VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Powell Residential, LLC
4101 Falconway Lane
Richmond, VA 23237
(804) 319-6246

Current Inspector: Angela Rodgers-Reaves (804) 662-9774

Inspection Date: Nov. 14, 2023

Complaint Related: No

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: On 11/14/2023 approximate time 12:50p.m-2:21p.m The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: none The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 2 Number of staff records reviewed: 1 Number of interviews conducted with residents: residents not on site Number of interviews conducted with staff: 1 Observations by licensing inspector: 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 Angela Rodgers-Reaves, Licensing Inspector at (804) 840-0253 or by email at angela.r.reaves@dss.virginia.gov Violation Notice Issued: Yes

Violations:

Standard #:	22VAC40-73-650-B
Description:	Based on the review of facility records and staff interview the facility failed to ensure that resident physician orders included a diagnosis. Evidence: Resident # 2 The review of the resident?s physician orders with the Administrator revealed that the physician?s orders for resident # 2 did not include diagnosis for any of the residents prescribed medications
Plan of Correction:	FACILITY RESPONSE: ?Called Cedarfield Pharmacy, talked to manager and had the diagnosis included on the medications. Doctor was notified to include diagnosis on the labels also
Standard #:	22VAC40-73-680-I
Description:	Based on the review of facility records and staff interview the facility failed to ensure that the medication administration records (MARs) included the date and time given and the initials of direct care staff administering the medications. Evidence: Resident #s 1 and 2 The review of the resident?s MARs with the Administrator on 11/14/2023 revealed that the MAR was not documented to note that the 8:00a.m medications on 11/14/2023 had been administered to resident #s 1 and 2.
Plan of Correction:	FACILITY RESPONSE: "8:00a. medications were administered by the Administrator on the 14th of November but was not recorded until later that day. Future Administration of medicine will include distribution and recording at same time. Date and time given initial of direct care giving the medication.?