VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jeanne's Elderly Care
1682 Monterey Road
Roanoke, VA 24019
(540) 563-1262

Current Inspector: Angela Marie Swink (276) 623-6575

Inspection Date: March 6, 2024

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 PERSONNEL 22VAC40-73 ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-80 COMPLAINT INVESTIGATION

Comments:

Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 3/6/2024 12:50pm to 4:40pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 3/5/2024 regarding allegations in the areas of: PERSONNEL, ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS, and RESIDENT CARE AND RELATED SERVICES Number of residents present at the facility at the beginning of the inspection: 6 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 6 Number of staff records reviewed: 0 Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 3 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the allegations of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the complaint but identified during the course of the investigation can also be found on the violation notice. 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. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact A Marie Swink, Licensing Inspector at 276-635-6575 or by email at angela.swink@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-130-A
Complaint related:	Yes
Description:	Based on document review and staff interview, the facility failed to ensure that all staff who are mandated reporters under ? 63.2-1606 of the Code of Virginia report suspected abuse or neglect of residents in accordance with that section. EVIDENCE: 1.The licensing inspector (LI) received a complaint of physical abuse and neglect allegations of resident 3 on 3/5/2024. 2. During an interview conducted with one LI and staff person 1 on 3/6/2024, it was confirmed that these allegations of suspected abuse were brought to their attention on 3/4/2024, however, staff 1 did not report these allegations of suspected abuse to their local Adult Protective Services Agency as required by ?63.2-1606 of the Code of Virginia.
Plan of Correction:	In the future the administrator will report as required when allegations of suspected abuse or neglect are brought to attention.
Standard #:	22VAC40-73-310-H
Complaint related:	No
Description:	Based on resident record review and staff interview, the facility failed to ensure not admitting individuals with a prohibited condition. EVIDENCE: 1.The record for resident 1 contained a Report of Resident Physical Examination, dated 12/18/2023, that has documentation that the resident requires continuous licensed nursing care. 2.During the on-site inspection on 3/6/2024, an interview conducted with one Licensing Inspector and staff person 1, staff person 1 revealed the record for resident 1 was current. 3.The record for resident 5 contained a Report of Resident Physical Examination, dated 10/3/2023, that has documentation that the resident presents imminent physical threat or danger to self or others. 4.During the on-site inspection on 3/6/2024, an interview conducted with one Licensing Inspector and staff person 1, staff person 1 revealed the record for resident 5 was current.
Plan of Correction:	Administrator contacted families of resident 1 and resident 5 and both families contacted the resident?s doctors and the doctors reviewed and corrected report of resident physical examination. In the future when reviewing new resident paperwork will make sure resident physical examination is filled out correctly and not admitting individuals will a prohibited condition.
Standard #:	22VAC40-73-440-A
Complaint related:	No
Description:	Based on resident record review and staff interview, the facility failed to ensure all residents of assisted living facilities shall be assessed face to face using the uniform assessment instrument (UAI) in accordance with Assessment in Assisted Living Facilities (22VAC30-110) with the sections to complete including functional status. EVIDENCE: 1.The record for resident 1, contained a UAI, dated 1/15/2024, with no indication if the resident has a need for assistance with the following activities of daily living: bathing, dressing, bowel, bladder, walking, stairclimbing, and mobility. 2.During the on-site inspection on 3/6/2024 an interview conducted with one Licensing Inspector and staff person 1, staff person 1 revealed record for resident 1 was current.
Plan of Correction:	The UAI for resident 1 was corrected to show her need for assistance with activities of daily living: bathing, dressing, bowel, bladder, walking, stairclimbing and mobility. The administrator will thoroughly check to make sure there is no missing information.