VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Vinson Hall
6251 Old Dominion Dr.
Mc lean, VA 22101
(703) 536-4344

Current Inspector: Marshall Massenberg (804) 543-5188

Inspection Date: Sept. 18, 2020

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 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.

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 inspection was initiated on 9/18/2020 and concluded on 9/18/2020. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 156. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed resident records and staff records. Criminal record checks and sworn statements of all staff hired since last inspection and other documentation submitted by the facility was reviewed to ensure documentation was complete. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-90-30-B
Description:	Based on record review, facility failed to ensure that the sworn statement or affirmation shall be completed for all applicants for employment. Evidence: Staff #11 was originally hired on 10/12/2016 with a sworn statement dated 9/27/2016, was terminated on 12/27/2019, and then rehired on 2/27/2020 without a current sworn statement and criminal record check.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-90-40-B
Description:	Based on record review, facility failed to ensure that criminal history record report was obtained on or prior to the 30th day of employment for each employee. Evidence: Staff #11 was originally hired on 10/12/2016 with a criminal history record report dated 9/26/2016, was terminated on 12/27/2019, and then rehired on 2/27/2020 without a current sworn statement and criminal record check.
Plan of Correction:	Not available online. Contact Inspector for more information.