VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Viva Memory Care at Chesapeake
130 Great Bridge Blvd.
Chesapeake, VA 23320
(757) 436-2109

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: June 13, 2023

Complaint Related: No

Areas Reviewed:

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 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: An unannounced monitoring inspection took place on 06/13/2023 at 8:43 am to 10:50 am. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self-reported incident was received by VDSS Division of Licensing on 05/03/2023 and 05/05/2023 regarding allegations in the area(s) of: Resident Care and Related Services Number of residents present at the facility at the beginning of the inspection: 56 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: An observation of residents was completed. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the self- report of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the self-report but identified during the course of the investigation can also be found on the violation notice. 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 (Donesia Peoples), Licensing Inspector at (757) 353-0430 or by email at donesia.peoples@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-460-A
Description:	Based on staff interview and record review the facility failed to assume general responsibility for the health, safety, and well-being of the residents. Evidence: 1. The record for resident #1 contains an incident report dated 05/03/2023 that documents ?private duty sitter failed to provide assistance to resident when sitting on the ground.? 2. Staff # 3 reported during an interview with this inspector to have observed the following: resident #1 sliding down to the ground and reach for assistance from staff #1, however staff #1 did not provide assistance to the resident. 3. The record for resident #1 contains an incident report dated 05/04/2023 that documents ?resident?s private duty sitter was observed pushing resident back into a chair and restricting her from walking around freely.? 4. Staff # 3 reported during an interview with this inspector to have observed the following: staff #2 pushed resident #1 down into the chair when the resident was attempting to stand up from out of the chair.
Plan of Correction:	Staff 1 and Staff 2 were both removed from caring for Resident #1 By 7/31/2023, the Executive Director/designee will provide training to current community staff and private duty staff, currently providing services at the community, on Resident Rights and Abuse and Neglect. BOM/designee will provide orientation to private duty staff prior to start of care to include, but not limited to, Resident Rights and Abuse and Neglect; private duty companies and families will be made aware of this needed orientation as warranted. The Executive Director/designee requests plan of care, from agency, prior to start of care to assure resident?s needs are being appropriately met. The Executive Director/designee will complete a review of private duty staff records at least quarterly to assure compliance with training requirements.