VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Cobbdale Assisted Living (Fairfax Co)
3503 Burrows Avenue
Fairfax, VA 22030
(571) 414-1850

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: Jan. 20, 2021 and Jan. 21, 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 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 32.1 Reported by persons other than physicians 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. 22VAC40-80 THE LICENSING PROCESS.

Technical Assistance:

A completed Renewal Application must be submitted prior to the expiration of the current license. The facility should receive an application in the mail, however if an application has not been received one can be obtained from the DSS web site or by calling the main office at 703-934-1505.

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 1/20/2021 and concluded on 1/21/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was six. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed two resident records, two staff records, staff work schedule, annual fire and health inspection, fire drill reports, and healthcare and dietary oversight reports submitted by the facility to ensure documentation was complete. Criminal Background Checks for staff hired since the last inspection conducted on 2/4/2020 were reviewed. Information gathered during the inspection determined no violations with applicable standards or law. No violations were issued. The exit interview was held via telephone with the administrator on 1/21/2021.