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: July 20, 2021

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 ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS

Technical Assistance:

610.B - Menus -A snack menu for the current week shall be posted that list the snack being provided/available. 980.G - Emergency Food Supply - foods that do not require refrigeration or cooking in emergencies that can possibly cut off power sources, i.e. protein/fruit bars, non-perishable pasteurized milk, dry fruit and cereal, peanut butter, ready to eat canned goods.

Comments:

A renewal inspection was initiated on 7/15/2021 and concluded on 7/20/2021. The administrator(person was contacted by telephone to initiate the inspection. The administrator reported that the current census is 12 residents. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed two (2) resident records, two (2) staff records, menus, postings, staff schedules, medication administration records and physician orders, staff qualifications and health information, health and fire inspection reports, etc submitted by the facility to ensure documentation The inspector conducted the on-site portion of the inspection on 7/20/2021. An exit interview was conducted with the administrator on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Follow-up completed on previous violations, including risk violation from 6/9/2021 inspection, facility was found in compliance. . Information gathered during the inspection determined non-compliance) with applicable standards or law, and the violation is documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-250-D
Description:	Based on a review of two staff files, one staff file did not have documentation to support the completion of an annual tuberculosis screening by a physician/designee or Health Department official. Evidence: The file for staff # 2 contained a tuberculosis screening form that did not have a signature of a physician/designee or Health Department official..
Plan of Correction:	Not available online. Contact Inspector for more information.