VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Arden Courts (Annandale)
7104 Braddock Road
Annandale, VA 22003
(703) 256-0882

Current Inspector: Jacquelyn Kabiri (703) 397-3017

Inspection Date: June 7, 2023

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 ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS 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

Technical Assistance:

Documentation was discussed with the provider.

Comments:

An unannounced monitoring inspection was conducted on 6/7/23. At the time of entrance, 58 residents were in care. Meals, medication administration, and activities were observed. Building and grounds were inspected. Records were reviewed. The sample size consisted of eight resident records and four staff records. Violations were discussed and an exit meeting was held. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Marshall Massenberg, Licensing Inspector at (703) 431-4247 or by email at m.massenberg@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-250-D
Description:	Based on documentation, the facility failed to ensure that each staff person submits the results of a tuberculosis risk assessment, on or within seven days prior to the first day of work at the facility. The risk assessment shall be no older than 30 days. Evidence: Staff #4's record was reviewed during the inspection. Staff #4's record contained documentation that indicated that the staff member started to work at the facility on 7/29/22. The earliest tuberculosis risk assessment, included in Staff #4's record, was dated 8/15/22.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-450-H
Description:	Based on observation and record review, the facility failed to ensure that care and services specified in the individualized service plan (ISP) are provided to each resident. Evidence: Resident #2's ISP, dated 2/8/23, states that she requires staff assistance with eating. The ISP also states that Resident #2 has a seizure disorder that requires staff to monitor her for signs and symptoms of seizures. After breakfast was brought to Resident #2; Resident #1 was observed feeding Resident #2, instead of facility staff.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-620-A
Description:	Based on documentation, the facility failed to ensure that oversight of special diets is conducted every six months, by a dietitian or nutritionist. Evidence: The last documented dietitian report was dated 2/3/22. The last dietary oversight was more than six months old, at the time of the inspection.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-860-I
Description:	Based on observation and documentation, the facility failed to ensure that cleaning supplies and hazardous materials are kept in a locked area. Evidence: Desenex foot prescription strength foot powder was observed to be unlocked and unattended in the bathroom of Resident #8. Resident #8's record contained an Assessment of Serious Cognitive Impairment form, dated 3/29/23, that states that he has a serious cognitive impairment with an inability to recognize danger or protect his safety and welfare. Antibacterial denture cleaning tablets were observed to be unlocked and unattended in the bedroom of Resident #9. Resident #9's record contained an Assessment of Serious Cognitive Impairment form, dated 6/3/23, that states that she has a serious cognitive impairment with an inability to recognize danger or protect her safety and welfare.
Plan of Correction:	Not available online. Contact Inspector for more information.