VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Whispering Pines Assisted Living Facility
200 Leaksville Road
Luray, VA 22835
(540) 743-2273

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: Oct. 25, 2021

Complaint Related: No

Areas Reviewed:

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 EMERGENCY PREPAREDNESS 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

Comments:

A monitoring inspection was initiated on 10/25/2021 and concluded on 11/04/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 19. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed 2 resident records, 2 staff records, fire drills, fire drills and criminal history reports submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance with applicable standards or law, and a violation was documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-450-C
Description:	Based on record review, the facility failed to ensure that Individual Service Plans (ISPs) included all required components. EVIDENCE: 1. Nursing note for resident 1, dated 09/29/2021 indicates use of a Geri Chair; however, this is not addressed on the ISP. 2. The ISP for resident 2, dated 08/12/2021 indicates resident is disoriented to place and time, but does not include a written description of the services to be provided to address this need. 2. The ISP for
Plan of Correction:	All resident ISPs will be audited to ensure completeness and all required components are included.