VIRGINIA DEPARTMENT OF SOCIAL SERVICES

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

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: April 30, 2025

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

Technical Assistance:

August Renewal Reminder Ensure forms are completed fully.

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: 04/30/2025 9:45 AM to 12:45 PM 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: 75 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 6 Number of staff records reviewed: 4 Number of interviews conducted with participants: 2 Number of interviews conducted with staff: 1 Observations by licensing inspector: Meals and Activities Additional Comments/Discussion: Interviews were conducted with facility staff as translation. 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 Amanda Velasco, Licensing Inspector at (703) 397 4587 or by email at Amanda.Velasco@dss.virginia.gov

Violations:

Standard #:	22VAC40-61-260-A
Description:	Based on participant record review and staff interview, the facility failed to ensure that each participant had a physical examination by a licensed physician within 30 days preceding admission. Evidence: 1. Participant 1?s record, admitted 11/25/2024, contains a physical exam dated 12/03/2024. 2. Participant 2?s record contains a physical exam dated 01/06/2025. 3. Participant 3?s record, admitted 08/19/2024, record contains a physical exam dated 09/11/2024. 4. Participant 4?s record, admitted 08/12/2024, contains a physical exam dated 08/15/2024. 5. In an interview with the LI on 04/30/2025, Staff 1 confirmed that the physical exams were not completed in the 30 days preceding admission.
Plan of Correction:	The Center will ensure that each participant has a physical examination by a licensed physician within 30 days preceding admission.
Standard #:	22VAC40-61-330-G-5
Description:	Based on direct observation and staff interview, the center failed to ensure that the current month?s activity schedule was posted in a readily accessible location in the center. Evidence: 1. During a tour of the center on 04/30/2025, the LI did not observe a posted monthly activity calendar. 2. In an interview with the LI on 04/30/2025, Staff 1 confirmed that the activity calendar is not posted as it is sent to participants digitally.
Plan of Correction:	The Center will post each month?s activity schedule in a location easily visible and accessible to participants.
Standard #:	22VAC40-61-360-B
Description:	Based on direct observation and staff interview, the center failed to ensure that the weekly menu for meals and snacks was dated and posted in an area conspicuous to participants. Evidence: 1. During a tour of the center on 04/30/2025, the LI did not observe a posted weekly menu. 2. In an interview with the LI on 04/30/2025, Staff 1 confirmed that the activity calendar is not posted as it is sent to participants digitally.
Plan of Correction:	The Center will post the weekly menu of meals and snacks including dates in a visible and accessible location to participants.