VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Pulaski Adult Day Service & Fall Prevention Center, Inc.
211 Fifth Street
Dublin, VA 24084
(540) 307-5487

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Nov. 9, 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 GROUND ? 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 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:

Type of inspection: Monitor Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 11/09/2022 10:15am-12:30pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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 Crystal B. Mullins Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-410-E
Description:	Based on observations made during the tour of the center, the center failed to ensure cleaning products and harmful materials shall be kept locked when not in use. EVIDENCE: 1. On the end of the counter located in the crafting area, near the director?s office a 50 count Artnaturals hand sanitizer wipe was sitting which was 75% alcohol and had a warning on the back that read: ?Keep out of the reach of children? A 50 count hand sanitizer wipe by Wet Ones with 70% alcohol was also found with a warning on the back that read: ?Keep out of reach of children.?
Plan of Correction:	The facility will no longer use sanitizer hand wipes. Liquid hand sanitizer will be locked in the Nursing office and used only with supervision. [sic]
Standard #:	22VAC40-61-460-H
Description:	Based on observations made during the tour of the center, the center failed to keep hot water temperatures between 105-120 degrees Fahrenheit in the sinks used by the participants. EVIDENCE: 1. The common bathroom on the left reached a temperature of 127.2 degrees Fahrenheit. 2. The common bathroom on the right reached a temperature of 123.6 degrees Fahrenheit.
Plan of Correction:	The gas water heater has been checked and is set at maximum water temperature of 120 degrees. Water temperatures are checked daily and reach 105 after running water for 10 minutes. [sic]