VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Premier Residential and Assisted Living
904 George Washington Hwy North
Chesapeake, VA 23323
(757) 410-2754

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: June 20, 2024

Complaint Related: Yes

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 22VAC40-80 COMPLAINT INVESTIGATION

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: An unannounced complaint inspection took place on 6/20/24 at 8:17 am to 10:57 am. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A (complaint) was received by VDSS Division of Licensing on 05/22/2024 regarding allegations in the area(s) of: Personnel and Resident care and Related Services Number of residents present at the facility at the beginning of the inspection: 22 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: 6 Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 3 Observations by licensing inspector: An observation of Residents in the common area was completed and a review of the staffing schedule was completed. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the (allegations) of non-compliance with standard(s) or law. However, violations not related to the complaint but identified during the course of the investigation can 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. 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 #:	22VAC40-73-210-B
Complaint related:	No
Description:	Based on the onsite record review the facility failed to ensure in a facility licensed for both residential and assisted living care, all direct care staff shall attend at least 18 hours of training annually. Evidence: 1. The record for staff #1, hire date 03/02/23, did not include documentation of 18 hours of annual training. 2. Staff #1?s record contains documentation of only 3.35 hours of training completed since 03/02/23. 3. Staff #6 acknowledged the record for staff #1 did not contain documentation of a completion of 18 hours of annual training.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-250-D
Complaint related:	No
Description:	Based on the onsite interview, it was determined that the facility failed to ensure health information required by these standards shall be maintained at the facility and shall be included in the staff record for each staff person. Evidence: 1. The record for staff #1, hire date 03/02/23, contains a risk assessment for tuberculosis (TB) dated 03/02/23. The record does not contain an annual risk assessment for TB completed after 03/02/23. 2. Staff # 6 acknowledged the record for staff #1 did not contain an annual risk assessment for TB.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-260-A
Complaint related:	No
Description:	Based on the record review and staff interview it was determined that the facility failed to ensure each direct care staff member shall maintain current certification in first aid. Evidence: 1. The record for staff # 1, hire date 03/02/23, does not contain a current certification in first aid. The record contains a certification in first aid that expired on 04/12/24. 2. The record for staff # 2, hire date 8/21/23, did not contain documentation of a certification in first aid. 3. The record for staff # 3, hire date 8/05/23, did not contain documentation of a certification in first aid. 4. Staff #6 acknowledged the records for staff #1, staff #2, and staff #3 did not contain a current certification in first aid.
Plan of Correction:	Not available online. Contact Inspector for more information.