VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Generations at Haysi
190 Medical Center Blvd
Haysi, VA 24256
(276) 865-4638

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Dec. 28, 2023

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 GROUND ? 22VAC40-61 EMERGENCY PREPAREDNESS

Comments:

Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 12/28/2023 Begin: 11:20am End: 1:30pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of participants present at the facility at the beginning of the inspection: 6 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed:3 Number of staff records reviewed:3 Number of interviews conducted with participants:1 Number of interviews conducted with staff: 3 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. 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 Crystal B. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-180-E
Description:	1. Staff #2?s date of hire was 03/25/2013. There was not a current annual evaluation for tuberculosis included in Staff #2?s file. The last tuberculosis evaluation was dated 07/01/2022.
Plan of Correction:	12/28/23, performed a TB screening for on employee this date to be compliant with regulation. [sic]
Standard #:	22VAC40-61-250-B
Description:	1. Participant #3 started care at the center on 07/01/2023. On the date of the inspection, 12/28/2023, this participant?s file did not contain a current photograph or narrative physical description of the participant
Plan of Correction:	Will be corrected next date participant attends ADC. [sic]