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Source: VA State Licensing Agency
Type of inspection: Renewal Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/1/2026, 2:30 pm to 3:45 pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents 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: 1 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 1 Observations by licensing inspector: facility maintenance and repair, staff-resident interaction, snacks Comments: Request for increase in capacity An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards or law, and a violation was 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 will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Base on observation, the facility did not ensure that all furnishings, fixtures, and equipment, including furniture, window coverings, shall be kept clean and in good repair. Evidence: The window blind in the upstairs dining/sitting room had a broken slat. The heating/air conditioning vents had accumulated dirt/dust. There were two broken chairs on the floor in the upstairs dining/sitting room.
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 3/2/2026, 3:30 pm to 4:49 pm 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 2/24/2026 regarding allegations in the areas of: Staffing And Supervision and Resident Care And Accommodations 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: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: resident rooms/access to rooms, file documentation, staffing, resident/staff interaction, facility telephones and doorbell. Additional Comments/Discussion: A joint visit was made by the licensing inspector and licensing administrator with representatives of a local community partner. The facility has a ring camera system that allows the licensee/administrator to see, hear and speak to visitors. The facility's new telephone was working and updated on the VDSS public website in 2025. An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support non-compliance with standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Type of inspection: Complaint. Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Two complaint s were received by VDSS Division of Licensing on 12/2/25 regarding allegations in the areas of: Personnel, Staffing and Supervision, 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: 9 (one on vacation) 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 interviews conducted with staff: 1 Observations by licensing inspector: food supply, building cleanliness and repair, medication storage/administration records Additional Comments/Discussion: Building currently undergoing updating. Communicated with contractor on site. An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support the allegation of non-compliance with standards 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. Use the following last two statements on every Inspection Summary: For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 1/13/26, 2pm to 3:30 pm 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 1/7/26 regarding allegations in the areas of: Administration and Administrative Services; Personnel; Staffing and Supervision; Resident Care and Related Services; Resident Accommodations and Related Services; Building and Grounds 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 interviews conducted with residents: 1 Number of interviews conducted with staff: 1 Observations by licensing inspector: facility maintenance and cleanliness, staffing, telephones, access to upstairs and bedrooms, facility updates/remodeling Additional Comments/Discussion: Facility reported a change in facility contact telephone number, VDSS public website was updated to reflect the new telephone number in October 2025. An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support non-compliance with standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Type of inspection: 60 Day Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 1/13/26, 2p to 3p 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. Number of resident records reviewed: 2 Number of staff records reviewed: 1 Number of interviews conducted with staff: 1 Observations by licensing inspector: File documentation, medication storage and administration, facility cleanliness, food supply, renovations/updates to facility, equipment, staffing Additional Comments/Discussion: An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards or law, and violations 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 violations will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Based on documentation review, the facility did not ensure that at least once every six months, all staff currently on duty on each shift shall participate in an exercise in which the procedures for resident emergencies are practiced. Evidence: When asked, staff #1 stated that there was no documentation of emergency exercises available for review.
Based on a documentation review, the facility did not ensure that a fire and emergency evacuation drill shall be in accordance with the current edition of the Virginia Statewide Fire Prevention Code (13VAC5-51).and on each shift in a quarter. Evidence: Fire drills were not documented on each shift in a quarter, fire drills were documented as conducted at the same shift/time (5 p.m.) for the months of November 2025, December 2025 and January 2026.
Based on observation, the facility did not ensure that all furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers, shall be kept clean and in good repair and condition. Evidence: Two dressers in the front downstairs bedroom had broken and/or missing drawers.
Based on observation, the facility did not ensure that bedrooms shall contain a study chair for each resident and a bedside light accessible to each resident. Evidence: Two bedrooms on the lower floor had two residents and one chair. Two bedrooms, one on the upper floor and one on the lower floor, did not have a bed light that was accessible to each bed.
Based on documentation review, the facility did not ensure that for each resident assessed for residential living care a, licensed health care professional, practicing within the scope of his profession, shall perform an annual review of all the medications of the resident. Evidence: When requested, staff #1 stated that there was no annual medication review.
Type of inspection: Complaint. Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/27/2025, 3:00 pm to 4:30 pm The Acknowledgement of Inspection form was signed and emailed to the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 10/20/2025 regarding allegations in the areas of: Administration and Administrative Services, Personnel, Staffing and Supervision, 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: 1 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of interviews conducted with residents: 7 Number of interviews conducted with staff: 1 Observations by licensing inspector: facility cleanliness/odors, resident grooming, room temperatures, administrator/resident Additional Comments/Discussion: house rules, updating of service plans, bath/personal care logs, substance abuse An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support allegations of non-compliance with VDSS standards 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 Yvonne Randolph, Licensing Inspector, at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Type of inspection: Renewal Dates of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/9/25 2:30p to 4p, 10/21/25 10-10:30 am 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: 2 Number of interviews conducted with staff: 1 Observations by licensing inspector: medication administration records, file documentation, resident bedrooms, snacks, facility maintenance and repair Additional Comments/Discussion: the licensee is requesting an increase in capacity - three bedrooms were measured for compliance, Decision regarding the increase in capacity is pending approval. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards or law, and violations 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 violations will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Based on file reviews, the facility did not ensure that a risk assessment shall be completed annually on each resident as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it. Evidence: An annual tuberculosis screening was not found in the file of resident #1. When asked, staff # 1 was unable to find an annual risk assessment.
