VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Auburn Hill at Swift Creek
5800 Harbour Lane
Midlothian, VA 23112
(804) 250-5740

Current Inspector: Coy Stevenson (804) 972-4700

Inspection Date: June 12, 2024

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 ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS 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

Technical Assistance:

Discussed with the provider including required orientation topics into their established training tracking system, or utilize already developed forms on the VDSS website that includes all required topics.

Comments:

Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: The renewal process began on June 07, 2024. The licensing inspector arrived onsite at approximately 11:30 AM. The inspection on this date concluded at approximately 3:00 PM. On June 12, 2024, the licensing inspector arrived onsite at approximately 10:00 AM and concluded at approximately 1:00 PM. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 89 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 8 Number of staff records reviewed: 5 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: Common areas of the facility were observed to include dining areas, recreational areas, lounge areas, nurse stations, medication storage areas. Observations of interactions between residents and employees of the facility were also made. Additional Comments/Discussion: No health or safety issues noted. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Coy Stevenson, Licensing Inspector at 804-972-4700 or by email coy.stevenson@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-250-D
Description:	Based on record reviews and interviews, it was determined that the facility did not ensure that each new hire provides documentation on, or within seven days prior to the first day of working at the facility, and prior to coming in contact with residents, the results of a risk assessment documenting the absence of tuberculosis in a communicable form. Evidence: 1) A review of Employee #2?s file did not contain a risk assessment documenting the absence of tuberculosis in a communicable form. Employee #2?s file did contain a risk assessment; however, the form was incomplete. The sections of the form used to determine risk were incomplete/blank. 2) Employee #6 and Employee #7 confirmed that the risk screening in Employee #2?s file was incomplete.
Plan of Correction:	Employee #2?s tuberculosis risk assessment was completed on 04/16/2024 by the Director of Memory Care, LPN. On or within 7 days of hire a tuberculosis risk assessment will be completed by the Director of Health and Wellness/LPN designee The Business Office Manager/designee will ensure a copy of the completed tuberculosis risk assessment is maintained in the employee?s personnel file.