VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Heritage Village Assisted Living and Memory Care
13650 Heathcote Boulevard
Gainesville, VA 20155
(703) 468-1895

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: March 19, 2021 and March 23, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

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 complaint inspection was initiated on March 19, 2021 and concluded on March 24, 2021. A complaint was received by the department regarding allegations in the areas of staffing and resident care. The administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation supported the allegation of a non-compliance with standards or law, and violations were issued. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-290-A
Complaint related:	No
Description:	Based on review of the staff schedule and interviews as part of the complaint inspection, it was determined the facility did not maintain a written work schedule that includeed the names and job classifications of all staff working each shift. Not all absences, substitutions, or other changes were noted on the schedule. Evidence: The facility submitted a staff schedule for February 28, 2021 through March 27, 2021. The schedule demonstrated multiple days where the minimum staffing was not scheduled. Administration demonstrated where they had filled multiple open staffing slots, but did not specify their role on the staff schedule.
Plan of Correction:	Going forward the Master Schedule will be updated, in writing to show coverage for call outs and supplemental staffing. This will be retained by the Director of Health Services for a period of 12 months.