804) 840-8313 or by email at Belinda.Dyson@dss.virginia.gov

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: 12/13/2024 10:30 a.m.-12:15 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: 2 Number of staff records reviewed: 2 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 3 Observations by licensing inspector: All required postings, physician's orders, medication administration records, medications, residents involved in activities, Additional Comments/Discussion: Staff members were given the opportunity to ask questions. 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 Belinda Dyson, Licensing Inspector at (804) 662-9780 or by email at Belinda.Dyson@dss.virginia.gov

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 9/30/2024, 10/1/2024,10:30 a.m.-12:00 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint/self-reported incident were received by VDSS Division of Licensing on 9/1/2024 a self reported incident and on 9/16/2024 a complaint regarding allegations in the area(s) of: Personnel, Resident Care and Related Services, Resident Accommodations and related Provisions, Building and Grounds. 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: NA Number of staff records reviewed: NA Number of interviews conducted with residents: 8 Number of interviews conducted with staff: 2 Observations by licensing inspector: Medication Administration Records, Physician's orders, food supplies, lunch meal, observation of residents hygiene, resident's personal allowance receipts. Additional Comments/Discussion: Staff members were given the opportunity to ask questions. Investigated by 2 Licensing Inspectors. The evidence gathered during the investigation did not support the (allegation(s)/self-report) of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 (name), Licensing Inspector at (804) 662-9780 or by email at Belinda.Dyson@dss.virginia.gov

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: 7/9/2024 10:30 a.m.-11:00 a.m. and 8/7/2024 10:00 a.m.-10:30 a.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self-reported incident was received by VDSS Division of Licensing on 7/1/2024 and subsequent APS report received 7/3/2024 regarding allegations in the area(s) of: staffing and supervision and resident care and related services. 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: 1 Number of staff records reviewed: NA Number of interviews conducted with residents: NA Number of interviews conducted with staff: 2 Observations by licensing inspector: Staff schedule, medication administration record for resident identified, other documentation re the resident Additional Comments/Discussion: Staff members were given the opportunity to ask questions. Accompanied by another Licensing Inspector An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support the (allegation(s)/self-report) of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 Belinda Dyson, Licensing Inspector at (804) 662-9780 or by email at Belinda.dyson@dss.virginia.gov

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 5/1/2024 9:15 a.m.-10:45 a.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 4/29/2024 regarding allegations in the area(s) of: RESIDENT CARE AND RELATED SERVICES RESIDENT ACCOMMODATIONS AND RELATED PROVISIONS BUILDINGS AND GROUNDS EMERGENCY PREPAREDNESS 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: NA Number of staff records reviewed: NA Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 2 Observations by licensing inspectors: Emergency supplies, new HAVAC system installed, menus and food supplies. Room sizes were measured at the time of the relocation to this new location and were within the required regulations. Additional Comments/Discussion: Administrator and staff were given the opportunity to ask questions. Accompanied by Licensing Inspector. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the allegations resident care and accommodations, resident accommodations, and related services, building and grounds, emergency preparedness of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 Belinda Dyson, Licensing Inspector at 804 662-9780 or by email at Belinda.Dyson@dss.virginia.gov

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: 3/18/2024 10:30-11:30a.m. 3/27/2024 The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A (complaint/self-reported incident) was received by VDSS Division of Licensing on 3/1/2024 regarding allegations in the area(s) of: General Provisions and Admissions, Retention and Discharge of Residents. Number of residents present at the facility at the beginning of the inspection: 9 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of residents interviewed: 1 Number of staff records reviewed: NA Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Additional Comments/Discussion: Administrator and staff members were given the opportunity to ask questions. Inspector was accompanied by Licensing Administrator and another Inspector An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the (allegation(s)/self-report) of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 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 Belinda Dyson, Licensing Inspector at (804) 662-9780 or by email at belinda.dyson@dss.virginia.gov