VIRGINIA DEPARTMENT OF SOCIAL SERVICES

NOVA Adult Day Care Center Inc.
44675 Cape Court
Suite 130
Ashburn, VA 20147
(703) 433-8888

Current Inspector: Laura Lunceford (540) 219-9264

Inspection Date: May 10, 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:

An unannounced monitoring inspection was conducted 5/10/2022. At the time of entrance there were approximately 32 participants in care and six staff members providing supervision. Four participant and three staff records were reviewed. No participants received medications during the inspection. Participants were observed having breakfast. Activities observed included current events, traditional games, Bingo and morning exercise. Criminal Background Checks of all staff hired since previous inspection conducted on 8/5/2020 were reviewed. Participant interviews were not conducted because the participants? first language is not English and no interpreters were provided. Violation notice issued with the assessed risk reviewed and exit interview held. Thank you for your cooperation and if you have any questions please call 703-479-4708 or contact me via e-mail at lynette.storr@dss.virginia.gov.

Violations:

Standard #:	22VAC40-61-260-A
Description:	Based on documentation review and interview the center failed to ensure that within the 30 days preceding admission, a participant shall have a physical examination by a licensed physician. Evidence: Participants #1, #2, #3 and #4 did not have documentation of a physical exam.
Plan of Correction:	Physician will be contacted by the Center Nurse to obtain physical exams.