VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jan's Residential Home I
307 N. High Street
P. O. Box 666
Blackstone, VA 23824
(434) 298-0993

Current Inspector: Coy Stevenson (804) 972-4700

Inspection Date: May 25, 2021 and May 28, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 BUILDING AND GROUNDS 22VAC40-80 COMPLAINT INVESTIGATION.

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A complaint inspection was initiated on 05/25/2021 and concluded on 05/28/2021. A complaint was received by the department regarding allegations in the areas of administration /administrative services and maintenance of buildings/grounds. The administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation supported the allegations of non-compliance with standards or law, and violations were issued. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-70-A
Complaint related:	Yes
Description:	VIOLATION: Based upon staff interviews and documents submitted by the facility, the facility failed to report to the Division of Licensing Programs of any major incident that negatively affected or threatens the the welfare of any resident. EVIDENCE: During the staff interview, the licensee confirmed that the facility did not have bed bugs. The licensee/administrator confirmed that the facility had a recent scabies outbreak. Several staff members and residents were infected with scabies. Prior to the inspector's contact , the facility failed to provide a 24 hour notice to the licensing inspector concerning the initial outbreak of scabies. The licensing inspector was notified of the incident during the complaint investigation.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-70-C
Complaint related:	Yes
Description:	VIOLATION: Based upon staff interviews and documents submitted by the facility, the facility failed to submit an incident report to the Central Regional Licensing Office within seven days from the date of the incident. EVIDENCE: The administration team confirmed ,during the complaint investigation interview, that the facility failed to submit an incident report to the Central Regional Licensing Office concerning the scabies outbreak.
Plan of Correction:	Not available online. Contact Inspector for more information.