VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Hazelwood House Adult Day Care Center
1107 West Danville Street
South hill, VA 23970
(434) 447-7661

Current Inspector: Belinda Dyson (804) 662-9780

Inspection Date: June 4, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-60 SUPERVISION. 22VAC40-60 BUILDINGS AND GROUNDS. 22VAC40-60 PROGRAMS AND SERVICES. 22VAC40-60 EMERGENCY PREPAREDNESS.

Technical Assistance:

Technical Assistance was provided in reference to Phase II Training for the new facility Director and any additional Key Staff.

Comments:

A Representative with the Division of Licensing conducted an unannounced, mandated, monitoring inspection on 06/04/2019 from 11:45am to 2:30pm. At the point of entrance the facility had 11 participants in care and the facility Director was available and on-site. The Licensing Representative reviewed, four participant and three staff records, reviewed the facility physical plant, reviewed the facility medication administration records and interviewed participants on-site. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return it to me within 10 calendar days from today. You will need to specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. Your plan of correction must contain: 1) steps to correct the noncompliance with the standards, 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s).

Violations:

Standard #:	22VAC40-60-450-A
Description:	Based on review of the facility physical plant, the facility failed to keep the building in good repair. Evidence: On 06/04/2019 with a Representative with the Division of Licensing and the facility Director, it was observed that the men's rest room wall contained a hole located near the baseboard.
Plan of Correction:	Not available online. Contact Inspector for more information.