VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Vienna Manor II, LLC
1914 Horseshoe Drive
Vienna, VA 22182
(703) 403-7583

Current Inspector: Alexandra Roberts

Inspection Date: Oct. 15, 2019

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 ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 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.

Comments:

An unannounced renewal inspection was conducted on 10/15/19. At the time of entrance, eight residents were in care. Meals, medication administration, an an activity were observed. Building and grounds were inspected. Records were reviewed. The sample size consisted of four resident records and three staff records. The violation was discussed and an exit meeting was held. Areas of non-compliance are identified on the violation notice. Please complete the 'plan of correction' and 'date to be corrected' for each violation cited on the violation notice and return to the licensing office within 10 calendar days. Please specify how the deficient practice will be or has been corrected. Just writing the word 'corrected' is not acceptable. The 'plan of correction' must contain: 1) Steps to correct the non-compliance with the standards, 2) Measures to prevent the non-compliance from occurring again, and 3) Person responsible for implementing each step and/or monitoring any preventative measures. Thank you for your cooperation and if you have any questions, please contact me via e-mail at m.massenberg@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-680-D
Description:	Based on observation and interview, the facility failed to ensure that medications are administered in accordance with the physician's instructions and consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing. Evidence: Facility staff reported that Resident #2 was administered her morning medication, before the licensing inspector's arrival. No medications were observed being administered to Resident #2 at breakfast. The order for Resident #2's Naproxen, dated 4/4/18, states that the resident shall have one tablet a day in the morning with food. Facility staff confirmed that food was not given with Resident #2's Naproxen.
Plan of Correction:	Resident # 2 normally eat her breakfast at 7:30am , then take Naproxen after her breakfast. On 10/15/2019 Resident # 2 refused her breakfast at 7:30am. Administrator immediately counselled the MT about giving Naproxen with foods as ordered by her Physician. Administrator will provide additional training on all MT about specific meds that needs to be administered with foods as ordered by their Physician.