VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Green Valley Manor
1011 Pennsylvania Avenue
Winchester, VA 22601
(540) 450-5642

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: Sept. 30, 2021 and Nov. 24, 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 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

Technical Assistance:

The facility staff could benefit from additional training or refresher training as it relates to: 1. Developing behavior management plans; 2. Monitoring sliding scale insulin; 3. Timely incident reporting, especially to APS and case management services.

Comments:

A renewal inspection was initiated on 9/30/2021 and concluded on 11/24/2021. The administrator was contacted by email to initiate the inspection. The administrator reported that the current census was 36. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed 3 resident records and MARs for 3 residents, 3 staff records including serv-safe certificates for 2 staff and background checks for an additional 3 new staff, outside inspections, activity schedules and menus, DAP contracts submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 11/24/2021 remotely to potential Covid exposures. That is also what caused the time delay between start to finish of inspection. An exit interview was conducted with the Administrator on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. The information gathered during the inspection determined no violations with applicable standards or law. No violations were issued.