VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Studley
7436 Studley Road
Mechanicsville, VA 23116
(804) 779-4847

Current Inspector: Kimberly Davis (804) 662-7578

Inspection Date: March 3, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 3-3-23 from 10:00 a.m.- 11:00 a.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 7 Number of interviews conducted with staff: 1 Additional Comments/Discussion: An unannounced monitoring inspection was conducted by licensing staff to follow up on previously cited high risk violations. An exit meeting was conducted to review the inspection findings. 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. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Kimberly Davis, Licensing Inspector at (804) 662-7578 or by email at Kimberly.M.Davis@dss.virginia.gov Violation Notice Issued: Yes A copy of this document will be sent to the licensee/provider for signature.

Violations:

Standard #:	22VAC40-73-1040-A
Description:	Based on observation the facility failed to ensure that doors leading to the outside shall have a system of security monitoring of residents with serious cognitive impairments, such as door alarms, cameras, constant staff oversight, security bracelets that are part of an alarm system, or delayed egress mechanisms. Evidence: -The facility?s census includes residents with serious cognitive impairment. -The side door was locked from the inside with a deadbolt lock which is a safety concern in the event of a fire. Staff # 1 attempted several times to unlock the door before finding the correct key. Upon unlocking the door, Staff # 1 opened the door and determined that the door alarm was not working as the base of the alarm was on the door, but the door alarm itself had been removed. -The licensing inspector opened the front door which contained an alarm, but upon opening the door, the alarm did not sound. Staff # 1 confirmed that the front door alarm was not working.
Plan of Correction:	Door alarms will be replaced in a timely manner and new batteries will be provided to keep as back up. New alarms ordered on 3-3-23.
Standard #:	22VAC40-73-870-A
Description:	Based on observation the facility failed to ensure that the exterior of the building was maintained in good repair. Evidence: The doorbell at the side door entrance was detached and did not work. Photographic evidence was taken.
Plan of Correction:	Doorbell will be fixed in a timely manner, new doorbell ordered on 3-3-23.