VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Glow Cares Assisted Living Facility
8150 Newman Drive
Mechanicsville, VA 23116
(240) 432-3427

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: April 18, 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

Comments:

Type of inspection: Renewal Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 4/18/23 11:30 am ? 12:15p The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of resident records reviewed: 3 Number of staff records reviewed: 1 Number of interviews conducted with residents: 3 Number of interviews conducted with staff: 1 Observations by licensing inspector: Medication storage and administration, physical plant, lunch meal, postings An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standards 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. 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 Yvonne Randolph, Licensing Inspector at (804) 662-7454 or by email at Yvonne.randolph@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-440-A
Description:	Based on a review of three resident files, the uniform assessment instrument was not completed prior to admission for one resident. Evidence: A uniform assessment instrument was not found during a review of the file for resident # 3
Plan of Correction:	UAI was found and placed in file.
Standard #:	22VAC40-73-450-A
Description:	A review of three resident files found that an individualized service plan was not completed within 72 hours of admission for one resident. Evidence: An individualized service plan was not found during a review of the file for resident # 3
Plan of Correction:	Service plan completed and placed in file.
Standard #:	22VAC40-73-450-E
Description:	Based on a review of three resident files, the individualized service plan for two residents was not signed and dated by the resident or his legal representative. Evidence: A signature of the resident or legal representative was not on the individualized service plans for residents # 2 and # 3
Plan of Correction:	Service plans have been signed,