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: Jan. 8, 2024

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 ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS

Comments:

Type of inspection: Renewal Date of inspection the licensing inspector was on-site at the facility for each day of the inspection: 1/8/2024 9:30 am to 11 am The Acknowledgement of Inspection form was emailed for each date of the inspection. Number of residents 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 resident records reviewed: 4 Number of staff records reviewed: 2 Number of interviews conducted with staff: 1 Observations by licensing inspector: Building and Grounds, Medication Storage and Administration, Postings 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 Yvonne Randolph, Licensing Inspector at 804-662-7454 or by email at

Violations:

Standard #:	22VAC40-73-750-B
Description:	Based on a inspection of the building, bedrooms did not have an operable bed lamp or bedside light accessible to each resident. Evidence: Two bedrooms did not have a lamp or bedside light accessible to residents.
Plan of Correction:	Bedside lamps presented a fire hazard/risk for the residents in the two bedrooms as the residents were placing clothing items over the lamp shades . Alternative options for lighting will be explored
Standard #:	22VAC40-73-940-A
Description:	Based on a review of facility documentation, the facility did not comply with the Virginia Statewide Fire Prevention Code (13VAV5-51) as determined by at least an annual inspection by the local official. Evidence: The last documented inspection was completed in 2021.
Plan of Correction:	Facility staff has been in communication with the local fire official. The inspection will be delayed due to a fire staff vacancy. Will continue communication and try to secure a potential date for the inspection .