VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Angel's Adult Daycare Center LLC
430 North Main Street
Suffolk, VA 23434
(757) 334-0474

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

Inspection Date: Aug. 31, 2022 and Sept. 8, 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

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: 08/31/2022 at 10:02 am and 09/08/2022 from 8:30 am to 10:04 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: 0 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 1 Number of staff records reviewed: 3 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 #:	22VAC40-61-230-D
Description:	Based on record review, the center failed to ensure the plan of care be developed to maximize the participant's level of functional ability and to support the principles of individuality, personal dignity, and freedom of choice and include the items listed in the standard. Evidence: 1. The plan of care for Participant #1 dated 8/25/22 does not include the date identified for the needs listed, the expected outcome or goal to be achieved in meeting all of the needs identified, when and who will provide the activities and services to be provided, the time by which the outcome or goals should be achieved, and date outcome or goal achieved.
Plan of Correction:	Angel's Adult Day Care LLC has corrected the plan of care on form Standard: 22VAC40-61-230.
Standard #:	22VAC40-61-340-C
Description:	Based on documentation, the center failed to ensure if a catering service or contract food service is used, the service be approved by the local health department. The center shall be responsible for monitoring continued compliance by obtaining a copy of the Virginia Department of Health approval. Evidence: 1. The center utilizes a catering service and was unable to provide a current copy of its Virginia Department of Health approval. The documentation provided is a health permit which expired 06/30/2022.
Plan of Correction:	Angel's Adult Day Care Center LLC has secured a copy of the Catering Service's Virginia Department of Health certificate and will be able to provide a copy upon request.
Standard #:	22VAC40-61-410-A
Description:	Based on observation, the center failed to ensure the interior and exterior of all buildings be maintained in good repair, kept clean and free of rubbish, and free from safety hazards. Evidence: 1. During a tour of the center, three separate windows were observed to be cracked. The ramp outside the entrance also was noted to have wood planks that were raised, uneven, and not secured. In addition, the front porch had unsecured bricks.
Plan of Correction:	Angel's Adult Daycare LLC has sealed the cracked windows, repaired the raised wooden planks and secured the bricks on the front porch.