VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Evergreen Adult Day Healthcare Center
4115 Annadale Road
Suite 207
Annandale, VA 22003
(703) 534-5049

Current Inspector: Alexandra Roberts (804) 845-6956

Inspection Date: Oct. 4, 2022

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:

Licensing Inspector (LI) conducted an announced initial inspection on 10/4/2022. LI walked the physical plant, verified window and room measurements, reviewed policies and procedures, first aid kit and staff records. All inspections have been completed. No violations cited today and exit interview held. 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 Lynette Storr, Licensing Inspector at (703) 479-4708 or by email at Lyn lynette.storr@dss.virginia.gov