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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: 5/15/2025 at 9:30am-11:15am 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: 10 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: 2 Observations by licensing inspector: Facility postings and facility documentation were observed. Additional Comments/Discussion: n/a 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 Tyia Venable, Licensing Inspector at (804) 393-2157 or by email at tyia.venable2@dss.virginia.gov
Based on a review of facility documentation, the facility failed to implement a semi-annual review on the emergency preparedness and response plan for all staff and residents. Evidence: Facility documentation noted the last review of the emergency prepardness and response plan was 7/18/2024. When asked staff 3 stated the semi-annual review was not completed.
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: On 01/24/2024 approximate time 11:51a.m- 2:07p.m. On 02/01/2024 approximate time of 11:17-11:52p.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: 4 Number of staff records reviewed:3 Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 2 Observations by licensing inspector: Medication administration observation conducted on 02/01/2024. 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 Angela Rodgers-Reaves Licensing Inspector at (804) 840-0253 or by email at Angela.r.reaves@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: 06/29/2023 Approximate time 11:30a.m-12:58p.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: 9 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Yes Number of resident records reviewed: 4 Number of staff records reviewed: 4 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 2 Observations by licensing inspector: Technical assistance offered. 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. 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 Angela Rodgers-Reaves, Licensing Inspector at (804) 840-0253 or by email at angela.r.reaves@dss.virginia.gov
Based on the review of facility records and interview with the facility Administrator the facility failed to ensure that the emergency preparedness plan was reviewed annually, document the review by signing and dating the plan, and make necessary plan revisions. Such revisions shall be communicated to staff, residents, and volunteers and incorporated into the orientation and semi-annual review for staff, residents, and volunteers. Evidence: Upon request the facility did not submit for the inspector?s review documented evidence that an annual review of the facility?s emergency preparedness plan is being conducted.
Based on the review of facility records and interview with the facility Administrator the facility failed to ensure that in a facility licensed only for residential living care, all direct care staff must attend at least 14 hours of training annually. Evidence: Facility staff #1-Documented date of hire 05/08/2017 Facility staff training records reviewed with the facility Administrator only documented six hours of annual training.
A renewal inspection was initiated on 08/04/2021 and concluded on 09/08/2021. The facility Administrator was contacted by telephone to initiate the inspection. The facility Administrator reported that the current census was thirteen (13). The inspector emailed the facility Administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed 2 resident records, 2 staff records, staff schedules, physician's orders, Medication Administration Records ( MAR
Based on the review of facility policy, interviews conducted with the facility staff and the Administrator and observation the licensee failed to ensure compliance with all regulations for licensed assisted living facilities and terms of the license issued by the department; with relevant federal, state, and local laws; with other relevant regulations; and with the facility's own policies and procedures. Evidence: Upon request to review the facility?s COVID-19 policy for screening visitors the facility Administrator submitted on 08/31/2021 via email a document titled ?Policy and Procedures for Covid-19 monitoring For the safety of Residents, Staff and Visitors ?Visitors Log?. The document in part also notes ?Staffs are required to ask the following information- Screening questionnaire? Upon arrival to the facility on 09/02/2021 to initiate the onsite renewal inspection and after the inspector conducted the DOLP COVID-19 screening questions with facility staff #1, facility staff #1 twice extended an invitation to the inspector to enter the facility without conducting the facility?s required COVID-19 Screening Questionnaire. The inspector reviewed the required COVID-19 protocol with facility staff #s 1and 2 and declined the invitation to enter the facility and terminated that portion of the inspection.
This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A monitoring inspection was initiated on 04/24/2021 and concluded on 05/18/2021. The licensing inspector emailed the administrator a list of documentation required to complete the inspection. The evidence gathered during the inspection determined compliance with applicable standards or laws. The facility Administrator reported that the current census was 13. The inspector reviewed two resident records, two staff records, and other facility documentation such as staff schedules, annual review of residents? rights, pharmacy review, medication administration records, facility policy etc. submitted by the facility to ensure documentation was complete. A virtual tour of the physical plant was conducted on 05/13/2021. Technical assistance was offered to the Administrator regarding the physical plant and the resident?s outdoor sitting areas. If you have any questions please feel free to contact me at (804) 662-9774 or by e-mail at Angela.r.reaves@dss.virginia.gov
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