VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Essex House
17976 Tidewater Trail
Tappahannock, VA 22560
(804) 443-5921

Current Inspector: Shelby Haskins (804) 305-4876

Inspection Date: June 8, 2021

Complaint Related: No

Areas Reviewed:

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

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 monitoring inspection was initiated on 6/9/2021 and concluded on 6/14/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that there are 13 residents in care. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed two (2) resident records, two (2) staff records, fire and health inspection reports, health care oversight, medication administration records, physician orders, staff schedules, pharmacy review, resident log notes, emergency procedures, etc. submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined one non-compliance with applicable standards or law, and the violation is documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-450-C
Description:	Based on a review of two comprehensive individualized service plans, the plans did not include an identified dietary need. 1. A review of the May 2021 physician orders and dietary progress notes for resident # 1 document "heart healthy diabetic" diet. The comprehensive service plan submitted for resident # 1 stated "regular diet". 2. A review of the May 2021 physician orders and May 2021 medication administration orders (MARs) for resident # 2 document "puree" diet. The comprehensive service plan submitted for resident # 2 stated "regular diet".
Plan of Correction:	Not available online. Contact Inspector for more information.