S. 22nd St. Alf
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State Inspection History
State Inspections
Source: VA State Licensing Agency
Oct 14, 2025Routine11Report
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: 10/14/2025 9am - 3:30pm 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: 3 Number of staff records reviewed: 3 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 3 Observations by licensing inspector: Observed the residents participating in social hour and going on an outing. 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 Alexandra Roberts, Licensing Inspector at 804-845-6956 or by email at Alexandra.N.Roberts@dss.virginia.gov
Based on record review, the facility failed to ensure that at or prior to the time of admission, there shall be a written agreement or acknowledgment of notification dated and signed by the resident or applicant for admission or the appropriate legal representative and by the licensee or administrator. Evidence: 1. Resident 1, admitted on 07/25/2025, the resident agreement was completed on 07/28/2025. 2. Staff 1 and Staff 2 confirmed that the resident agreement was completed after Resident 1?s admission date. 3. This was previously cited during the 09/04/2024 inspection.
Based on record review and staff interview, the facility failed to ensure that the licensee, administrator, or his designee who has successfully completed the department-approved individualized service plan ( ISP
Based on record review and interview, the facility failed to ensure that the individualized service plan shall be signed and dated by the licensee, administrator, or his designee, (i.e., the person who has developed the plan), and by the resident or his legal representative. Evidence: 1. Resident 2?s ISP
Based on record review and interview, the facility failed to ensure that the MAR
Based on observation and interview, the facility failed to ensure that operable windows shall be effectively screened. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed the following: - One second floor window on the left side of the facility did not have a screen on the window. - One first floor window on the left side of the facility did not have a screen and the screen was laying against the facility. - One second floor window of the facility did not have a screen. The screen was in the back patio area laying against the facility. 2. Staff 1 and Staff 2 acknowledged the screens were not on the windows.
Based on observation and interview, the facility failed to store cleaning supplies and other hazardous materials in a locked area. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed unsecured Clorox bleach, Clorox wipes, Draino, Lysol spray in the kitchen, unsecured supply closet, first floor common bathroom, unsecured laundry room and in resident 1?s bathroom. 2. Staff 2 acknowledged the items being stored in a locked area.
Based on observation, the facility failed to ensure that all furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers, be kept clean and in good repair and condition. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed first floor HVAC vent to be covered in thick brown dust. 2. During facility tour on 1014/2025, licensing staff observed Resident 1?s bathroom toilet seat not attached to the toilet.
Based on observation, the facility failed to ensure that all furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers, be kept clean and in good repair and condition. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed first floor HVAC vent to be covered in thick brown dust. 2. During facility tour on 1014/2025, licensing staff observed Resident 1?s bathroom toilet seat not attached to the toilet.
Based on observation and interview, the facility failed to ensure that all inside and outside steps, stairways, and ramps shall have nonslip surfaces. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed the stairway to go to the second floor did not have non-slip surface. 2. During facility tour on 10/14/2025, licensing staff observed the stairway to go to the third floor did not have non-slip surface. 3. Staff 1 and Staff 2 confirmed that the steps did not have a non-slip surface.
Based on observation and interview, the facility failed to ensure that handrails are inside of stall showers. Evidence: 1. During facility tour on 10/14/2025, licensing staff observed that Resident 1?s shower stall did not have handrails inside of the shower. 2. Staff 1 and Staff 2 confirmed that the shower does not have handrails.
Based on record review and interview, the facility failed to ensure that the rights and responsibilities of residents are provided and fully informed prior to or at time of admission. Evidence: 1. Resident 1, admitted 07/25/2025, the rights and responsibilities of residents of assisted living facilities were dated to be provided on 07/28/2025. 2. Staff 1 confirmed that the rights and responsibilities of residents of assisted living facilities were dated to be provided on 07/28/2025 after 07/25/2025 admission date.
Jan 29, 2025Routine
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: 01/29/2026 2:00pm ? 2:45pm 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: 1 Number of staff records reviewed: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 3 Observations by licensing inspector: Observed residents engaging with one another and staff in common area. Additional Comments/Discussion: N/A 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 Alexandra Roberts, Licensing Inspector at (804) 845-6956 or by email at Alexandra.n.roberts@dss.virginia.gov
Violation cited
Sep 3, 2024Routine
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: 09/03/2024 9:00am - 4;30pm 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: 3 Number of staff records reviewed: 3 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Observed residents leaving to go to activity centers and eating 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. 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 Alexandra Roberts, Licensing Inspector at 804-845-6956 or by email at Alexandra.N.Roberts@dss.virginia.gov
Based on record review and staff interview, the facility failed to ensure that the infection prevention policies and procedures were reviewed annually for any updates. Evidence: 1. LI reviewed infection control and prevention policy. Policy was created 01/01/1985 per document footer. LI requested documentation of annual review. 2. During interview on 09/03/2024, staff 4 confirmed the facility had not completed an annual review of the infection prevention policies and procedures.
