VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Alexandria Adult Day Services Center
1108 Jefferson Street
Alexandria, VA 22314
(703) 746-5676

Current Inspector: Nina Wilson (703) 635-6074

Inspection Date: June 13, 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:

Licensing inspector (LI) reviewed the following standards with facility: 22VAC40-61-220 and 22VAC40-61-300.

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: 06/13/2025 Time in: 12:14 pm Time out: 2:43 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: 13 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed: 2 Number of staff records reviewed: 3 Number of interviews conducted with participants: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: LI observed participants participating in scheduled activities and dining for lunch. Additional Comments/Discussion: N/A 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 Nina Wilson, Licensing Inspector at (703) 635-6074 or by email at nina.wilson@dss.virginia.gov.

Violations:

Standard #:	22VAC40-61-160-A-1
Description:	Based on staff record and interview, the facility failed to ensure that each direct care staff member maintained current certification in first aid from the American Red Cross, American Heart Association, National Safety Council, or American Safety and Health Institute. Evidence: 1. Staff 1 (hire date, 03/04/2025) works as a direct staff, and their record included a first aid certification from the National CPR Foundation. 2. On 06/13/2025, LI interviewed staff 3 who confirmed that staff 1?s record did not include a first aid certification from one of the entities identified in the standard.
Plan of Correction:	The staff record reviewed indicated completion of a first aid course; however, the certification was not issued by an entity recognized under VDSS standards. As of June 27, 2025, the employee is scheduled to complete a first aid training course through the National Safety Council, which is an approved provider under VDSS guidelines. Documentation of successful completion and certification will be maintained in the staff member?s file to ensure ongoing compliance.
Standard #:	22VAC40-61-170-F
Description:	Based on volunteer record and review, the facility failed to ensure that all volunteers attend an orientation including information on their duties and responsibilities, participant rights, confidentiality, emergency procedures, infection control, the name of their supervisor, and reporting requirements. All volunteers should sign and date a statement that they have received and understood the information. Evidence: 1. Upon request the facility did not provide staff 5?s orientation documents. 2. On 06/13/2025, LI interviewed staff 3 who confirmed that volunteers did not sign and date an orientation statement.
Plan of Correction:	The Facilities Volunteer Coordinator retired in November 2024. As a result, signed orientation documentation for volunteers during that time could not be located and was unavailable. To prevent future occurrences, the new Recreation Manager and Volunteer Coordinator will implement a process to ensure that all volunteer orientation sessions are properly documented and signed by attendees. Additionally, all orientation records will be stored in a centralized, accessible location to ensure that all facility staff can access them as needed. This change will occur immediately.