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: Dec. 7, 2023

Complaint Related: No

Areas Reviewed:

Administration and Administrative Services 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 Background Checks for Assisted Living Facilities Sworn Statement

Comments:

Date of Inspection: December 7, 2023 Type of Inspection: Monitoring inspection Census: 5 Number of records reviewed and interviews conducted- 6 records, 3 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The LI observed residents participating in independent activity programs and eating lunch. Licensing Inspector compared physician orders for medications to the medications available to be administered to the residents. 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. 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 records review and staff interview, it was determined that the facility failed to, within 30 days preceding admission, have a physical examination by an independent physician. Evidence: Resident A did not have a physical examination on file. Resident A was admitted on 11/29/2023.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-660-A
Description:	Based on direct observation and staff interview, it was determined that the facility failed to lock a Schedule II drug under a separate locked storage compartment. Evidence: Resident B?s prescribed Schedule II drug was inside an unlocked refrigerator in the kitchen.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-710-B
Description:	Based on direct observation, resident records review and staff interview, it was determined that the facility failed to have a physician?s written order or written consent from the resident?s legal representative prior to using a physical restraint (bedrail). Evidence: Resident B was in bed with a bedrail in the up position while resident was in bed. Resident B did not have a written order for the physical restraint, nor was there written consent from the resident?s legal representative to use the physical restraint.
Plan of Correction:	Not available online. Contact Inspector for more information.