VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Oakland Manor
1830 Matoax Avenue
Petersburg, VA 23805
(804) 722-3692

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: Dec. 13, 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 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS

Comments:

Type of inspection: Renewal, Mandated Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 12/13/24, 11am12:30 pm 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: 1 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: 2 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: Building maintenance and repair, file documentation, required postings, lunch meal, staffing, medication storage Additional Comments/Discussion: The Licensee reports that the facility will be discharging the current residents and will be requesting a license for Residential Only level of care. An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards or law, and violations 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 violations will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 yvonne.randolph@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-250-D
Description:	Based on file review, the facility did not ensure that each staff person or household member required to be evaluated shall annually submit the results of a risk assessment, documenting that the individual is free of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it. Evidence: The files for staff # 1 and # 2 did not have documentation of an annual evaluation for tuberculosis.
Plan of Correction:	Oakland Manor will ensure that each direct care staff will have an annual risk assessment documented in their employee file. Staff 1 and 2 completed annual evaluation for tuberculosis.
Standard #:	22VAC40-73-260-A
Description:	Based on file reviews, the facility did not ensure that each direct care staff member shall maintain current certification in first aid from the American Red Cross, American Heart Association, National Safety Council, American Safety and Health Institute, community college, hospital, volunteer rescue squad, or fire department. Evidence: Current certification in first aid was not documented in the files for staff # 1 and # 2.
Plan of Correction:	Oakland Manor will ensure that all direct care staff are certified in CPR/First Aid. The CEO of the company is certified to train staff in CPR/First Aid. Both employees are certified. However, training was not filed in the employee folder. The CEO will conduct monthly audits to ensure compliance. Employee 1 and 2 are CPR/First Aid certified.
Standard #:	22VAC40-73-580-A
Description:	Based on file review, the facility did not ensure that when any portion of an assisted living facility is subject to inspection by the Virginia Department of Health, the facility shall be in compliance with those regulations, as evidenced by an initial and subsequent annual reports from the Virginia Department of Health. Evidence: An annual health inspection was not provided when requested. The licensee reported thar an annual inspection was not been secured.
Plan of Correction:	Oakland Manor has contacted department of environmental health for inspection. Oakland Manor is waiting for the inspector to call for the inspection.