Traway Assisted Living Home Aka Synergy Community Supports, LLC

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: 9/3/25, 9:40 am to 11 :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: 2 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: 2 Number of interviews conducted with staff: 2 Observations by licensing inspector: breakfast meal, signaling system, personal care, building maintenance and repair, staff/resident interactions Additional Comments/Discussion: Residents preparing to go to the "Y" for scheduled exercise and "tea time" activity. An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined no violations with applicable standards 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 Yvonne Randolph, Licensing Inspector at (804) 441-1180 or by email at yvonne.randolph@dss.virginia.gov

Type of inspection: Monitoring, Mandated Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/22/25, 12:15 pm to 2:00 pm Number of residents present at the facility at the beginning of the inspection: 3 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: 2 Observations by licensing inspector: file documentation, postings, staff/resident interaction, facility maintenance and cleanliness Additional Comments/Discussion: The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. 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

Type of inspection: Renewal Date the licensing inspector was on-site at the facility for each day of the inspection: 4/1/2024, 11a-1:30p The Acknowledgement of Inspection form was emailed 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: 1 (and 1 discharge) 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 maintenance and cleanliness, resident outing, staff/resident interactions, required postings An exit meeting was 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 Yvonne Randolph, Licensing Inspector at 804-662-7454 or by email at yvonne.randolph@dss.virginia.gov

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for the inspection: 10/27/2022 The Acknowledgement of Inspection form was signed and left at the facility for 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: 2 Number of staff records reviewed: 2 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 1 Additional Comments/Discussion: Monitoring inspection initiated on 10/27/2022 and concluded with a documentation review on 11/3/2022. 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 Yvonne Randolph, Licensing Inspector at (804) 662-7454 or by email at yvonne.randolph@dss.virginia.gov Violation Notice Issued: No A copy of this document will be sent to the licensee/provider for signature.

A renewal inspection was conducted at the facility on 4/18/2022. The facility's administrator was on-site for the inspection and reported two residents in care. Two residents were observed on-site. The inspector reviewed two (2) resident records, two (2) staff records, the menu, the activity calendar, required postings, physician orders, fire and health inspections, fire and emergency evacuation drills, inspected medication administration and storage and the building, etc. for compliance. The inspection determined no violations with applicable standards or law. No violations were issued.

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 renewal inspection was initiated on 4/20/2021 and concluded on 4/21/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that there were three residents in care. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed two (2) resident records, two (2) staff records, staff credentials, medication administration records, physician orders, fire inspection report, annual training, etc. submitted by the facility to determine compliance. 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.