VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Virginia Home for Boys and Girls
8716 West Broad Street
Henrico, VA 23294
(804) 270-6566

Current Inspector: Dawn Espelage (540) 759-8852

Inspection Date: Aug. 3, 2023 and Aug. 15, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-131 Organization and Administration 22VAC40-131 Personnel 22VAC40-131 Additional Requirements for Specific Programs 22VAC40-80 The License 22VAC40-191 Background Checks for Child Welfare Agencies

Technical Assistance:

Discussed the sworn statement in relation to CRF standard 22 VAC 40-151-240.B.7. Discussed initial objectives and strategies as noted in CRF standard 22 VAC 40-151-650. Discussed the information concerning current medications, need for continuing therapeutic interventions, educational status, and other items important to the resident's continuing care shall be provided to the legal guardian or legally authorized representative in relation to discharge as noted in CRF standard 22 VAC 40-151-680.E. Discussed the behavior support plan and who it shall be developed in consultation with as noted in CRF standard 22 VAC 40-151-800.B.

Comments:

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: 8/3/23 from 10:18 AM ? 5:10 AM, 8/4/23 from 9:51 AM ? 5:07 PM, and 8/7/23 from 9:15 AM ? 6:11 PM The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents in care 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?s records reviewed: 2 Number of staff records reviewed: 8 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 5 Additional Comments/Discussion: An entrance meeting was held on 8/3/23. The Director of Group Care Services and the Assistant Director of Group Care Services were accessible and available during the inspection. The following is a listing of the activities for this inspection: Reviewed two current resident records and two discharged resident records. Reviewed medication administration records. Eight staff records were reviewed. Five staff members and two residents were interviewed. An inspection of the interior and exterior of the facility was completed. Other documentation reviewed during this inspection included, but was not limited to the following: emergency drill documentation, menus, and staff work schedules. The Director of Group Care Services and the Group Home Manager were interviewed during the preliminary findings meeting held at the facility on 8/7/23. The exit meeting was held on 8/14/23 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 Michele Freeman, Licensing Inspector at (804) 662-7062 or by email at michele.freeman@dss.virginia.gov.

Violations:

Standard #:	22VAC40-151-640-A
Description:	Violation: Based upon review of the resident?s record, the facility failed to include in the resident?s record a completed face sheet. Findings: 1) Current resident, CR1, was admitted to the licensee?s facility on 7/13/23; the face sheet in the resident?s record was missing the following elements: the last known residence and the religious preference. 2) Staff, S10, acknowledged the findings.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-151-730-B
Description:	Violation: Based on review of the information readily accessible to staff for current residents, CR1 and CR2, and interview with staff, the facility failed to include the following elements in the event of an emergency. Findings: 1) 730.B.4.c ? Substance abuse and use was blank. 2) During the interview, staff, S10, confirmed the above-mentioned element is missing from CR1?s and CR2?s readily accessible information.
Plan of Correction:	Not available online. Contact Inspector for more information.