VIRGINIA DEPARTMENT OF SOCIAL SERVICES

You Matter Adult Day Services
4240 Bonnibank Road
Richmond, VA 23234
(804) 447-6590

Current Inspector: Tamara Watkins (804) 662-7422

Inspection Date: April 23, 2024

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 22VAC40-80 THE LICENSE 22VAC40-80 THE LICENSING PROCESS 22VAC40-80 SANCTIONS 63.2 GENERAL PROVISIONS 63.2 PROTECTION OF ADULTS AND REPORTING 63.2 LICENSURE AND REGISTRATION PROCEDURES 63.2 CRIMINAL PROCEDURES 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: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/23/2024 2:00p ? 3:45p 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: 33 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 6 Number of staff records reviewed: 0 Number of interviews conducted with participants: 3 Number of interviews conducted with staff: 1 Additional Comments/Discussion: 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 Tamara Watkins, Licensing Inspector at (804) 662-7422 or by email at tamara.g.watkins@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-230-F
Description:	Based on a review of participant records the center failed to ensure that plan of care forms for each resident is completed in their entirety. Evidence: The plan of care for resident #1 is missing the start date on the plan. The plan of care for resident #3 is missing the start date on the plan and the form was incomplete. The plan of care for resident #4 is missing the start date on the plan and the form was incomplete. The plan of care for resident #5 is missing the start date on the plan and the form was incomplete. There is no plan of care in the resident record for Resident #6.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-240-A
Description:	Based on a review of participant records the center failed to date the written agreement between the participant and the center. Evidence: The agreement in the participant record has no start date and the signature of the center representative is not dated for participant #1. The agreement signed by the participant is not dated. The agreement signed by the participant is not dated for participant #4 and the form is incomplete. The agreement is not signed or dated by the center representative for participant #5. The agreement is signed by the participant and the center representative.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-250-B
Description:	Based on a review of resident records the facility failed to keep current personal information for each participant in the participant record form. Evidence: The start of care (date of admission) is missing on the participant record form for the following participants: #1, 2 (form is blank) 3, 4,5&6. The is no photo of written description for participants #3& 6.
Plan of Correction:	Not available online. Contact Inspector for more information.