Purcellville Home Assisted Living Facility Inc.
16764 Hillsboro Road
Purcellville, VA 20132
Current Inspector: Jamie Eddy (703) 479-5257
Inspection Date: Feb. 8, 2016
Complaint Related: No
- Areas Reviewed:
22VAC40-72 GENERAL PROVISIONS
22VAC40-72 ADMINISTRATION AND ADMINISTRATIVE SERVICES.
22VAC40-72 STAFFING AND SUPERVISION.
22VAC40-72 ADMISSION, RETENTION AND DISCHARGE OF RESIDENTS
22VAC40-72 RESIDENT CARE AND RELATED SERVICES
22VAC40-72 RESIDENT ACCOMMODATIONS AND RELATED PROVISIONS.
22VAC40-72 BUILDINGS AND GROUNDS.
22VAC40-72 EMERGENCY PREPAREDNESS.
22VAC40-72 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS WHO CANNOT RECOGNIZE DANGER OR PROTECT THEIR OWN SAFETY AND WELFARE.
- Technical Assistance:
Licensing Inspector discussed with Owner/Admininstrator the requirements for the resident room that is located in the basement. Owner/Administrator will consult with a physician to ensure that the resident's needs can best be met in a more isolated area of the home and put in place some behavioral interventions to encourage socialization.
An unannounced mandated monitoring inspection was conducted on 2/8/16. At the time of entrance three residents were in care with one staff person. The sample size consisted of three resident records, one staff record, one individual interview and tone ancillary staff member interview. Resident and staff records and other documentation reviewed. No new staff have been hired since previous inspection conducted on 9/21/2015. Residents were observed eating breakfast and lunch and engaging in activities including physical therapy, watching television and playing games. Medication administration was observed. Violation notice issued, risk ratings reviewed and exit interview held. Thank you for your cooperation and if you have any questions please call 703-479-4708 or contact me via e-mail at email@example.com.
Standard #: 22VAC40-72-380-A Description: Facility failed to ensure that prior to or at the time of admission to an assisted living facility, the following personal and social information on a person shall be obtained and placed in the individual's record: Name, address and telephone number of all legal representatives, name, address and telephone number of personal physician, name, address and telephone number of personal dentist, previous mental health/mental retardation services history and current behavioral and social functioning including strengths and problems. Evidence: Review of Resident #2's records indicated that the required information was not in the resident record. Plan of Correction: Owner/Administrator to update all information and review all resident records to ensure that the information is complete.
Standard #: 22VAC40-72-440-C Description: Facility failed to ensure that the individualized service plan shall reflect the resident's assessed needs. Evidence: Resident #1's most recent ISP does not include the physical therapy services she receives. Resident#2's most recent ISP dated 2/4/16 does not include her assessed behavioral needs and wandering tendencies. Additionally, Resident #2's ISP documents that she does not require assistance during the overnight however an assessment dated 1/11/16 documents that the resident has some sleep disturbances. Resident #2's ISP indicates that the resident in on a puree diet however the resident is currently prescribed a regular diet. Plan of Correction: Owner/Administrator to review and update all ISPs to ensure that all assessed needs are reflected.
Standard #: 22VAC40-72-640-A Description: Facility failed to ensure that no medication, dietary supplement, diet, medical procedure or treatment shall be started, changed or discontinued by the facility without a valid order from a physician or other prescriber. Evidence: Resident #3's Systane eye drops were discontinued per the request of the family however a physician's order to discontinue was not obtained. Plan of Correction: Owner/Admininstrator to follow up with family and physician to assess if the eye drops are therapeutically necessary.
Standard #: 22VAC40-72-840-I Description: Facility failed to ensure that cleaning supplies and other hazardous materials shall be stored in a locked area. Evidence: Upon inspector's arrival a cleaning supply tote with cleaning supplies in it was observed in the large bathroom on the first floor sitting on the floor. Plan of Correction: Owner/Administrator will in-service cleaning service regarding the storage of cleaning supplies.
Standard #: 22VAC40-72-890-D-2 Description: Facility failed to ensure that the following sturdy safeguards shall be provided, with installation in compliance with the Virginia Uniform Statewide Building Code (13 VAC 5-63): Grab bars by toilets. Evidence: There are not grab bars installed by the toilet in the downstairs bathroom. Plan of Correction: Owner/Administrator to schedule installation.
Standard #: 22VAC40-72-890-D-3 Description: Facility failed to ensure that the following sturdy safeguards shall be provided, with installation in compliance with the Virginia Uniform Statewide Building Code (13 VAC 5-63): Handrails inside and stools available to stall showers. Evidence: The downstairs bathroom shower does not have handrails. Plan of Correction: Owner/Administrator to schedule installation.
A compliance history is in no way a rating for a facility++.
The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.