Based on file reviews, the facility did not ensure that a current picture of each resident shall be readily available for identification purposes. Evidence: The face on the pictures of resident #1 and #2 was blacked out and not identifiable
Based on a documentation review, the facility did not ensure that a fire and emergency evacuation drill shall be in accordance with the current edition of the Virginia Statewide Fire Prevention Code (13VAC5-51).and on each shift in a quarter. Evidence: When fire drills were requested, staff #1 stated that there was no fire drills available for review.
Based on file reviews, the facility did not ensure that each staff person or household member 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: An annual tuberculosis screening was not found in the file of staff #1. When asked, staff #1 stated that anannual screening had not been completed.
Based on documentation review, the facility did not ensure that for each resident assessed for residential living care a, licensed health care professional, practicing within the scope of his profession, shall perform an annual review of all the medications of the resident. Evidence: When requested, staff #1 stated that there was no annual medication review.
Based on observation, the facility did not ensure that all furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers, shall be kept clean and in good repair and condition. Evidence: Two dressers in the front downstairs bedroom had broken and/or missing drawers. (Photo taken)
Based on a documentation review, the facility did not ensure that, at least once every six months, all staff currently on duty on each shift shall participate in an exercise in which the procedures for resident emergencies are practiced. Evidence: When asked, staff #1 stated that there was no documentation of emergency exercises available for review.
Based on observation, the facility did not ensure that the interior of the building shall be maintained in good repair. Evidence: The front 1st floor bedroom had a discolored and stained floor and a vent cover missing.(Photos taken)
Based on observation, the facility did not ensure that bedrooms shall contain a study chair for each resident and a bedside light accessible to each resident. Evidence: Two bedrooms on the lower floor had two residents and one chair. Two bedrooms, one on the upperr floor and one on the lower floor, did not have a bed light that was accessible to each bed.
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/10/25, 5 pm to 6:30 pm 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 4/7/25 regarding allegations in the area of: Resident Care and Related Services and Administrative and Administration Services. 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: Resident files were not available for review. Number of staff records reviewed: Staff files were not available for review. Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 2 (licensee/administrator by telephone) Observations by licensing inspector: physical plant and medication administration records, dinner, meal preparations, postings Additional Comments/Discussion: A joint inspection was completed with a representative of local social services. The licensee/administrator was not on site An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation supported some, but not all of the allegations; areas of non-compliance with standards or law were: Resident Care and Related Services A violation notice was issued; any violations not related to the 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 violations will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 area s 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov
Based on observation, the facility did not ensure that the interior and exterior of all buildings shall be maintained in good repair and kept clean and free of rubbish. Evidence: One bedroom (1st floor at entrance) had a discolored floor and clothes in untidy piles scattered around the room. (Photo taken). A violation related to this standard was found and cited during a previous inspection on 1/28/25.
Based on a review of medication administration records and interviews, the facility did not ensure that each staff person who administers medication shall be authorized by ? 54.1-3408 of the Virginia Drug Control Act, i.e. be licensed by the Commonwealth of Virginia to administer medications or be registered with the Virginia Board of Nursing as a medication aide. Evidence: A review of medication administration records found that staff # 1 documented administering medications to nine residents on 4/9/25 and 4/10/25. Residents stated during interviews on 4/10/25 that staff # 1 administered their medications on 4/9/25 and 4/10/25. A n interview with staff # 2 and a review of the Virginia Board of Health Professions license lookup website confirmed that staff # 1 is not licensed by the Commonwealth of Virginia or registered as a medication aide with the Virginia Board of Nursing.
Based on documentation reviews, the facility did not ensure that at the time medication is administered, the facility shall document on a medication administration record ( MAR
Based on interviews, the facility did not ensure that all records shall be made available for inspection by the department?s representative. Evidence: Licensing staff requested resident records during an on-site inspection on 4/10/25. Staff # 1 informed licensing staff that the records were not available for review.
Based on observation, the facility did not ensure that all furnishings, fixtures and equipment shall be kept clean and in good repair and condition. Evidence: The closet in two of the 1st floor bedrooms was missing doors. The sofa in the upstairs common area had multiple fabric tears. There was a large opening in the wall of one 1st bedroom exposing pipes. (Photos taken)
Based on observation, the facility did not ensure freedom of movement for the residents to their personal space and that residents shall not be locked out of their rooms. Evidence: Resident # 1 stated during an interview that his bedroom is on the 2nd floor of the facility. During a inspection of the facility, it was observed that the door leading to the 2nd floor bedrooms was locked. Free access to the bedrooms is restricted as the key to the locked door is kept in the possession of the staff on duty.
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