VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Avalon House on Gerard Court
6442 Gerard Court
Falls church, VA 22043
(301) 656-8823

Current Inspector: Marshall Massenberg (804) 543-5188

Inspection Date: Dec. 15, 2021 and Dec. 16, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 32.1 Reported by persons other than physicians 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE.

Comments:

An unannounced mandated monitoring study began on 12/15/2021 and concluded on 12/16/2021. At the time of entrance eight residents were in care. The sample size consisted of four resident records, three staff records, and one individual interview. Resident and staff records and other documentation were reviewed. Residents were observed eating lunch and engaging in bingo. Medication administration was observed. Violation notice issued, risk ratings reviewed and exit interview held. Areas of non-compliance are identified on the violation notice. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return to the licensing office within 10 calendar days. Please specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. The plan of correction must contain: 1) steps to correct the non-compliance with the standard(s), 2) measures to prevent the non-compliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s). Thank you for your cooperation and if you have any questions please call 703-479-5247 or contact me via e-mail at jamie.eddy@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-925-A
Description:	Based upon observation and interview, the facility failed to ensure there was an adequate supply of toilet tissue and soap. Toilet tissue shall be accessible to each commode and soap shall be accessible to each face/hand washing sink and each bathtub or shower. Evidence: Upon inspection of the building, LI observed that soap was not available for hand washing in the first floor bathroom. Staff did produce soap from a locked closet next to the bathroom and placed the soap on the sink in the bathroom.
Plan of Correction:	The toilet tissue and soap had been stored in a closet next to the bathroom in the hallway. Toilet tissue and soap have been placed in he bathroom. Manager and Administrator will do spot checks to ensure both the soap and the toilet tissue is placed in the bathroom and available to residents when the supply runs low or out rather than being store in the hall closet next to the bathroom.