VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Petersburg Home for Ladies
311 South Jefferson Street
Petersburg, VA 23803
(804) 861-0660

Current Inspector: Shelby Haskins (804) 305-4876

Inspection Date: June 14, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS

Technical Assistance:

Resolution on resident council notes Notification of renovations Disclosure format Resident #2 UAI reads ?app? but ISP says ?behaviors less than weekly?

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: 6-14-2023, 9:09 a.m. ? 2:30 p.m. 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: 36 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 Alex Poulter, Licensing Inspector at (804)662-9771 or by email at alex.poulter@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-1120-B
Description:	Based on record review and interview with staff, the facility failed to ensure at least 21 hours of scheduled activities were available to the residents. Evidence: The May 2023 monthly calendar documented the following number of hours per week in the special care unit (SCU): May 7-13th: 16 hours May 14-20th: 17 hours May 21 ? 27th: 16 hours The June 2023 monthly calendar documented the following number of hours per week in the special care unit (SCU): June 4-10th: 14 hours June 11-17th: 19 hours June 18-24th: 18.5 hours June 25-30th: 15 hours. 2. Staff #1 confirmed during interview the number of hours was less than 21 hours per week based on the May and June 2023 SCU activities calendar.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-320-A
Description:	Based on record review, the facility failed to ensure on the resident?s physical examination, that the physician included a description of reactions to person?s known allergies. Evidence: Resident #4 admitted 5-25-2023. Resident #4?s physical examination dated 5-18-2023 documented allergies to ?tramadol, ceclor, ciprofloxacin, cefaclor, doxycycline?; however, no description of allergy reactions were documented. Resident #5 admitted 12-03-2021. Resident #5?s physical examination dated 11-02-2021 documented allergy to ?macrobid?; however, no allergy reactions were documented.
Plan of Correction:	Not available online. Contact Inspector for more information.