VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Eleanor
7472 Eleanor Drive
5515 Mechanicsville Turnpike
Mechanicsville, VA 23111
(804) 730-2846

Current Inspector: Kimberly Davis (804) 662-7578

Inspection Date: Dec. 9, 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. 22VAC40-80 THE LICENSING PROCESS.

Comments:

An unannounced monitoring inspection was conducted by the licensing inspector on December 9, 2021 from 7:30 a.m.- 11:30 a.m. A census of 5 residents was reported. A sample of four resident records and three staff records were reviewed. A tour of the facility was conducted to include the observance of buildings and grounds, menu/breakfast meal, and emergency food/water supply. Medication pass observation was conducted and Medication Administration Records (MARs)/physician's orders were reviewed. The violations cited are identified in this report. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return it to the licensing office within 10 calendar days. Please specify how the violation will be corrected. The plan must contain: 1) step(s) 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 during this inspection. I can be reached at Kimberly.M.Davis@dss.virginia.gov or (804) 662-7578.

Violations:

Standard #:	22VAC40-73-260-C
Description:	Based on a tour of the facility, the facility failed to ensure that a listing of all staff who have current certification in first aid or CPR was posted in the facility so that the information is readily available to all staff at all times. Evidence: The facility did not have a listing of all staff certified in first aid or CPR posted.
Plan of Correction:	Administrator will update the staff information sheet to make these corrections.
Standard #:	22VAC40-73-750-B
Description:	Based on a tour of the facility, the facility failed to ensure that each resident room contained a chair and a lamp for each resident. Evidence: -Room # 1 did not contain a lamp. -Room # 2 which has two residents did not contain a chair for each resident and contained only 1 lamp. (Photograph evidence was taken of the areas.)
Plan of Correction:	The Administrator will ensure chairs and lamps are placed back in the appropriate designated areas.
Standard #:	22VAC40-73-860-I
Description:	Based on a tour of the facility the facility failed to store cleaning supplies and other hazardous materials in a locked area. Evidence: -Cleaning products or other hazardous were observed in the main resident bathroom that were not in a locked area. -Cleaning products were exposed under the kitchen sink as the cabinet door was missing. (Photograph evidence was taken of these areas.)
Plan of Correction:	Administrator will ensure doors, cabinets, and storage areas will be replaced and fixed appropriately to ensure proper storage of cleaning products. Administrator will ensure cleaning products are stored safely elsewhere until areas of proper storage are repaired. Awaiting materials that have been ordered and maintenance contractor will complete work once materials arrive on their projected date of 12/30/2021.
Standard #:	22VAC40-73-870-A
Description:	Based on a tour of the facility the facility failed to ensure that the interior and exterior was maintained in good repair. Evidence: -The front porch contained multiple areas of chipped paint. -The back deck contained multiple areas of chipped paint and an area of damaged wood. -The wall in the main hallway contained long black marks. -The wall in the dining room contained black marks. (Photograph evidence was taken of the areas).
Plan of Correction:	Maintenance will be completed by contractors who have been hired to repair any areas of disrepair. These repairs are on schedule to be completed.