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Evergreen Adult Day Healthcare Center
4115 Annadale Road
Suite 207
Annandale, VA 22003
(703) 534-5049
Current Inspector:
Alexandra Roberts
(804) 845-6956
Inspection Date:
Feb. 13, 2023
Complaint Related:
No
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Areas Reviewed:
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22VAC40-61 GENERAL PROVISIONS 22VAC40-61 ADMINISTRATION 22VAC40-61 PERSONNEL 22VAC40-61 SUPERVISION 22VAC40-61 ADMISSION, RETENTION, AND DISCHARGE 22VAC40-61 PROGRAMS AND SERVICES 22VAC40-61 BUILDINGS AND GROUNDS 22VAC40-61 EMERGENCY PREPAREDNESS 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 SANCTIONS. 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2(19.2) Criminal Procedures. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report
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Technical Assistance:
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A completed Renewal Application must be submitted prior to the expiration of the current license. An application can be obtained from the DSS website. Please mail the application and payment to VDSS ? Western Licensing Office, 190 Patton Street, Suite 100, Abingdon, VA 24210 ? ATTN: Application Processing.
Please update the posted resident rights to reflect the current Licensing Administrator ? Sharae Henderson, 804-629-3479
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Comments:
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An unannounced monitoring inspection was conducted on 2/13/2023. At the time of entrance there were zero participants in care. Five participants are enrolled and come once a week. The Licensing Inspector completed a tour of the physical plant that included the building and grounds of the facility. Five participant and four staff records were reviewed. Criminal Background Checks of all staff hired since previous inspection were reviewed. 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.
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 Lynette Storr, Licensing Inspector at (703) 479-4708 or by email at Lyn lynette.storr@dss.virginia.gov
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Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.
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