One on One Family and Friends, LLC

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: 8/21/2025 10:00 a.m.-11:15 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 8/15/2025 regarding allegations in the area(s)of STAFFING AND SUPERVISION, ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS, 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: All residents were attending day support program during the inspection. 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: 1 Observations by licensing inspector: Resident's bedroom particularly windows and clothing, entire facility, Recent exterminator's report , correspondence between facility staff and VA case manager. Additional Comments/Discussion: Staff member was given the opportunity to ask questions. Review of the identified resident's uniform assessment instrument, individualized service plan and communication log notes. 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 (name), Licensing Inspector at (xxx) xxx-xxxx or by email at name@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: 7/15/2025 10:30 a.m-12:20 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: 1 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: none Number of interviews conducted with staff: 1 Observations by licensing inspector: All required postings. Physician's orders, medication administration records, Liability insurance declaration, Additional Comments/Discussion: Staff member was given the opportunity to ask questions. 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: 6/24/2025 10:15 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/self-reported incident) was received by VDSS Division of Licensing on (date) regarding allegations in the area(s) of: Number of residents present at the facility at the beginning of the inspection: 1 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: 1 Observations by licensing inspector: Additional Comments/Discussion: 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: Monitoring. Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/29/2025 10:00 a.m.-11:15 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 4/20/2025 regarding allegations in the area(s) of: GENERAL PROVISIONS, ADMINISTRATION AND ADMINISTRATIVE SERVICES, PERSONNEL, STAFFING AND SUPERVISION Number of residents present at the facility at the beginning of the inspection: All were attending day support programs 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: 1 Number of interviews conducted with residents: NA Number of interviews conducted with staff: 1 Observations by licensing inspector: Documentation reviewed on information reported to law enforcement, Board of Health Professionals and to APS by the facility. Additional Comments/Discussion: Staff member was given the opportunity to ask questions 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) 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: 7/9/2024 attempted inspection and 7/15/2024 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: 2 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 6 Number of staff records reviewed: 2 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: All required postings, physician's orders, medication administration records. 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 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 Belinda Dyson, Licensing Inspector at (804) 662-9780or by email 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: 4/22/2024 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: none, all were attending day support programs The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 3 Number of staff records reviewed: 2 Number of interviews conducted with residents: none Number of interviews conducted with staff: 1 Observations by licensing inspector: All required postings, physician's orders , medication administration records, medications Additional Comments/Discussion: Staff member was given the opportunity to ask questions 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 Belinda Dyson , Licensing Inspector at (804) 662-9780 or by email at Belinda.dyson@dss.virginia.gov

Type of inspection: Initial Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 01/22/2024 11:15 am-1:30 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: NA 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: NA Number of interviews conducted with staff: 2 Observations by licensing inspector: Measurements were taken for requested capacity Additional Comments/Discussion: Administrator was given an opportunity to ask questions. 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 should the facility be issued a license to operate. 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 Belinda Dyson, Licensing Inspector at (804) 662-9780 or by email at belinda.dyson@dss.virginia.gov