VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Living Waters Senior Care
379 North Main Street
Timberville, VA 22853
(404) 520-4841

Current Inspector: Jill James (540) 418-2631

Inspection Date: Feb. 18, 2020

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 BUILDING AND GROUNDS

Technical Assistance:

Recommend total body skin assessments be done prior to or upon admission. If the individual refuses then the admission is put "on hold" until can be completed. It is obvious from the most recent incident that the paperwork received from the physician is not always complete or accurate in that regard. There was no indication of the physical condition of the individual's extremities. There was, however, a long history of resistance to care, especially was it related to removing shoes and other clothing. This individual is not eligible for return to the facility. This was discussed at length with the administrator.

Comments:

A complaint was received in the licensing office on 2/13/ 2020 and a followup unannounced inspection was conducted on 2/18/20. A review of staff files found no evidence of multiple cases of contact dermatitis. One case was identified for a staff person no longer in employ with no details regarding source. Bed identified in the complaint had been replaced with both new beds and mattresses. This process needs to continue throughout the facility. The administrator had paperwork indicating a new cover had been ordered and kitchen staff new that all food being transported to back area was to be covered with aluminium foil for transport to that area. A moldy window unit had been removed but there was no indication that any resident had recently been treated for e-coli as a result of that air conditioner. Validity was identified as it related to concerns about carpeting, snacks and the need for exterminator services. Details can be found in the violation portion of this report. Thank you to everyone for your cooperation during this complaint inspection process. If you have additional questions or concerns please call (540)332-2330 or e-mail this inspector at sharon.deboever@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-100-A
Complaint related:	Yes
Description:	Facility staff acknowledged that there had been a problem with mice in the facility and that the exterminator had made a visit. Upon review of the receipt from the exterminator dated 2/6/20 he only reviewed facility for roaches not mice. The report does note that no roaches were identified.
Plan of Correction:	The administrator has contacted the exterminator and ask that they return and review the facility for mice and assist in ridding the building of the problem. The administrator will forward a copy of that review to the licensing office upon completion. The administrator assumes responsibility for correction and future compliance.
Standard #:	22VAC40-73-590-B
Complaint related:	Yes
Description:	Based on a discussion with staff, residents and the administrator snacks were not currently available to residents at all times. Scheduled snacks were observed. Their correction plan was discussed.
Plan of Correction:	Snacks will be maintained in a refrigerator and cabinet in the back area for staff to access when requested by residents outside of scheduled snack times. Staff in memory care would then not have to exit the area and other staff have access as needed. The administrator in conjunction with the owner will be responsible for correction and future compliance.
Standard #:	22VAC40-73-870-A
Complaint related:	Yes
Description:	Based on a walk through of the facility carpeting was identified in need of replacement. It was black and in some areas torn. The administrator explained that they are replacing carpeting 2 to 3 rooms per month and that the rooms I reviewed for the priority for the next replacement. Consideration needs to be given to enhancing the replacement schedule based on this observation. There was no odor in the room identified on the report.
Plan of Correction:	The administrator will discuss with the owner making adjustments in the replacement schedule to more quickly upgrade the flooring in the individual bedrooms. To cut down on potential odor all staff will be reminded to remove any disposable underwear immediately upon changing and not leave them in the trash cans in any area. The administrator and owner assume responsibility for correction and future compliance. A carpet replacement schedule will be forwarded to the licensing office.
Standard #:	22VAC40-73-870-D
Complaint related:	Yes
Description:	Interviews indicated there was an issue with mice in the facility but the exterminator had come to the facility. A review of the receipt from the exterminator dated 2/6/20 indicated he had examined the facility for roaches but not mice. It did note that no roaches were found in the facility. This inspector did not visually observe any mouse droppings or see mice during this inspection.
Plan of Correction:	The administrator has contacted the exterminator and ask that they return and review the facility for mice and assist in ridding the building of the problem. The administrator will forward a copy of that review to the licensing office upon completion. The administrator assumes responsibility for correction and future compliance