VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Alpha House I
4526 Brickwood Meadow Ct.
Petersburg, VA 23803
(804) 861-0596

Current Inspector: Irvin Goode (804) 543-5188

Inspection Date: Feb. 5, 2024

Complaint Related: No

Areas Reviewed:

22VAC40-151 Administration 22VAC40-151 Residential Environment 22VAC40-151 Programs and Services 22VAC40-151 Programs and Services 22VAC40-151 Disaster or Emergency Planning 22VAC40-80 The License 22VAC40-151-240-Personnel

Technical Assistance:

Discussed storage room being organized and free of clutter 520B Discussed the stove burners and ensuring that they are operable 470B

Comments:

Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 2/5/2024 from 10:30a.m. 6:30 p.m. and 2/6/2024 12:00 to 7:00 p.m. The Licensing Inspectors Irvin Goode and Sherry Woodard met with the Program Director to initiate the inspection on the 2/5/2024 and 2/6/2024 Number of residents in care at the beginning of the inspection (2) The Licensing Inspectors completed a tour of the physical plant that included building and grounds of the facility. Number of resident?s records reviewed (1) Number of discharge records reviewed () Number of staff records reviewed: (2) Background checks only (4) Number of new staff records reviewed: (0). Number of interviews conducted with residents (1) Number of interviews conducted with staff (1) Observations by licensing inspector: posting of the license and inspection documents was observed. The following is a listing of the activities for this inspection: Reviewed one current resident record and one discharged resident records. Reviewed medication administration records. Two personnel records with no new staff. One staff member and 1 resident were interviewed. An inspection of the interior and the exterior of the facility was completed. Other documentation included emergency fire drill documentation, menus, and staff work schedules, fire inspection and the health and safety inspections. The Licensing inspectors also reviewed Certificate of Insurance. The evidence gathered during the inspection determined (5) violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website within five (5) business days of your receipt of the inspection summary. 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, Irvin D. Goode, Licensing Inspector at 804-543-5188 or by email at Irvin.Goode@dss.virginia.gov

Violations:

Standard #:	22VAC40-151-220-A-4
Description:	Violation: - Based on record review, the agency failed to include the minimum education requirements for the job description of team leader. 1. (SR-I) was hired 8/3/20. 2. Job description reviewed in record for (SR-1) was signed by staff on 5/20/23 and did not include minimum educational requirements for the position of team leader. 3. The finding were discussed during the exit interview.
Plan of Correction:	4 The job description for team leader shall be updated by Feb 28, 2024, to reflect the following educational qualifications: A team leader at Alpha House shall have a baccalaureate degree in the human service field (social work, psychology, early childhood education, human development, sociology, counseling, etc.) and 3 years professional experience working with children. The updated Team leader Job description on shall be presented to both current team leaders for signature and shall be placed in their personnel files by Feb. 28, 2024. Program Director shall be responsible to make correction and meet deadline
Standard #:	22VAC40-151-640-E-1
Description:	Violation: - Based on record review, DC 1, the agency failed to add the following information on the face sheet. Findings: 1. DC 1 date of discharge was 1/19/2024. 2, A review of face sheet DC1 did not contain the date of discharge.
Plan of Correction:	Director shall review will all the staff the importance of updating the face sheet with discharge information during staff meeting on 2/20/24. This was an oversight in updating the face sheet for this resident. Discharge information is typically written on the face sheet on discharge date of resident. Record did contain discharge summary and discharge to legal guardian information
Standard #:	22VAC40-151-640-E-2
Description:	Violation: - Based on record review, DC 1, the agency failed to add the following information on the face sheet. Findings: 1. DC 1 date of discharge was 1/19/2024. 2, A review of face sheet DC1 did not contain a reason for the discharge.
Plan of Correction:	Director shall review will all the staff the importance of updating the face sheet with discharge information during staff meeting on 2/20/24. This was an oversight in updating the face sheet for this resident. Discharge information is typically written on the face sheet on discharge date of resident. Record did contain discharge summary and discharge to legal guardian information.
Standard #:	22VAC40-151-640-E-3
Description:	Violation: - Based on record review, DC 1, the agency failed to add the following information on the face sheet. Findings: 1. DC 1 date of discharge was 1/19/2024. 2, A review of face sheet DC1 did not contain the names and addresses of persons to whom the resident was discharged.
Plan of Correction:	Director shall review will all the staff the importance of updating the face sheet with discharge information during staff meeting on 2/20/24. This was an oversight in updating the face sheet for this resident. Discharge information is typically written on the face sheet on discharge date of resident. Record did contain discharge summary and discharge to legal guardian information.
Standard #:	22VAC40-151-640-E-4
Description:	Violation: - Based on record review, DC 1, the agency failed to add the following information on the face sheet. Findings: 1. DC 1 date of discharge was 1/19/2024. 2, A review of face sheet DC1 did not contain the forwarding address of the resident.
Plan of Correction:	Director shall review will all the staff the importance of updating the face sheet with discharge information during staff meeting on 2/20/24. This was an oversight in updating the face sheet for this resident. Discharge information is typically written on the face sheet on discharge date of resident. Record did contain discharge summary and discharge to legal guardian information.