VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Golden Years and More
13114 Canova Drive
Manassas, VA 20112-7840
(703) 407-9492

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: March 11, 2022

Complaint Related: No

Areas Reviewed:

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

Comments:

Date of Inspection: March 11, 2022 Type of Inspection: Monitoring Inspection If you have any questions or email changes, please do not hesitate to contact me at laura.lunceford@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- 2 resident records and 2 staff records, 4 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The healthcare over sight report, dietician report, fire drill, activity schedule and menus were reviewed at the time of inspection. 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).

Violations:

Standard #:	22VAC40-73-320-A
Description:	Based on resident record review and staff interview, it was determined that the facility failed to have admitting documentation as required. Evidence: Resident A had no documentation of a physical prior to admission as well as no initial tuberculosis risk assessment as required.
Plan of Correction:	All new admissions will have the paperwork filled out as required. All admitting paperwork will be timely and will be reviewed by the facility nursing staff prior to admission.
Standard #:	22VAC40-73-320-B
Description:	Based on resident record review and staff interview, it was determined that the facility failed to have documentation of a subsequent tuberculosis evaluation as required. Evidence: Resident B had no socumentation of an annual risk assessment for tuberculosis as required.
Plan of Correction:	All residents in care will have annual tuberculosis risk assessments as required. Facility nursing staff will audit the records and ensure compliance.
Standard #:	22VAC40-73-940-A
Description:	Based on facility document review and staff interview. it was determined that the facility failed to have a current fire inspection as required. Evidence: The last fire inspection documentation was 2019. There was no current fire inspection documentation.
Plan of Correction:	The fire marshal will be contacted to schedule an inspection to ensure complaince.