VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Good Neighbor Village Inc.
8825 Buffin Road
Richmond, VA 23231
(804) 795-9813

Current Inspector: Tyia Venable (804) 393-2157

Inspection Date: March 21, 2025

Complaint Related: No

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: Approximate time 9:40a.m-11:52a.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: 5 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 2 Number of staff records reviewed:2 Number of interviews conducted with residents:5 Number of interviews conducted with staff: 3 Observations by licensing inspector: Additional Comments/Discussion: 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 Angela Rodgers-Reaves, Licensing Inspector at (804) 840-0253 or by email at Angela.r.reaves@dss.virginia.gov Violation Notice Issued: Yes

Violations:

Standard #:	22VAC40-73-210-A
Description:	Based on the review of facility records with facility staff the facility failed to ensure that all direct care staff attend at least 14 hours of training annually. Evidence: Staff #1 The review of facility records with staff #s 3 and 4 on 03/21/2025 revealed that the facility did not submit upon request documented evidence that staff #1 attended fourteen hours of annual training
Plan of Correction:	FACILITY'S RESPONSE: "We currently keep records of training type and hours completed in multiple locations. The nurse keeps a copy of all the staff?s training logs, and the Administrator is responsible for transferring that information into employee folders. However, the Administrator failed to transfer that information. To correct this, we will implement a system of checks and balances. The Administrator and the Nurse will conduct quarterly checks of each other?s documentation to ensure that all information has been entered correctly and will make note of the date and will initial the document as verification of the data check."
Standard #:	22VAC40-73-250-D
Description:	Based on the review of facility records and interviews conducted the facility failed to ensure that each staff person submitted the results of the annual risk assessment and documented that the individual is free of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it. Evidence: Staff #1 The review of facility records with facility staff #s 3 and 4 on 03/21/2025 revealed that the most recent tuberculosis assessment conducted for staff #1 was dated 10/10/2023.
Plan of Correction:	FACILITY'S RESPONSE: "We already had a TB Screening and Risk Assessment Tool completed on 10/11/24 for staff #1; It had been inadvertently given back to the nurse by the COO/Administrator, rather than being placed in staff #1?s employee folder. This was corrected the next day by the nurse and the COO/Administrator, and the TB document is now in the staff member?s employee folder. All other folders were correct. 2. To ensure this doesn?t happen again, the Administrator and the nurse will both check the employee folders quarterly to make sure that all TB Screening and Risk Assessment Tools completed in that quarter have been placed in the employee folders."