VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Victory Assisted Living
27 Centre Hill Ct
Petersburg, VA 23803
(804) 861-8756

Current Inspector: Belinda Dyson (804) 662-9780

Inspection Date: April 7, 2022

Complaint Related: No

Areas Reviewed:

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 22VAC40-80 THE LICENSE.

Comments:

An unannounced renewal inspection was completed from 9:50 a.m.-11:45 a.m. by Licensing Inspector. There are 14 residents in care at this time all were attending day support program during the inspection. Follow up was completed on the previous violation notice and all violations were corrected. A tour of the physical plant was completed. A sample size of 6 resident's records and 4 staff records were reviewed for compliance. Physician's orders, medication administration records and medications of the sample and others were observed. No new hires since last inspection. First aid kit supplies were complete. Administrator was on 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 by (or within 10 days). You will need to specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. Your plan of correction must contain: 1) steps to correct the non-compliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). Please contact me by e-mail at belinda.dyson@dss.virginia.gov if further assistance is needed. Thank you for your assistance during this inspection.

Violations:

Standard #:	22VAC40-73-450-E
Description:	Based on a review of 6 resident's records, 2 records did not have the required documentation. Evidence: Resident's #3 individualized service plan did not have the signature and date by the resident or their legal representative. Resident's #6 individualized service did not have the signature and date developed by the Administrator or the designee.
Plan of Correction:	Administrator will review the individualized service plans again with the residents will have all signatures and dates completed on the form. Administrator will review records periodically to make sure all required forms and signed, dated and current.
Standard #:	22VAC40-73-690-A
Description:	Based on observation of the medication/pharmacy review, the annual review for the facility it is not current. Evidence: The last pharmacy/medication review by the pharmacist was completed 1/1/2019.
Plan of Correction:	Administrator will speak with and schedule a review with the pharmacist as soon as possible. They were not coming out into the facility because of COVID.