VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Seasoned Adult Day Care LLC
813 W. Nine Mile Road
Highland springs, VA 23075
(804) 651-9254

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: Nov. 6, 2024

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: Mandated Monitoring Dates of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 8/29/24 (attempted) and 11/6/24 10:15 a to 11:30 p 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: 1 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 2 Number of staff records reviewed: 2 Number of interviews conducted with participants: 1 Number of interviews conducted with staff: 1 Observations by licensing inspector: File documentation, postings, outdoor garden, staff/participant interaction Additional Comments/Discussion: An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards or law, and violations 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 will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard ors 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 Yvonne Randolph, Licensing Inspector at (804) 662-7454 or by email at yvonne.randolph@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-110-B
Description:	Based on file reviews, the facility did not ensure that part time staff who work with participants shall receive orientation training no later than six weeks after their starting date of employment. Evidence: Orientation training was not documented in the files of staff # 1 and # 2. A blank orientation form was present in the files (a form that had not been filled).
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-150-A
Description:	Based on file reviews, the facility did not ensure that staff who provide direct care to participants shall attend at least 12 hours of training annually. Evidence: The files for staff # 1 and # 2 had no annual training documented. The documented date of hire for staff # 1 ad # 2 was 2/15/23.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-180-E-2
Description:	Based on file reviews, the facility did not ensure that all staff and volunteers shall be screened annually for the absence of tuberculosis Evidence: An annual tuberculosis screening was not documented in the files for staff # 1 and # 2 .
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-220-E
Description:	Based on file reviews, the facility did not ensure that the assessment shall be reviewed and updated at least every 6 months. Evidence: The assessments for participants # 1 and # 2 was not reviewed and updated at least every 6 months. The last document assessment for the participants is dated 9/22/23.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-230-E
Description:	Based on file reviews, the facility did not ensure that the plan of care shall be reviewed and updated at least every six months. Evidence: The files for participants # 1 and # 2 did not have a documented review of the plans of care.
Plan of Correction:	Not available online. Contact Inspector for more information.