VIRGINIA DEPARTMENT OF SOCIAL SERVICES

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

Current Inspector: Irvin Goode (804) 543-5188

Inspection Date: March 18, 2021 , March 24, 2021 , April 2, 2021 , April 5, 2021 , April 7, 2021 and April 19, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-151 INTRODUCTION. 22VAC40-151 22VAC40-151 PROGRAMS AND SERVICES 22VAC40-151 PROGRAMS AND SERVICES 22VAC40-151 DISASTER OR EMERGENCEY PLANNING

Technical Assistance:

Discussed other policies and procedures that are applicable to their positions, duties, and responsibilities in relation to orientation and training as noted in 250.A.3.e. Discussed restrictions on physical activities as noted in 740.E.1.g.

Comments:

This inspection was conducted by the licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A renewal inspection was initiated on 3/18/21 and concluded on 4/19/21. The Program Director was contacted by telephone on 3/18/21 to initiate the inspection. The Program Director reported that the current census was three (3) residents. The Licensing Specialist emailed the Program Director a list of items required to complete the inspection. The following is a listing of the activities for this inspection: Reviewed one resident record. Reviewed health care and medication administration records. Two personnel records were reviewed. No discrepancies were found with the CRF matrix. The Program Director was interviewed on 4/8/21. Other documentation reviewed during this inspection included, but was not limited to the following: emergency drill documentation, staff work schedules, and daily log book entries. 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
Description:	22 VAC 40-151-50.F Violation: Based on review of the current resident?s, CR1?s, record and interview with staff, the facility failed to comply with its own emergency and evacuation procedures (revised 6/2020) as it pertains to quarantining residents testing positive for Coronavirus or COVID-19. Findings: 1) Below are excerpts from the facility?s policy ? a. ?Residents with symptoms or thought to have been exposed to the corona virus will be separated from others as much as possible to avoid the spread of the illness. Efforts will be made to quarantine resident to their individual bedroom and bathroom. Residents experiencing symptoms of illness suspected to be the Corona Virus will also be quarantined while medical treatment is obtained and specific medical instructions are given. Alpha House will follow medical directives as they are given to properly treat ill residents.? b. ?For residents known to have the Corona Virus, they will be in isolation. Isolation as defined by CDC ?will require the person to remain in a separate room from others?. Based on bed space at Alpha House I at the time an individual is determined to need isolation as the result of a confirmed case of Corona Virus efforts will be made to move their room to point furthest away from other residents. Also, staff will place on their bedroom door that the room is in isolation to ensure all are aware of possible hazards by entering the room. During a resident?s isolation staff shall assume residents? chores and meal preparation for the resident. Staff shall use universal precautions. A bathroom will be designated for residents in isolation.? c. ?Residents will take meals during a confirmed communicable illness in their bedrooms using paper cups, plates, and disposable utensils as a precaution to prevent the spread of virus. Staff shall provide sensory supervision for the resident in medical isolation every 15 minutes.? 2) Below are excerpts from CR1?s DSS Contact notes ? a. ?2/22/21 ? Notified DSS that CR1 had been returned to AH due to Covid positive and no one willing to take her in placement. ? b. ?2/25/21 ? CR1 to CVS for Covid test (3rd).? c. ?2/27/21 ? Received word Covid test negative.? 3) This Licensing Specialist noticed several instances in CR1?s Progress Notes and the facility?s Daily Log notes where staff did not ensure that CR1 remained in her room for quarantine while positive for COVID-19. 4) Below is an example, an excerpt from CR1?s Progress Note, which was written by a Relief Counselor ? a. ?2/25/21 ? 8p-8a ? CR1 is in her room upon arrival, she comes out eats, goes in the frig then ask housemate for a piece of pie, then goes back to her room and go to bed. CR1 slept through the night w/no problems, and gets up when prompted to prepare for school. CR1 ate cereal, had her meds and went back to her bedroom.? 5) The Licensing Specialist asked staff, S3, if CR1?s Progress Note dated for 2/25/21 complies with the facility?s emergency and evacuation procedures as it pertains to quarantining residents with Coronavirus or COVID-19. S3 stated, ?no.? 6) The Licensing Specialist asked S3 if all staff have been trained on the facility?s emergency and evacuation procedures (revised 6/2020). S3 advised all staff have been trained and provided a list of the staff members who were trained. 7) According to the resident roster submitted for this inspection and the facility?s Daily Log Notes, two other residents were in the facility along with CR1.
Plan of Correction:	Alpha House staff shall review the policy and procedures re. Quarantine resident?s positive with Covid 19 by April 26, 2021. Director shall also review documents to determine policy changes needed based on experience with the virus within Alpha House and CDC recommendations as of April 2021.