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Alpha House II
3903 West Autumn Drive
Petersburg, VA 23803
(804) 861-0533

Current Inspector: Irvin Goode (804) 543-5188

Inspection Date: Feb. 20, 2020 , Feb. 28, 2020 and March 3, 2020

Complaint Related: Yes

Areas Reviewed:
22VAC40-151 INTRODUCTION.
22VAC40-151
22VAC40-151 PROGRAMS AND SERVICES
22VAC40-151 PROGRAMS AND SERVICES

Technical Assistance:
None

Comments:
An unannounced complaint inspection was conducted on 2/20/20 from approximately 10:02 a.m. to 5:06 p.m. by the Licensing Specialist and local agency representatives. The complaint was in regard to behavior interventions at this children?s residential facility. A phone interview with a staff member was conducted on 2/25/20. The Licensing Specialist returned to the facility on 2/28/20 from approximately 9:05 a.m. to 9:59 a.m. to interview a staff member in order to seek clarification and additional information about the complaint. At the time of the incident, the census was three (3) residents. The current census is one (1) resident.

The following is a listing of the activities for this inspection:
The record for an active resident and a discharged resident were reviewed. The record for one staff member was reviewed. Interviews were conducted with staff and residents. Relevant policies and procedures and applicable sections from the daily log were reviewed.

The Program Director was available and accessible during the inspection. The Acknowledgement of Inspection form was signed and left at the facility.

Upon receipt of this violation notice, a plan of correction is requested for each violation. The Plan of Correction should include, as appropriate: - steps to correct noncompliance of a regulation, - measures to prevent reoccurrence of noncompliance, - person(s) responsible for implementing each step and/or monitoring any preventive measure(s), and - the date by which the noncompliance will be corrected. Be advised that the Violation Notice, including the Plan of Correction and this Summary page will be posted on the VDSS web page and available for review by the general public. Do not write any names or other confidential information into your plan of correction.

Violations:
Standard #: 22VAC40-151-50-F
Complaint related: Yes
Description: Violation: Based on review of the facility?s behavior interventions policy and interviews with staff, the facility failed to comply with its own policies and procedures.
Findings:
1) The Licensing Specialist asked staff, S2, for a copy of the facility?s behavior intervention policy. A section of this policy states the following ? ?Staff shall not physically restrain a resident unless the resident is an immediate threat to themselves or another person. Any staff member having physical contact with a resident shall complete a SIR form prior to leaving their shift. In situations where resident behavior escalates to the level of needing psychical (sic) restraint the local police may be contacted as necessary to address the resident and ensure safety to all. ?
a. S2 explained this policy needs to be updated. S2 further explained the current policy, a verbal understanding among staff is the following ? ?If there is a crisis situation and intervention is needed then staff can act on it. The police can be called without my permission. Staff need to call me after the police have been called so I can be aware of the situation.?

2) This policy was requested because a video of two residents fighting in the facility?s van was sent to the Licensing Specialist. According to the facility?s serious incident reports, this fight occurred on 12/29/19.
a. According to S2 and the facility?s daily log notes dated for 12/29/19, the video was recorded by a resident.
b. Current resident, CR1, and discharged resident, DR1, were fighting. The video shows CR1 hovering over DR1 who was seated in the van. CR1 pummeled DR1 and pulled her hair. The video shows DR1?s attempts to defend herself against CR1.
c. This video, which lasts for 39 seconds, shows a staff member watching the fight. The face of the staff member was not revealed. Staff, S1, stated she is the staff member in the video.
i. S1 did not consider this type of fighting as extreme. She stated, ?It was just two girls fighting.?
d. S1 did not attempt to stop the residents from fighting. S1 states the following while watching the residents fight-
i. At approximately 20 seconds, S1 states, ?Alright, y?all had enough?? At approximately 24 seconds, S1 states, ?Y?all had enough?? At approximately 27 seconds, S1 states, ?Huh??
e. According to the serious incident reports for the residents, the following was reported-
i. CR1 ?broke some nails and had a scratch on her face.?
ii. DR1 ?broke some nails and her glasses. ?

3) The Licensing Specialist interviewed S1 and asked her to explain why she did not stop the residents from fighting.
a. S1 stated, ?I do not break up fights because it is not in my job description. Other staff may try to break up a fight, but I do not.? ?My job is to tell [S2] and write up the reports. [S2] will ask me if the police need to be called. I called [S2] five minutes after getting [DR1] off the van.?
b. S2 disagreed with the way S1 handled this incident. S2 stated, ?S1 should have called the police if she was not going to intervene.?
c. S2 showed the Licensing Specialist the following is in S1?s job description beneath ?Duties and Responsibilities? ? ?Must follow and implement behavior management of children being served.?

4) If the existing written policy had been followed, S1 would have stopped the fight.
a. The video shows that CR1 was an immediate threat to DR1.
b. The video shows that CR1?s behavior escalated to the level of needing a physical restraint.

Plan of Correction: Review will all saff the responsibilities of safety and security for all parties to include residents, staff, community, and property, in writing by March 14, 2020. Reviewed/retrained S1 actions to be taken should similar situation arise. Consulted with Crater Detention Home (DJJ) to coordinate restraint and crisis intervention training for all staff to potentially occur in May 2020 over a three-day period. Times and dates to be determined and coordinated by Director of Alpha House with Crater Detention and DJJ Administration.

Standard #: 22VAC40-151-800-C
Complaint related: Yes
Description: Violation: Based upon review of the current resident?s, CR1?s, and the discharged resident?s, DR1?s, behavior support plans and interview with staff, the facility failed to demonstrate that staff had knowledge and understanding of a resident?s behavior support plan, prior to working alone with the resident.
Findings:
1) The Licensing Specialist reviewed CR1?s and DR1?s behavior support plans and noticed that staff, S1, did not sign it.
a. The facility?s behavior support plan states the following as it pertains to a staff member?s signature on this document ? ?Staff signature below demonstrates knowledge and understanding of resident specific behavior support plan.?

2) S2 did not dispute the Licensing Specialist?s findings.

Plan of Correction: Staff S1 reviewed residents behavior support plan and signed that it was reviewed on 2/28/20. Director will ensure each staff signs behavior support plans as they are written and updated for all residents.

Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.

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