VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Giles Adult Day Services
701 Wenonah Avenue
Pearisburg, VA 24134
(540) 921-3024

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Oct. 5, 2020

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.

Technical Assistance:

Please ensure that all information is listed on page 2 of your participant agreement in regards to the address and telephone number of the Regional Licensing Office.

Comments:

This inspection was conducted by licensing staff sing an alternate remote protocol, necessary due tot he state of emergency health pandemic declared by the Governor of Virginia. A mandated monitoring inspection was initiated on 10/1/2020 and concluded on 10/05/2020. The director was contacted by telephone to initiate the inspection. There were six participants present and three staff. The inspector emailed the director a list of items required to complete the inspection. The Inspector reviewed two participant records and two staff records submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance with applicable standards or law and one violation was documented on the violation notice issued to the facility. The Licensing Inspector has reviewed with the director in charge COVID-19 guidance posted on the ADCC webpage. Please develop a plan of correction for the violation cited along with a date of correction and return a signed and dated copy back to the licensing office within 10 days (10/15/2020) of receipt. If you have any questions or concerns please contact your licensing inspector at 276-608-1067. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-61-260-B
Description:	Based on review of documentation, the center failed to ensure that the physical examination on file at the center included all necessary documentation. EVIDENCE: 1. Participant #2 has a physical dated 06/05/2020. On this physical there are allergies to Amoxicillin, Depakote, and Hydroxyzine listed. There are no descriptions of the participant's reactions.
Plan of Correction:	Facility will use physical form from DSS website. Facility documented rxn to allergies, which are balance issues. [sic]