VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Pentecostal Children's Home DBA Appalachian Foster Care Alliance
308 Coeburn Ave SW
Norton, VA 24273
(276) 437-0170

Current Inspector: Jamie Morgan (276) 525-5656

Inspection Date: April 5, 2023 , April 6, 2023 and April 13, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-131 ORGANIZATION AND ADMINISTRATION 22VAC40-131 PROVIDER HOMES 22VAC40-131 CHILDREN?S SERVICES 22VAC40-191 BACKGROUND CHECKS FOR CHILD WELFARE AGENCIES

Technical Assistance:

22VAC40-131-340.E.b.3 criteria for achievement was discussed

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: 4/5/2023 from 9:40 a.m. to 12:15 a.m. On 4/5/2023 the agency?s automated record keeping system, Extended Reach, experienced a nationwide outage and the inspection could not continue. An Acknowledgement of Inspection form was signed and left at the facility on 4/5/2023. The inspection resumed remotely on 4/6/2023 at 10:45 a.m. A preliminary findings review was conducted by Teams Meet on 4/13/2023 and inspection documents were provided. An exit interview was also conducted on 4/13/2023 by Teams Meet. Number of children in care: 14 Number of approved provider homes: 6 The licensing inspector completed a tour of the physical plant that included the office setting and conditions. Number of children?s records reviewed: 2 Number of provider home records reviewed: 2 Number of staff records reviewed: 0 (No new staff hired) 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 Dawn Caldwell, Licensing Inspector at 804-385-6864 or by email at dawn.caldwell@dss.virginia.gov

Violations:

Standard #:	22VAC40-131-260-B
Description:	Violation: Based on record reviews and interview, the agency failed to address required elements in the Social History for Foster Child 2 (FC2). Findings: 1) The Social History for FC2 did not address the education and occupation of the child?s aunts, uncles, and grandparents. 2) The Social History for FC2 did not address the medical and psychiatric history of the child's aunts, uncles, and grandparents as it relates to the suitability of the child for placement. 3) The findings were discussed during the preliminary findings review. 4) Staff 1 (S1) reviewed FC2?s Social History and acknowledged the findings. 5) The findings were reviewed during the exit interview and Staff 1 (S1) acknowledged the findings.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-131-340-E-4
Description:	Violation: Based on record review, the agency failed to include target dates for each goal and objective in the service plans for Foster Child 1 and 2 (FC1 and FC2). Findings: 1) Service Plans for FC1 and FC2 did not indicate target dates for each goal and objective. 2) The findings were reviewed during the preliminary findings review. 3) Staff 1 (S1) reviewed the service plans for FC1 and FC2 and acknowledged the findings. 4) The findings were reviewed during the exit interview and Staff 1 (S1) acknowledged the findings.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-131-350-B-10
Description:	Violation: Based on record review, the agency failed to address required elements in the Quarterly Progress Review for Foster Child 1 (FC1). Findings: 1) A Quarterly Progress Review report for the period 12/1/2022 to 3/1/2023 did not address the child?s assessment of his own progress. 2) Goals identified in the service plan for FC1 included the following: a. ?Discuss ongoing concerns and issues related to foster and biological parents during counseling.? b. Learn 2 positive anger management skills. c. Listen and follow directions from the teacher. 3) The Quarterly Progress Review report included a field for the child?s assessment of his own progress which was answered as follows: ? [child] is 3 years old and has difficulty understanding why she is in foster care?? 4) The findings were discussed during the preliminary findings review. 5) Staff 1 (S1) reviewed the Quarterly Progress Review report and acknowledged the findings. 6) The findings were reviewed during the exit interview and Staff 1 (S1) acknowledged the findings.
Plan of Correction:	Not available online. Contact Inspector for more information.