VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Dijon
6171 Dijon Drive
Mechanicsville, VA 23116
(804) 803-0038

Current Inspector: Coy Stevenson (804) 972-4700

Inspection Date: Nov. 16, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A monitoring inspection was initiated on 11/16/2020 and concluded on 11/17/2020. The administrator was contacted by email/telephone to initiate the inspection. The facility reported that the current census is four (4) residents. The inspector emailed the person in charge a list of items required to complete the inspection. The inspector reviewed two (2) resident records, two (2) staff records, medication administration records, physician orders, fire inspection report, health care oversight, staff schedules, etc submitted by the facility to determine compliance. Information gathered during the inspection determined non-compliance with applicable standards or law, and a violations is documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-680-D
Description:	Based on a review of October 2020 and November 2020 medication administration records (MARs),medications were not administered in accordance with the physician's orders/instructions. Evidence: . 1. The physician's order for clonidine 0.1mg states "give clonidine 1mg tablet if SBP is >160 (see as needed order to document giving clonidine)". Note: SBP is the systolic blood pressure reading. 2. The as needed order states "Clonidine 0.1mg, 1 tablet by mouth every 8 hours as needed for SBP >=180". 3. The MARs reviews documented the SBP a.m. reading as 192 on 10/15/20 and as 192 on 11/2/20. 4. The administration of as needed clonidine is not documented on the MARs on 10/15/20 or 11/2/20 in accordance with the physician's order.
Plan of Correction:	I followed up and found that the readings are in compliance. In the future, staff will ensure that the MARs reflect accurate and legible readings.