VIRGINIA DEPARTMENT OF SOCIAL SERVICES

International Rejuvenation Center
221 West Main Street
Marion, VA 24354
(276) 782-1819

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Oct. 8, 2024

Complaint Related: Yes

Areas Reviewed:

STAFFING AND SUPERVISION BUILDINGS AND GROUND

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/08/2024 Begin: 10:15am End: 11:17am The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection A complaint was received by VDSS Division of Licensing on 10/02/2024 regarding allegations in the area(s) of: resident supervision and physical plant. Number of residents present at the facility at the beginning of the inspection: did not gather The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed: 0 Number of interviews conducted with residents:1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the allegation(s) of non-compliance with standard(s) or law. However, violation(s) not related to the complaint(s) but identified during the course of the investigation can be found on the violation notice. 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 #:	22VAC40-73-870-E
Complaint related:	No
Description:	Based on observations made during the tour of the facility, the facility failed to keep all furnishings, fixtures, and equipment including sinks, toilets, bathtubs, and showers clean and I n good repair and condition. EVIDENCE: 1. The common bathroom located beside Room #101 was found to have a shower curtain which was stained black at the bottom area, believed to be from soap scum and mildew and lack of cleaning. 2. The shower in this same bathroom was found to have black specs and what appeared to be a mold/mildew substance believed to be from lack of cleaning visible on the bottom 6 inches of the shower surround.
Plan of Correction:	Cleaned and will monitor regularly. Totally cleaned and paned with required paint. [sic]
Standard #:	22VAC40-73-925-A
Complaint related:	No
Description:	Based on observation of facility, the facility failed to have an adequate supply of toilet tissue accessible at each commode. EVIDENCE: 1. The common bathroom beside Room #101 did not have any toilet tissue available.
Plan of Correction:	Placed supplies will monitor regularly. [sic]