VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Tina's World of Love
1751 Church Street
Suite C
Norfolk, VA 23504
(757) 500-4306

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: Oct. 12, 2022

Complaint Related: No

Areas Reviewed:

22VAC40-61 GENERAL PROVISIONS 22VAC40-61 ADMINISTRATION 22VAC40-61 PERSONNEL 22VAC40-61 SUPERVISION 22VAC40-61 ADMISSION, RETENTION AND DISCHARGE 22VAC40-61 PROGRAMS AND SERVICES 22VAC40-61 BUILDINGS AND GROUND 22VAC40-61 EMERGENCY PREPAREDNESS 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

Technical Assistance:

Background Checks

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/12/2022 from 9:15 am to 11:55 am. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of participants present at the facility at the beginning of the inspection: 4 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 4 Number of staff records reviewed: 7 An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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 M. Tess Pittman, Licensing Inspector at (757) 641-0984 or by email at tess.pittman@dss.virginia.gov.

Violations:

Standard #:	22VAC40-61-50-E
Description:	Based on record review, the center failed to review the rights and responsibilities of participants annually with each participant, or, if a participant is unable to fully understand and exercise his rights and responsibilities, the annual review shall include his family member or his legal representative. Evidence: 1. Participant #3 and Participant #4 did not have evidence of an annual review of rights and responsibilities of participants in their participant file within the past year.
Plan of Correction:	Agency will ensure that all participants and or the authorized Representative have an opportunity to review the rights and responsibilities of the participants annually.
Standard #:	22VAC40-61-230-D
Description:	Based on record review, the facility failed to ensure the plan of care included descriptions of identified needs, dates identified, expected outcomes or goals, activities and services and dates of outcomes or goal achieved. Evidence: 1. Participant #3?s assessment dated 9/14/2022 documented a need for supervision and mechanical assistance (cane) with walking, no assistance with bladder or bowel continence, and supervision with toileting; however, the POC dated 9/14/2022 states the participant will receive only mechanical assistance with walking, requires assistance with incontinency (bladder and bowel) weekly or more, and does not address the participant?s need for supervision with toileting.
Plan of Correction:	Agency will ensure the plan of care includes descriptions of identified needs, dates identified, expected outcomes or goals, activities and services and dates of outcomes or goal achieved.