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Source: VA State Licensing Agency
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/9/25, 4:15 pm to 4:50 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 9/29/25 regarding allegations in the area of: Resident Care and Related Services Number of residents present at the facility at the beginning of the inspection: 0 Number of resident records reviewed: 0 Number of staff records reviewed: 0 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 2 by telephone Observations by licensing inspector: resident personal care/grooming and staffing and supervision Additional Comments/Discussion: Arrived at the facility at 4:15 pm and could not gain access to the facility. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the allegation of non-compliance with standards or law, and violations were issued. Any violation not related to the complaint 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 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 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 at least one direct care staff member shall be awake and on duty at all times in each building when at least one resident is present. Evidence: On 10/14/25 the licensing inspector arrived at the facility at approximately 4:15 pm to find the lights off and the facility locked. There was no response to knocks at the door or to the door bell. After approximately 15 minutes, multiple residents were observed exiting a van and returning to the facility. There was no response to the residents? knocks or doorbell rings. A female appeared at the door after approximately five minutes who stood at the door but would not open it. After about 2 minutes, the female opened the door; the licensing inspector displayed her badge, identified herself, and asked for the staff on duty. The female, who did not identify herself, responded that staff # 1 ?left for the day? and that staff # 2 ?will not be in until 6:30 pm?. The female was later identified by staff # 1 as the wife of staff # 2 and as not a staff member. Staff # 1 called the licensing inspector at 5:03 pm to confirm that he and staff # 2 were now on site at the facility. There was no evidence to support that direct care staff was awake and on duty from approximately 4:40 pm to 5:00 pm when multiple residents were in the building.
Based on observation, the facility did not ensure that personal assistance and care are provided to each resident as necessary so that the needs of the resident are met, including assistance with bathing, grooming and personal hygiene. Evidence: Resident personal appearance and grooming was observed to be disheveled (lacking attention) on 10/14/25 i.e. not shaved, soiled and ill-fitting clothing. A bath schedule/log was requested on 10/16/25 and 10/18/25, The bath log submitted by email on 10/20/25 failed to document any assistance with baths as it was blank.
Type of inspection: Mandated Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10:15 am to 12:20 pm 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: 14 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 staff: 1 Observations by licensing inspector: bedrooms, required posting, medication storage, facility cleanliness, file documentation 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. 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) 441-1180or by email at yvonne.randolph@dss.virginia.gov
Based on observation, the facility did not ensure that there shall be not less than 450 cubic feet of air space per resident and not less than 60 square feet of floor area in bedrooms accommodating two or more persons. Evidence:
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 9/25/25 10:00am to 10:30 am 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 9/19/25 regarding allegations in the area of: Staffing and Supervision Number of residents present at the facility at the beginning of the inspection: 14 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: 2 Observations by licensing inspector: file documentation, incident reporting Additional Comments/Discussion: Resident became lost and confused attending church. The UAI
Based on documentation review, the facility did not ensure that the facility shall report to the regional licensing office within 24 hours any major incident that has negatively affected or that threatens the life, health, safety, or welfare of any resident. Evidence: A report was received on 9/19/25 from a local agency that resident #1 was transported to a local hospital after being found confused and wandering in Petersburg VA. The resident was hospitalized for several days. A report of the incident was not received by the regional licensing office as of 9/25/25.
Type of inspection: Mandated Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 11/5/24 11:20 a to 12:30 p 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: 18 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: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: File documentation, postings, building maintenance and cleanliness, medication storage and administration 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 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 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.
Based on file reviews, the facility did not ensure that all direct care staff shall attend at least 18 hours of training annually. Evidence: Staff # 1 and # 2 had no documented annual training.
Based on file reviews, the facility did not ensure that each staff person shall annually submit the results of a risk assessment, documenting that the individual is free of tuberculosis in a communicable form. Evidence: The files for staff # 1 and # 2 did not have documentation of an annual risk assessment. The last documented tuberculosis screening for staff # 1 was dated 1/25/23 and for staff # 2 was 8/23.
Based on file reviews, the facility did not 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: The individualized service plan for residents # 1 and # 2 had no signatures.
Based on observation, The facility did not ensure that each bedroom has a sturdy chair and a table of operable bedside light accessible to each resident. Evidence: One male bedroom on the 1st floor contained four beds. A bedside table. lamp and chair was not accessible to each bed.
