VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Hillside Residential Living
403 N. Coalter Street
Staunton, VA 24401
(540) 885-0191

Current Inspector: Jessica Gale (540) 571-0358

Inspection Date: July 10, 2023

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 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:

1.For areas not applicable on personal social data form add ?N/A?. 2.Reminder that RMAs are registered and not licensed so second box on UAI should always be used. 3.Consider updating diet form since no special diets will be provided. 4.Discussed options for administrator to pursue administrator licensing to change status from residential to assisted living. 5.Discussed behavioral issues related to resident H.

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 Acknowledgement of Inspection form was signed and left at the facility for the date of the inspection. Number of residents present at the facility at the beginning of the inspection: The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Updates continue throughout the building. Covered area in back for residents to be outside. New wall and sidewalk completed around building. Lock to electrical room on lower level is broken but in the process of being replaced. Number of resident records reviewed: 8. Number of staff records reviewed: 8. Number of interviews conducted with residents: 6. Number of interviews conducted with staff: 4. Observations by licensing inspector: Lunch ? no special diets, medication administration/cart, schedule 2 count verification, resident interaction Additional Comments/Discussion: Drills completed monthly. Facility continues residential only. Other outside inspections current. Administrator recently received certification as a TOVA trainer. Contract with visiting physician. Fire ? 9/22/22 Health ? 2/28/23 An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined no violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website within five (5) business days of your receipt of the inspection summary. The department's inspection findings are subject to public disclosure. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. Thank you to residents and staff for your cooperation during this renewal inspection process. Should you have any questions, please contact Sharon DeBoever, Licensing Inspector at (540) 292-5930 or by email at sharon.deboever@dss.virginia.gov