VIRGINIA DEPARTMENT OF SOCIAL SERVICES

JABA Adult Care Center-Louisa
522 Industrial Drive
Louisa, VA 23093
(540) 967-4432

Current Inspector: Belinda Dyson (804) 662-9780

Inspection Date: July 15, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-61 GENERAL PROVISIONS 22VAC40-61 ADMINISTRATION 22VAC40-61 PERSONNEL 22VAC40-61 SUPERVISION 22VAC40-61 ADMISSION, RETENTION, AND DISCHARGE 22VAC40-61 PROGRAMS AND SERVICES 22VAC40-61 BUILDINGS AND GROUNDS 22VAC40-61 EMERGENCY PREPAREDNESS 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 SANCTIONS. 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2(19.2) Criminal Procedures. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Comments:

A renewal inspection was initiated on July 15, 2021, and concluded on July 21, 2021. The Director was contacted by telephone to initiate the inspection. The Director reported that the current census was (8). The inspector emailed the Director a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed (2) resident records, (2) staff records, activities calendar,building tour, participant service plans,staff training records, staff schedules, and MARS submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 07/21/2021. An exit interview was conducted with the Director on July 21, 2021,where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-61-300-E-2
Description:	VIOLATION: Based upon the July 21, 2021, hybrid inspection the center failed to have all medications labled with each participant's, name of the medication, dosage, the frequency of administration. EVIDENCE: The center failed to have the identified medications labled with each participant?s name, a defined strength/dosage , and the frequency of administration of the following medications: 1) One 355 ML bottle of CVS Magnesium Hydroxide bottle, one CVS 2mg 12 caplets of Loperamide Hydrochloride, and one bottle of Tylenol. The staff confirmed that the tidentified medication was for general use .
Plan of Correction:	Not available online. Contact Inspector for more information.