VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Henry and William Evans Home
330 East Leicester Street
Winchester, VA 22601
(540) 662-8520

Current Inspector: Kevin Lassiter (804) 241-2093

Inspection Date: Feb. 12, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-151 22VAC40-151 III. RESIDENTIAL ENVIRONMENT 22VAC40-151 PROGRAMS AND SERVICES 22VAC40-151 PROGRAMS AND SERVICES 22VAC40-151 DISASTER OR EMERGENCEY PLANNING 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS.

Comments:

An unannounced renewal inspection was conducted on February 12, 2020 from 11:00 AM ? 4:00 PM and on February 13, 2020 from 9:50 AM - 12:00 PM. The facility reports a total of 12 children in placement at the time of the inspection. During this inspection, records were reviewed for two current residents, two discharged residents, and three personnel. A sampling of staff were reviewed against the CRF Title IV-E Matrix with no discrepancies. Interviews were conducted with two children and three staff. A tour of the facility?s exterior and all living areas within the facility was conducted. Residential environment requirements were assessed. The following was reviewed: daily logs, menus, staff work schedules, pet records, incident reports, emergency drill documentation, medication administration records, allowable variances, fire and sanitation inspection documentation, and insurance documentation. An exit interview was conducted at the conclusion of the inspection with the Program Director to review preliminary inspection findings. An acknowledgement form was signed. There was one violation. Upon the receipt of the violation notice, the licensee should identify the necessary corrective action and develop a plan of correction for each violation. The plan of correction should include the following: The steps to correct noncompliance with the standard(s); measures to prevent re-occurrence of noncompliance; person(s) responsible for implementation and monitoring of preventative measure(s); and date by which noncompliance will be corrected. The licensee has five (5) calendar days from receipt of the inspection documentation to complete the section titled Plan of Correction, sign each page of the documentation and return it to the Licensing Office. The licensee should retain a copy to be posted at the facility. Results of the inspection documentation are subject to public disclosure and will be posted on the VDSS web site within 5 days, regardless of whether the Plan of Correction is completed.

Violations:

Standard #:	22VAC40-151-250-B-5
Description:	Violation: Based on review of the personnel record for S1 and interview with personnel, S4, S1 did not receive annual retraining on the provider's policies and procedures regarding standard precautions. Evidence: 1) The personnel record for S1 did not contain documentation of annual retraining on the provider's policies and procedures regarding standard precautions, as required by 22VAC40-151-250-B-5. 2) When discussed with S4, S4 acknowledged that S1 did not receive annual retraining regarding standard precautions.
Plan of Correction:	S6 provided S1 with her retraining on the provider's policies and procedures regarding standard precautions on February 17, 2020. S1 has not completed all required annual retraining. S4 will be responsible for providing the training to S1 in February of each year, on or prior to the due date. S6 will ad S1 to the required staff training list as well as to the reminder list to prevent any further missed trainings.