VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Rosewood Village Hollymead Assisted Living, LLC
2029 Lockwood Drive
Charlottesville, VA 22911
(434) 963-7673

Current Inspector: Tamara Watkins (804) 662-7422

Inspection Date: Feb. 18, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 32.1 Reported by persons other than physicians 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 SANCTIONS.

Comments:

An unannounced renewal inspection was conducted on 01/22/20 (11:30 am -3:10 pm ). At the time of the inspection there were 85 residents in care. Ten resident and five staff files were reviewed as well as other required documentation. All new personnel records were reviewed since the last inspection for criminal history record reports and all were in compliance. Meals, medication administration and an activity was observed. Building and grounds were inspected. An exit meeting was held with the Administrator.

Violations:

Standard #:	22VAC40-73-440-A
Description:	Based on a review of 10 (ten) resident records the uniform assessment instrument was not completed prior to one resident's admission. Evidence: Resident #4 was admitted to the facility on 12/26/19. His UAI was completed after his admission on 12/27/19 and after his individualized service plan was developed on 12/26/19.
Plan of Correction:	The provider?s response(s) for the ?plan of correction? was not received as of 02/18/2020 and will not appear on this Violation Notice.
Standard #:	22VAC40-73-440-H
Description:	Based on a review of 10 (ten) resident records the facility failed to complete an annual Uniform Re-Assessment for one resident to determine if the resident's needs can continue to be met by the facility. Evidence: Resident #6 has been a resident of the facility since 10/5/17 and does not have an annual UAI completed. The last uniform assessment completed for her was dated 10/25/18.
Plan of Correction:	The provider?s response(s) for the ?plan of correction? was not received as of 02/18/2020 and will not appear on this Violation Notice.
Standard #:	22VAC40-73-450-F
Description:	Based on a review of 10 (ten) resident records an individualized service plan for one resident was not updated every 12 months. Evidence: Resident # 6 has resided at the facility since 10/5/2017.The last service plan developed for her was dated 10/25/18. She did not have an updated service plan.
Plan of Correction:	The provider?s response(s) for the ?plan of correction? was not received as of 02/18/2020 and will not appear on this Violation Notice.