VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Mountain Empire Older Citizens, Incorporated
1508 Third Avenue Easr
Big stone gap, VA 24219
(276) 523-0599

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: Nov. 17, 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 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation

Comments:

One licensing inspector conducted a one day unannounced monitoring inspection at Mountain Empire Adult Daycare. The inspections started at 10:50 am and concluded at 1:55 pm. During the inspection mid-day meals were observed, participants arrivals and health care needs checked, activities observed, first aid kit checked, building observed, participants observed, participants and staff interactions were observed, participants and staff records were reviewed. The center currently has 94 participants enrolled at the Center of which 0 ADC participants were in attendance and 17 PACE participants were present the day of the inspection. The center has 12 non-ambulatory participants, 0 MH/MR participants, 3 who use oxygen, 4 who have cognitive impairments and 2 with aggressive behaviors. An exit meeting was held with the director. One violation is being cited as a result of this inspection. Please develop a plan of correction for each of the cited violations along with a date of correction and return a signed copy and dated copy back to the licensing office within 10 calendar days (11/29/2021) of receipt. If you have any questions or concerns please contact your inspector at 276-608-3514. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-61-410-E
Description:	Based on observations made during the tour of the building, the facility failed to ensure cleaning products and harmful materials were stored in a locked place when not in use. EVIDENCE: 1. Bathrooms #135 and #128 had a 150 count of Clorox HealthCare Bleach Germicidal cleaner wipes stored in the cabinet above the toilet. These cabinets were found to be unlocked and unattended during the inspection.
Plan of Correction:	: On November 17th, it was discovered during VDSS inspection that Bathrooms #135 and #128 had a #150 count of Clorox Healthcare Bleach Germicidal cleaner wipes stored in the cabinet above the toilet. These cabinets were found to be unlocked and unattended during this inspection. Improvement Plan: Reeducation with ADC Staff. We have created a new tool as a checks and balance check-off list for the bathrooms requiring staff to document in the appropriate boxes that the Clorox Wipes are closed and stored in a locked cabinet before exiting the bathroom. We plan to monitor our staff by using the new assessment tool as a checks and balance to ensure all cleaning products and harmful material are in a closed container and are stored in a locked cabinet. We plan to monitor this process for the next 90-days. [sic]