VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Raspberry Hill Adult Daytime Center
1381 Crossings Centre Dr., Suite A
Forest, VA 24551
(434) 525-4422

Current Inspector: Cynthia Jo Ball (540) 309-2968

Inspection Date: March 24, 2022

Complaint Related: No

Areas Reviewed:

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

Comments:

On 3/24/2022 one inspector conducted a mandated monitoring visit (2:40 pm to 4:10 pm). Seven participants were in care with two direct care staff with them, and an additional direct care staff in the office. Two participant records and two staff records were fully reviewed, and all new staff and volunteer records were check for background check information. An exit meeting was held with the director on-site on the day of the inspection, and an opportunity to present additional evidence was given at that time. A telephone exit was held on 4/4/2021.

Violations:

Standard #:	22VAC40-61-180-D
Description:	Based on staff file review, the facility failed to have some required personal and social data in a staff file. EVIDENCE: 1. The file for staff 1 lacked information regarding an emergency contact.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-220-E
Description:	Based on participant record review, the facility failed to review and update participant assessments every six months. EVIDENCE: 1. The record for participant 2 does not contain any dated assessments. The undated, partial assessment lacks required information concerning: ambulatory ability; activities of daily living; health status to include diagnoses and medications; mental status including intellectual, cognitive, behavioral impairment, and known psychiatric or emotional problems; social environment; economic conditions, nutrition needs, communication limitations; and personal preferences that would enhance the participant's experience at the center. 2. The most recent assessment for participant 1, dated 3/8/2022, lacks required information concerning: health status to include medications; social environment; economic conditions, nutrition needs, communication limitations; and personal preferences that would enhance the participant's experience at the center.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-250-B
Description:	Based on participant file review, the facility failed to obtain some personal information for a participant. EVIDENCE: 1. The Raspberry Hill Adult Daytime Center Participant Record 22 VAC 40-61-B lacks the following information: Known Allergies, Advance Directive and/or DNR Information; Legal Representative, Other Health Care Provider, Local DSS, Other Agency, Mental Health Concerns, Substance Abuse Concerns, and Behavioral Concerns.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-300-C
Description:	Based on observation and participant record review, the facility failed to have authorization to administer a medication to a participant. EVIDENCE: 1. The medication administration record (MAR) for March 2022 for participant 2 shows that staff ad the facility administer the 1 PM dose of Carbidopa/Levo (100 mg 2 tab) po, which matches the written order dated 8/18/2021, however, the medication in the facility is Carbidopa/Levodopa 25/100.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-61-300-E-2
Description:	Based on observation, the facility failed to ensure that medications were labeled participant's names. EVIDENCE: 1. A Pro-Air inhaler, found in the box in the med cart for participant 2, had no name on it. 2. A bottle of Acetaminophen 500 mg, found in the box in the medication cart for participant 1, had no name on it. 3. A bottle of Chlorpheniramine Maleate 4 mg, found in the box in the medication cart for participant 3, had no name on it.
Plan of Correction:	Not available online. Contact Inspector for more information.