VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Oakland Manor LLC 2
1836 Matoax Avenue
Petersburg, VA 23805
(804) 451-0693

Current Inspector: Belinda Dyson (804) 662-9780

Inspection Date: Oct. 9, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS

Comments:

An unannounced monitoring inspection was completed today by 2 Licensing Inspectors and 1 Home Office staff member from 11:15 a.m.-2:00 p.m. The facility is licensed as Residential living level of care only with a capacity for 7 residents. There are 6 residents in care at this time and 2 residents were on the premises during the inspection, the other residents were attending day support programs. 3 staff members were on duty. Administrator was present during the inspection. A sample size of 4 resident's records and 3 staff records were reviewed for compliance. A tour of the physical plant was completed. The facility uses an electronic system for medication administration. Physician's orders, medications and the MARs were observed. First aid kit supplies were also observed. Residents interviewed did not voice any concerns at this time. Violations cited are identified within this report. All new personnel records were reviewed since last inspection for criminal history reports and all were in compliance. Administrator was the premises during the inspection. Violations cited are identified within this report. Please complete the plan of correction and date to be corrected for each violation cited on the violation notice and return to the Inspector within or by 10 days. You will need to specify how the deficient practice will be or has been corrected. Jut writing the cord ?corrected? is not acceptable. Your plan must contain 1) steps to correct the non-compliance with the standards, 2) measures to prevent the non-compliance from occurring again, and 3) person(s) responsible for implementing each step and or monitoring any preventative measure(s). Please contact my office if I can be of any further assistance. Thank you for your assistance during this inspection.

Violations:

Standard #:	22VAC40-73-580-A
Description:	Based on a review of the facility's annual health inspection report it was not current. Evidence: The report was dated 8/8/2018
Plan of Correction:	Administrator will contact the local health department to schedule the annual inspection. Once completed a copy will be sent to Licensing Inspector.The Administrator and or designated staff will make sure that annual inspections are completed timely and annually in the future.
Standard #:	22VAC40-73-860-G
Description:	Based on a tour of the physical plant and water temperatures taken, the temperature was not within required guidelines. Evidence: The water temperature registered at 124 degrees 2nd floor bathroom.
Plan of Correction:	The Administrator will instruct maintenance to adjust the water temperatures and keep check on the temperature monthly so that it will remain within the required guidelines.
Standard #:	22VAC40-73-870-E
Description:	Based on a tour of the physical plant all furnishings were not in good repair. Evidence: The blinds in room #2 and the day room had broken visible slats.
Plan of Correction:	The Administrator or designated staff will instruct maintenance to replace the broken blinds and to do visible observations daily of all furnishings to replace items that are in ill repair.
Standard #:	22VAC40-73-890-B
Description:	Based on a tour of the physical plant all areas were not adequately lighted. Evidence:Three light bulbs were not operable in the ceiling light in room #1, the bathroom light on the 2nd floor had missing bulbs.
Plan of Correction:	Administrator will instruct maintenance to purchase light bulbs and replace all those that are not operable in the facility. Visual inspections will be done by all staff for items in need of replacement or repair and report to Administrator or designated staff person.
Standard #:	22VAC40-73-940-A
Description:	Based on a review of the facility's annual fire inspection report, it was not current. Evidence: The report was dated 8/6/2018.
Plan of Correction:	Administrator will contact the local fire department to schedule an annual fire inspection. Once it is completed a copy will be sent tot he Licensing Inspector. Administrator and or designated staff person will make sure that all future annual inspections are done timely.
Standard #:	22VAC40-73-980-A
Description:	Based on a review of the first aid kit supplies, all items required were not included: Evidence: There were no blanket, flashlight or batteries in the kit.
Plan of Correction:	Administrator will instruct designated staff person to purchase missing items and place in the first aid kit. The kit will be checked monthly and any items missing shall be purchased and replaced at that time.