VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Memory Lane Assisted Living
123 Lakeview Drive
Woodstock, VA 22664
(540) 459-3738

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: May 3, 2021 and May 7, 2021

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 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 63.2 Protection of adults and reporting. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

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 renewal inspection was initiated on 05/03/2021 and concluded on 05/07/2021. The administrator was contacted by email to initiate the inspection. The administrator reported that the current census was 15. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed 2 resident records plus additional 3 medication records, 2 new staff records and 1 additional background check for a staff hired since the last inspection, documentation related to the fire inspection which is to be completed the week of May 7 and a letter from VDH regarding the health inspection. Additionally health care over site, emergency drills, pharmacy review, dietary oversight, staff schedules and additional training and certification records for staff as well as training related to the facilities Covid 19 policies and procedures was reviewed. The facility has had no complaints during this licensure period. The information gathered during the inspection determined no violations and applicable standards or law. No violations were issued. Thank you to the staff for your assistance and cooperation during this remote inspection process. Should there be additional questions or concerns please call (540)332-2330 or e-mail this inspector at sharon.deboever@dss.virginia.gov.