Based on record review and staff interview, the facility failed to ensure that written acknowledgement of the receipt of the disclosure by the resident or his legal representative shall be retained in the resident?s record. Evidence: 1. The records for residents 1,2, and 3 did not contain a written acknowledgement of the receipt of facility?s disclosure document. 2. During interview on 09/03/2024, staff 4 confirmed the resident records did not have written acknowledgement of the facility?s disclosure statement.
Based on record review and staff interview, the facility failed to ensure that each staff person required to be evaluated shall annually submit the results of a risk assessment, documenting that the individual is free of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it. Evidence: 1. The record for staff 1, hired on 07/17/2023, contained a most recent tuberculosis risk assessment form dated 01/27/2023. 2. During interview on 09/03/2024, Staff 4 confirmed there has not been an annual TB completed for staff 1 since 01/27/2023. 3. LI obtained photo evidence.
Based on record review and interview, facility failed to ensure that each resident or his legal representative is fully informed, prior to or at the time of admission and annually, that he should exercise whatever due diligence he deems necessary with respect to information on any sex offenders registered pursuant to Chapter 9 (? 9.1-900 et. seq.) of Title 9.1 of the Code of Virginia, including how to obtain such information with written acknowledgement maintained in the resident record. Evidence: 1. Resident 1,2 and 3 records did not contain documentation of annual sex offender registry review. 2. Staff 4 confirmed the facility did not have documentation of annual review.
Based on record review, the facility failed to ensure that at or prior to the time of admission, there shall be a written agreement or acknowledgment of notification dated and signed by the resident or applicant for admission or the appropriate legal representative and by the licensee or administrator. Evidence: 1. Resident 1, admitted 4/18/2024, resident agreement was completed 5/8/2024. 2. Resident 2, admitted 2/29/2024, resident agreement was completed 3/13/2024. 3. Staff 4 confirmed the written agreements for residents 1 and 2 were not completed at or prior to the time of admission. 4. LI obtained photo evidence.
Based on record review and staff interview, the facility failed to ensure that the licensee, administrator, or his designee who has successfully completed the department-approved individualized service plan ( ISP
Based on observation and record review, the facility failed to ensure that the Rights and Responsibilities of Residents of Assisted Living Facilities is posted in a conspicuous place with the name and telephone number of the appropriate regional licensing supervisor of the department, the Adult Protective Services' toll-free telephone number, the toll-free telephone number of the Virginia Long-Term Care Ombudsman Program and any substate(i.e., local) ombudsman program serving the area, and the toll-free telephone number of the disability Law Center of Virginia. Evidence: 1. During inspection on 09/03/2024, the LI observed the Rights and Responsibilities of Residents of Assisted Living Facilities posted in dining room with outdated contact names and phone numbers for required contacts. 2. Staff 4 confirmed that the posting was out of date and needed to be updated with correct information. LI provided correct information. 3. LI obtained photo evidence.
Based on record review and staff interview, the facility failed to develop written emergency procedures to address: Locating and shutting off utilities when necessary and building, site maps necessary to shut off utilities when necessary, and emergency call lists. Evidence: 1. During inspection on 09/03/2024, the LI reviewed the emergency preparedness plan, it did not contain information regarding locating and shutting off utilities, include a site map to indicate where to shut off utilities, or include emergency call lists. 2. During interview on 09/03/2024, staff 4 confirmed the emergency procedures did not address all the required elements. 3. LI obtained photo evidence.
Nov 27, 2023RoutineCleanReport
Date of Inspection: November 27, 2023 Type of Inspection: Renewal Inspection If you have any questions or email changes, please do not hesitate to contact me at laura.lunceford@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection or regulation, you can find the information on the internet: www.dss.virginia.gov. Census 4 Number of records reviewed and interviews conducted- 4 records (residents and staff), 2 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The Licensing Inspector reviewed the following at the time of inspection: healthcare oversight, Individualized service plans and dietician report.
May 26, 2023RoutineCleanReport
Licensing Inspector (LI) conducted an announced initial inspection on 5/26/2023 due to change in ownership. LI reviewed and verified window and room measurements and reviewed policies and procedures. The updated Fire Inspection has been submitted and reviewed. A qualified Administrator has been assigned to the facility. No violations cited today and exit interview held. Thank you for your cooperation and if you have any questions please call 703-479-4708 or contact me via e-mail at lynette.storr@dss.virginia.gov. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lynette Storr, Licensing Inspector at (703) 479-4708 or by email at lynette.storr@dss.virginia.gov
May 26, 2023RoutineCleanReport
Licensing Inspector (LI) conducted an announced initial inspection on 5/26/2023 due to change in ownership. LI reviewed and verified window and room measurements and reviewed policies and procedures. The updated Fire Inspection has been submitted and reviewed. A qualified Administrator has been assigned to the facility. No violations cited today and exit interview held. Thank you for your cooperation and if you have any questions please call 703-479-4708 or contact me via e-mail at lynette.storr@dss.virginia.gov. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lynette Storr, Licensing Inspector at (703) 479-4708 or by email at lynette.storr@dss.virginia.gov
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