VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harris Manor
24212 Gloria Drive
Petersburg, VA 23803
(804) 733-2830

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: Feb. 6, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 32.1 Reported by persons other than physicians 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 SANCTIONS.

Comments:

An unannounced renewal inspection was conducted at the facility from approximately 1:30 pm to 3:00 pm. The staff reported 16 residents in care, three staff and six resident files were reviewed for compliance along with other required program documentation. Since the last inspection, there has been no new staff hired. A plan of correction was completed on site and is included in the inspection reports. See violation notice for non-compliance.

Violations:

Standard #:	22VAC40-73-210-B
Description:	Based on a review of three staff files on 2/06/2020, One staff did not attend at least 18 hours of training annually. Evidence: Licensing staff found eight (8) hours of annual training documented in the file for staff # 2.
Plan of Correction:	The administrator will ensure that all staff attend at least 18 hours of training annually.
Standard #:	22VAC40-73-260-A
Description:	Based on a review of three staff files, one staff did not maintain current certification in first aid. Evidence: The fist aid certification for staff # 2 expired 9/16/2019.
Plan of Correction:	The administrator will ensure that staff maintain certification in the future and that current certification is maintained in the staff file.
Standard #:	22VAC40-73-550-G
Description:	Based on a review of three staff files on 2/6/2020, an annual review of rights and responsibilities of residents in assisted living facilities was not completed for two staff. Evidence: A file review found no documentation of an annual review of rights and responsibilities of residents in assisted living facilities for staff # 1 and # 3.
Plan of Correction:	The administrator will ensure that each staff person have a documented annual review of rights.