VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Golden Care Group LLC
2800 Squire Court
Chesapeake, VA 23323
(470) 530-5184

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: Sept. 15, 2023

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 ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

Comments:

Type of inspection: Initial Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: An announced initial inspection took place on 09/15/2023 from 8:55am to 9:50 am. 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: 0 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: Measurement of rooms reserved for residents were completed to include a review of required furnishings for resident rooms. A review of required postings, the first aid kit, and a medication storage case was reviewed. Additional Comments/Discussion: The initial onsite inspection was completed with the owner of the facility. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the initial inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The applicant has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to maintain future compliance with applicable standard(s) or law. If the applicant 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 should the facility be issued a license to operate. 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 a licensed 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 #:	22VAC40-73-960-A
Description:	Based on observation the facility failed to ensure a fire and emergency evacuation drawing shall show primary and secondary escape routes, areas of refuge, assembly areas, telephones, fire alarm boxes, and fire extinguishers. Evidence: 1. During a tour of the facility with staff #1 the fire and emergency evacuation drawing posted in the facility did not show primary and secondary escape routes, areas of refuge, assembly areas, telephones, fire alarm boxes, and fire extinguishers.
Plan of Correction:	Fire and Emergency Evacuation Drawing: The fire and emergency evacuation drawing has been updated to accurately reflect primary and secondary escape routes, areas of refuge, assembly areas, telephones, fire alarm boxes, and fire extinguisher locations.
Standard #:	22VAC40-73-980-A
Description:	Based on observation the facility failed to ensure the first aid kit shall include blankets, disposable sing-use breathing barriers or shield, cold pack, plastic bags, small flashlight and extra batteries, and a thermometer. Evidence: 1. During observation and review of the first aid kit with staff #1, the first aid kit did not contain a disposable single-use breathing barriers or shield or CPR mask
Plan of Correction:	CPR Resuscitator Mask: On September 21, 2023, we procured the required CPR Resuscitator mask and have duly added it to our First Aid kit.