VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Clean Hands Pure Hearts Adult Day Center LLC
1421 Kempsville Road
Suite D
Chesapeake, VA 23320
(757) 819-6774

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: July 29, 2025

Complaint Related: No

Areas Reviewed:

22VAC40-61 GENERAL PROVISIONS 22VAC40-61 ADMINISTRATION 22VAC40-61 PERSONNEL 22VAC40-61 SUPERVISION 22VAC40-61 ADMISSION, RETENTION AND DISCHARGE 22VAC40-61 PROGRAMS AND SERVICES 22VAC40-61 BUILDINGS AND GROUND 22VAC40-61 EMERGENCY PREPAREDNESS 22VAC40-80 THE LICENSE 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

Technical Assistance:

Participant Plan of Care 22VAC40-61-230-D

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: An unannounced monitoring inspection took place on 07/29/2025 at 10:05 am to 11:20 am. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of participants 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 participant records reviewed: 2 Number of staff records reviewed: 2 Number of interviews conducted with participants: 2 Number of interviews conducted with staff: 1 Observations by licensing inspector: Participants were observed in the common area. Additional Comments/Discussion: None 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 Donesia Peoples, Licensing Inspector at 757-353-0430 or by email at donesia.peoples@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-220-D
Description:	Based on the record review the center failed to ensure the assessment shall include at minimum a description of the participant?s medical and functional condition, including health status to include diagnosis and medication, mental status, including any known psychiatric or emotional problems. Evidence: 1. The record for participant #1 contains a physical examination report dated 07/01/25 that documents a diagnosis of hyperthyroid, depression, and allergic rhinitis. Participant?s #1 assessment dated 07/15/25 did not include the resident?s diagnosis of hyperthyroid, depression, and allergic rhinitis.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-510-A
Description:	Based on the center?s fire inspection report review and staff interview the center failed to ensure the center comply with the Virginia Statewide Fire Prevention Code (13VAC5-51) as determined by at least an annual inspection by the appropriate fire official. Evidence: 1. The center?s most recent fire inspection report is dated as completed on 06/26/24. 2. Upon request, and during an interview on 07/29/2025 with staff #1, staff #1 confirmed the center has not had an annual fire inspection completed after 06/26/24 and an annual fire inspection has not been scheduled with the local fire official.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-520-A
Description:	Based on review of the center?s emergency preparedness and response plan and staff interview the center failed to ensure the center shall develop an emergency preparedness and response plan that shall address: Documentation of initial and annual contact with the local emergency coordinator to determine (i) local disaster risks, (ii) community wide plans to address different disasters and emergency situations, and (iii) assistance, if any, that the local emergency management office will provide to the center in an emergency. Evidence: 1. The center?s emergency and response plan did not include documentation of annual contact with the local emergency coordinator. 2. The center?s fire inspection report dated 06/26/24 documents the most recent review of the center?s emergency preparedness as 06/26/24. 3. Upon request, and during an interview on 07/29/2025 with staff #1, staff#1 was not able to provide documentation of annual contact with the local emergency coordinator.
Plan of Correction:	Not available online. Contact Inspector for more information.