Type of inspection: Renewal Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 5/20/24, 2:15pm to 3:45pm 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: 14 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: 3 Number of interviews conducted with residents: 3 Number of interviews conducted with staff: 2 Observations by licensing inspector: medication storage and administration, resident/staff interactions, file documentation, upgrades to facility (flooring, bathrooms, bedrooms, ramp, bedding, etc) 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 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 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 Yvonne Randolph, Licensing Inspector at (804) 662-7454 or by email at yvonne.randolph@dss.virginia.gov
Based on file reviews, the individualized service plan for five residents was not signed and dated by the licensee, administrator, or his designee and by the resident or his legal representative. Evidence: The current individualized service plan for residents # 1, 2, 3, 4, 5 did not contain the signature of the licensee, administrator, or his designee or the resident or his legal representative,
Type of inspection: Monitoring Date of inspection the licensing inspector was on-site at the facility for each day of the inspection: 10/2/23 9:30 to 11:00 am The Acknowledgement of Inspection form was left at the facility for the date of the inspection. Number of residents present at the facility at the beginning of 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: 0 Number of interviews conducted with residents:0 Number of interviews conducted with staff: 3 Observations by licensing inspector: Licensing staff observed during tour updates to facility - new floors, ramp, furnishings, painting, kitchen upgrade, etc 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 Yvonne Randolph, Licensing Inspector at (x804) 662-7454 or by email at name@dss.virginia.gov
Based on a incident reported on a local news channel, the facility failed to report to the regional licensing office within 24 hours a major incident that negatively affected the life, health, safety or welfare or a resident. Evidence: 1. Facility communication notes document that the resident # 1 was last seen at the facility on 9/29./23. 2. A local news channel reported a missing resident at the facility on 9/30/2023. 3. The incident was reported to the regional licensing staff on 10/2/23 during an inspection.
Type of inspection: Renewal File # 718306 Date of inspection and time the licensing inspector was on-site at the facility for the inspection: 7/5/22 10am-12 noon The Acknowledgement of Inspection form was signed and left at the facility on the 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: 4 Number of staff records reviewed: 4 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: physical plant, medication storage and administration, postings, emergency food supply Additional Comments/Discussion: The facility recently added a handicap ramp, modified physical plant (bathrooms and bedrooms) to accommodate new residents in care discharged from a facility that closed. An exit meeting was conducted to review the inspection findings on 7/5/2022. 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 was given an 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. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected.
Based on a review of two resident files, a current picture was not maintained in two resident files. Evidence: The files for residents # 1 and # 2 did not contain a current picture of the resident.
Based on a review of two resident files, one resident assessed at for assisted living care did not have a written fall risk rating completed at the time of completion of the comprehensive individualized service plan ( ISP
Based on an inspection of medication administration, schedule II drugs and other drugs subject to abuse are not kept under a double lock (a locked storage compartment within a locked cart or cabinet). Evidence: All medications were stored together. Schedule II drugs and other drugs subject to abuse were not stored in a separate locked storage cabinet or container. Note: The licensee had a locked container on site, corrected during inspection.
A renewal inspection was initiated on 7/7/2021) and concluded on 7/9/2021. The facility's manager was contacted by telephone to initiate the inspection. The manager reported that that the current census was 10 residents. The inspector emailed the manager a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed two (2) resident records, two (2) staff records, activities calendar, heath care oversight, medication administration records and physician orders, fire and health inspection reports, etc. submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 7/9/2021,. During the on-site, the inspector interviewed a resident, completed a medication cart review, reviewed postings, inspected the building. An exit interview was conducted with facility's Office Manager and staff person in charge on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and violations were documented on the violation notice issued to the facility.
Based on an inspection of the building on 7/9/2021, the exterior and interior of the building is not being kept in good repair. Evidence: 1.The ceiling in the living room was found with water stains. 2.The door to the medication storage area was stained. 3. The treads(non-slip) on the front stairs leading to the 2nd floor were worn and tattered, the stairs were discolored. 4. The linoleum in the front hallway was worn with stains and marks. 5. The ceiling in the front hallway had water stains, one portion had been repaired but not painted. * Pictures taken*
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