VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Waltonwood Ashburn
44145 Russell Branch Parkway
Ashburn, VA 20147
(571) 918-4854

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: Aug. 12, 2020 and Aug. 13, 2020

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 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 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. The annual fire inspection is scheduled to take place at the end of August 2020.

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 8/12/2020 and concluded on 8/13/2020. The executive director was contacted by telephone to initiate the inspection. The executive director reported that the current census was 77. The inspector emailed the executive director a list of items required to complete the inspection. The inspector reviewed four resident records, four staff records, fire drill reports, health inspection, fire inspection, dietary and healthcare oversight reports, and staff work schedule submitted by the facility to ensure documentation was complete. Sworn disclosure statements and Virginia Criminal Background checks for all new staff hired since 8/15/2020 were reviewed. An exit interview was held by telephone. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations were documented on the violation notice issues to the facility. 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 standard(s), 2) measures to prevent the non-compliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s). Thank you for your cooperation and if you have any questions please call 703-479-5247 or contact me via email at jamie.eddy@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-260-A
Description:	Based upon a review of records, the facility failed to ensure that each direct care staff member who does not have current certification in first aid as specified in subdivision 1 of this subsection shall receive certification in first aid within 60 days of employment. Staff member #1 was hired on 11/11/2019. As of 8/13/2020 there is no evidence that this staff member has certification in first aid.
Plan of Correction:	Personnel files of all direct care associates were reviewed to ensure that all had appropriate first aid certification. Upon hire, all direct care staff will be auto enrolled in a first aid class no more than 30 days post hire date. All direct care staff will be scheduled to attend a recertification class a month in advance of expiration. Certification compliance will be reconciled monthly. Utilizing the scheduling system, direct care class participants will be scheduled in advance to attend the first aid training. Participation will be mandatory. Any staff members that do not meet this standard will be removed from the schedule until completed. Responsible parties include: Chris Leinauer (Executive Director), Maria Manalo (Resident Care Coordinator), and Audrey Poore (Business Office Manager).