VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Holston Family Service
3130 LEE HIGHWAY
Suite 105
Bristol, VA 24202
(276) 591-5301

Current Inspector: Jamie Morgan (276) 525-5656

Inspection Date: Sept. 15, 2022 , Sept. 27, 2022 and Oct. 24, 2022

Complaint Related: Yes

Areas Reviewed:

22VAC40-131 ORGANIZATION AND ADMINISTRATION 22VAC40-131 PROVIDER HOMES 22VAC40-131 CHILDREN?S SERVICES

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 9/15/2022 from 11:20 a.m. 3:15 p.m. A complaint was received by VDSS Division of Licensing on 8/15/2022 regarding allegations in the areas of: 22VAC40-131-140- Staff Composition and Qualifications 22VAC40-131-230- Monitoring and Re-evaluation of Provider Homes 22VAC40-131-250- Intake, Acceptance, and Placement 22VAC40-131-310 Clothing and Spending Allowance 22VAC40-131-330 Visitation and Continuing Contact with Children 22VAC40-131-370- Case Record Requirements 22VAC40-131-380- Behavior Support and Crisis Intervention 22VAC40-131-460 Children Placed in Treatment Foster Care Number of children?s records reviewed: 1 Number of staff records reviewed: 0 Number of interviews conducted with staff: 2 Collateral interviews: 1 The Licensing Specialist provided preliminary inspection documents to the agency and a preliminary findings review was conducted. An exit interview was conducted by Team Meeting on 10/24/2022. The evidence gathered during the investigation did not support the allegations of non-compliance with standard(s) or law. However, violation(s) not related to the complaint but identified during the course of the investigation can be found on the violation notice. 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 Dawn Caldwell, Licensing Inspector at 804-385-6864 or by email at dawn.caldwell@dss.virginia.gov

Violations:

Standard #:	22VAC40-131-40-B
Complaint related:	No
Description:	Violation: Based on record review, interview, and review of the agency?s policies and procedures, the agency failed to follow their own policy and procedure for documenting a case record review within the record for Child 1 (C1). Findings: 1. The agency?s policy and procedures require documentation be placed within a record when the record has been reviewed. 2. The agency provided the Licensing Specialist with an Acknowledgement of Receipt of Client File #270 that was signed by the client and documented the client's review of the record. 3. Staff 1 (S1) acknowledged the document was not placed within the record.
Plan of Correction:	The child-signed case record reviewed dated 5/27/22 was placed within the child's record prior to the licensure inspector's exit interview on 9/15/22. Holston will adhere to Holston stated policy in the future.