RECEIVED JUL 04 2019 ET - BRRJA COMMONWEALTH of VIRGINIA HAROLD W. CLARKE rartmen ie P.0. Box 26069, DIRECTOR Pepartment of Corrections RICHMOND, VIRGINIA 29261 June 20, 2019 (04) 674-2000 Superintendent Timothy Trent Blue Ridge Regional Jail Authority Lynchburg Adult Detention Center 510 Ninth Street Lynchburg, Virginia 24504 Dear Superintendent Trent, Enclosed is a copy of the Compliance Audit Report, which addresses the findings of the Board of Corrections Compliance Audit, conducted at the Lynchburg Adult Detention Center os May 14-16, 2019 and a Plan of Corrective Action Form. On the compliance audit report, under “Audit” is the number of standard{s) found to be non-compliant and a description of what the deficiency involved. On the aitached Plan of Corrective senor form, please indicate the action you propose to taketo resolve the deficiency, the anticipated completion date, and the Person(3) responsible for implemerting the planned corrective action. Please retain a copy for your ies Wilkin ten (10) working days of ressipt ofthis compliance audit report, please submit one (1 }) completed and signed copy of your plan of corrective action to the Virginia Department of Corrections ‘Compliance, Atretitation and Certification Unit. Your proposed corrective action(s) should be accomparied by Sufficient documentation to demonstrate that corrections were made, This information wil be maede to the Board of Corrections for review and consideration, ‘Your cooperation in this matter is greatly appreciated, Certification Analyst Compliance, Accredit Sema © Loews mn and Certification Unit Erma P. Locust Certification Supervisor Compliance, Accreditation and Certification Unit Enclosures tmiffileCERTIFICATION AUDIT REPORT TO THE BOARD OF CORRECTIONS June 19, 2019 Program Audited Audit Date Blue Ridge Regional Jail Authority-Lynchburg ADC May 14-16, 2019 Timothy Trent, Superintendent Major Raymond Espinoza, Site Administrator Audit Cyele June 2016-May 2019 Audit Team Tawana M. Ferguson, Certification Analyst Wayne A. McMillan, Certification Analyst Overview The Blue Ridge Regional Jail Authority's Lynchburg Adult Detention Center serves the counties of Bedford, Campbell, Halifax, Amherst and the city of Lynchburg, Virginia. Tt is administered by a staff of 134. The facility has a rated capacity of 429 and as of the date of the audit, the jail housed 80 female and 359 male inmates. The facility is certified to house juveniles and the superintendent is requesting recertification. Staff Interviews Seven (7) staff were interviewed and all were knowledgeable of their responsibilities and maintained professionalism in appearance and environment. The interviews revealed staff were aware of policies and procedures and had no issues sharing information with the auditors. Staff identified no significant problems within the facility.Inmate Interviews We interviewed 14 male and female inmates from a wide variety of security areas regarding services and interactions with staff. There were several issues of concem raised by the inmates. * Both male and female inmates complained about the grievance procedure in that they were not given grievance forms upon request. They also complained the request and grievance form were not returned within the allotted timeframe. ‘+ Book carts are not offered to inmates on a regular basis. Maintenance issues with showers, leaky faucets, toilets and water fountains throughout the facility, + Female Housing Unit B no lights for approximately 30 days. * Inmates transferring from other BRRJA sites aren’t afforded the two phone calls during the intake process. No board game activities in housing units. ‘+ Telephones in housing units aren’t working properly throughout the facility. Aw Results Out of 128 standards, 119 were audited, nine (9) were non-applicable, and there were four (4) deficiencies cited. Those deficiencies were Life, Health and Safety Standards, LIFE, HEALTH AND SAFETY STANDARDS NON-COMPLIANT LIFE, HEALTH AND SAFETY STANDARDS NON-COMPLIANT 43 4 OTHER STANDARDS 76 (9NIA’s) 0 Identical deficiencies from previous audits None Observations Positives Positive staff morale, Staff and environment appear professional, * Everyone willing to participate and cooperate. Staff appear to have a vested interest in performance of the facility, Staff care about work product and each other. Staff are very supportive and they stated they felt empowered by the superintendent and his administration, + The administrative staff were open and receptive to the audit team’s suggestions regarding jail operations and procedures.Areas of Attention Maintenance * Administration should devise a routine maintenance and sanitation schedule to address repairs and to thoroughly clean the housing units, Housing Unit C— Water fountain out of order. Housing Unit G — One shower out of order. Housing Unit K- Shower clogged/backed up. Housing Unit M - Upper tier shower out of order and heavy dirt and soap scum, Several water leaks from ceilings are in need of repair. Inmate barber equipment is to be sanitized after each use. Also an inventory of the equipment is to be completed. Warehouse * Conduct a perpetual inventory of all chemical spray bottles, Fire Safety Fire evacuation routes should be placed in hallways for easy visibility in case of an emergency. Those routes are to have markings to indicate current location of evacuation, Deficiencies 6VACI5-40-900 LHS SVACI5-40-1050 EHS CHS 6VACI5-40-1140 LHS Documentation failed to support there was a maintenance issue with inoperable lights in Housing Unit B from April 26 to May 14, 2019. There was no record of maintenance requests scheduled or when the repair was completed. During the tour of facility on May 14, 2019, supervisory staff that escorted the audit team were interviewed and verified the deficiency. Documentation failed to support shift supervisory staff recorded unusual incidents on daily supervisor’s inspection log sheets in particular, the lights in Housing Unit B were inoperable, During the tour of the facility on May 14, 2019, the audit team observed several large receptacles throughout the facility catching ‘water leaking from the ceilings. Several showers were covered with heavy soap scum and heavy black dirt at their bases. There several ceiling tiles missing/stained due to the water leakage. There were large buildups of dust on the vents throughout the housing units,6VAC15-40-1160 During the tour of the facility on May 14, 2019, the audit team LHS observed inoperable lights in Housing Unit B. The lights in in the unit’s personal grooming area in particular did not meet, the minimum 20 footcandle requirement. The site administrator submitted a work order request on April 26, 2019. According to the supervisory staff escorting the audit team, the lights in this area had been inoperable for approximately 30 days. ‘The repairs ‘were made on May 15, 2019 after the audit team walk through,PLAN OF ACTION SUBMITTED AND APPROVED B FACILITY/PROGRAM HEAD: SIGNATURE: DATE: REGIONAL DIRECTOR: SIGNATURE: DATE: ASSISTANT DIRECTOR /DESIGNEE: | SIGNATURE: DATE: PERSON RESPONSIBLE PLANNED CORRECTIVE ACTIONS) ANTICIPATED FOR IMPLEMENTATION COMPLETION DATE