Martha Jefferson House
1600 Gordon Avenue
Charlottesville, VA 22903
(434) 293-6136
Current Inspector: Kimberly Davis (804) 662-7578
Inspection Date: June 24, 2020
Complaint Related: No
- Areas Reviewed:
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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
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.
- Comments:
-
This inspection was conducted by licensing staff using an alternate remote protocol necessary due to a state of emergency health pandemic declared by the Governor of Virginia.
A monitoring inspection was initiated on June 23, 2020 and concluded on June 24, 2020. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 26. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed 3 resident records, 3 staff records, physician's orders, Medication Administration Records (MARs), and other facility documentation submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and violations were documented on the violation notice issued to the facility. Please specify how the violation will be corrected. The plan must contain: 1) step(s) to correct the non-compliance with the standard(s), 2) measures to prevent the non-compliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s). Thank you for your cooperation during this inspection. I can be reached at Kimberly.M.Davis@dss.virginia.gov or (804) 662-7578.able standards or law, and violations were documented on the violation notice issued to the facility.
- Violations:
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Standard #: 22VAC40-73-250-C Description: Based on a review of staff records, the facility failed to ensure that each staff record contained an annual tuberculosis (TB) risk assessment documenting that the staff person is free of tuberculosis in a communicable form.
Evidence: TB screening for Staff # 1 was dated 3-3-19.Plan of Correction: Human Resources Coordinator or designee will ensure each staff record contains an annual tuberculosis (TB)
screening.
Standard #: 22VAC40-73-550-G Description: Based on a review of resident records, the facility failed to ensure that the rights and responsibilities of residents in assisted living facilities was reviewed annually and that written acknowledgment of having been so informed was filed in the resident's record.
Evidence: The acknowledgment of the rights and responsibilities of residents in assisted living facilities for Resident # 2 was last dated 3-1-19.Plan of Correction: Social Services Coordinator or designee will ensure that the rights and responsibilities of residents in assisted living facility are reviewed annually.
Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.