VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jackson House Assisted Living Corporation
8 Jackson Lane
Boston, VA 22713-1720
(540) 987-8746

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: March 17, 2023

Complaint Related: No

Areas Reviewed:

Personnel Staffing and Supervision Admission, Retention and Discharge of Residents Resident Care and Related Services Resident Accommodations and Related Provisions Building and Grounds Emergency Preparedness

Comments:

Date of Inspection: March 17, 2023 8:30am-12:00pm Type of Inspection: Monitoring inspection If you have any questions or email changes, please do not hesitate to contact me at sarah.pearson@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection or regulation, you can find the information on the internet: www.dss.virginia.gov. Census 4 Number of records reviewed and interviews conducted- 6 records, 2 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The Licensing Inspector and the Administrator discussed the risk assessment ratings for the violations for this inspection. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and returned it to the office. You will need to specify how the deficient practice will be or has been corrected. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). The completed corrective action needs to be in the licensing office by March 27, 2023

Violations:

Standard #:	22VAC40-73-260-A
Description:	Based on staff record review and staff interview, it was determined that direct care staff did not maintain a current first aid certificate. Evidence: Staff A and B's First Aid certificates expired on 2/25/2023.
Plan of Correction:	American Red Cross instructor will retrain staff in CPR and First Aid by April 14, 2023.
Standard #:	22VAC40-73-320-B
Description:	Based on resident record review and staff interview, it was determined that a subsequent tuberculosis risk assessment was not completed an an annual basis. Evidence: Resident B did not have an up to date tuberculosis risk assessment on file.
Plan of Correction:	Tuberculosis risk assessment was completed on day of inspection on 3/17/2023.