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: Oct. 3, 2023

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

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/03/2023 Begin: 12:45pm End: 3:10pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of participants present at the facility at the beginning of the inspection: 12 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed:3 Number of staff records reviewed:3 Number of interviews conducted with participants:/2 Number of interviews conducted with staff: 1 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. 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. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-180-A
Description:	Based on review of staff records, the center failed to have one staff member screened annually for tuberculosis (TB), EVIDENCE: 1. Staff #2?s last TB screening was completed on 09/01/2022. An annual TB screening should have been completed for Staff #2 by 09/01/2023.
Plan of Correction:	1. Staff #2 completed TB Quantiferon test on 10-9-23. Director will monitor TB screening for staff. [sic]
Standard #:	22VAC40-61-250-B
Description:	Based on participant record review, the center failed to have a current photograph or a narrative physical description of the participant. EVIDENCE: 1. Participant #2 was enrolled at the center on 08/14/2023. On the date of the inspection; 10/03/2023, there was no picture or descriptive narrative in participant #2?s file.
Plan of Correction:	1.Participant?s picture had fallen off the chart and was replaced on the day of inspection [sic]
Standard #:	22VAC40-61-460-H
Description:	Based on the tour of the center, the center failed to have hot water at taps available to participants maintained within a temperature of 105 degrees Fahrenheit to 120 degrees Fahrenheit. EVIDNECE: 1. The common restroom to the right of the washing machine and dryer measured at 80.4 degrees Fahrenheit.
Plan of Correction:	1.The hot water heater is set at 120 degrees. Water temperatures will continue to be monitored. [sic]
Standard #:	22VAC40-61-490-B
Description:	Based on the tour of the center, the center failed to have sufficient space available for equipment, materials, and supplies used at the center. EVIDENCE: 1. On the date of the inspection (10/03/2023), the Licensing Inspector observed the are where the birds are kept/art area to be cluttered. Supplies and materials covered the surface of the desk in the corner and the floor underneath the desk. Supplies and equipment are scattered about the inside perimeter of this entire are (art area/where birds are). The storage cabinet for paints and brushes is covered and cluttered with supplies, equipment, and materials used at the center. There are two chairs located in this same area, they are not accessible due to empty bird seed containers and various old art projects.
Plan of Correction:	1.The bird`s flight cage is moved about the Center. The art/craft area has many participant projects in progress. The desktop is used for propagation of plants and no longer being used for office work. The two chairs are extra seating and not being used at this time. The empty birdseed containers are part of an ongoing project. [sic]