VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Chestnut Grove Home for Adults
786 Chris Barney Road
Dryden, VA 24243
(276) 546-1194

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: June 7, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 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

Comments:

Two licensing inspectors conducted an unannounced mandated monitoring visit at Chestnut Grove Assisted Living Facility on 06/07/2019. The inspection started at 10:15 am and concluded at 1:30 pm. There were 91 residents in care at the facility on the day of the inspection. Resident files were reviewed and the noon medication pass was observed. Medication Administration Records, medications, and physician's orders were reviewed. Staff files and resident files were also reviewed. A tour of the building and grounds was completed and lunch was observed. Residents were interviewed. The first aid kit and blood glucose monitoring supplies were observed and reviewed. Required postings were observed in the facility. Areas of non-compliance are identified on the attached violation notice. An exit meeting was held with the administration staff on 06/07/2019. The opportunity to locate items that were not readily available was given. Please complete the columns for "description of action to be taken" and "date to be corrected" for each violation cited on the violation notice, and then return a signed and dated copy to the licensing office within 10 calendar days of receipt (06/20/2019). If you have any questions or concerns, please feel free to contact your inspector at 276-608-1067. Thank you for you cooperation and assistance during this inspection.

Violations:

Standard #:	22VAC40-73-640-A
Description:	Based on an audit of the medication cart, the facility failed to implement their medication management plan in regards to proper disposal of medication. EVIDENCE: 1. Resident # 1 was discharged from the facility on 05/30/2019. This resident had a prescription for Airstada 1064mg to be administered intramuscularly every eight weeks. This medication was still available on the medication cart.
Plan of Correction:	All medications from resident discharges will be removed from the carts upon discharge. Will be monitored by Director of Nursing and Quality Assurance. [sic]
Standard #:	22VAC40-73-860-A
Description:	During the tour of the building, the facility failed to keep the interior of all buildings in good repair and kept clean. EVIDENCE: 1. At the end of the hallway, near the exit, on the north side of the building, the licensing inspector observed a puddle of what appeared to be soda in the hallway. This puddle could pose a trip hazard.
Plan of Correction:	Puddle of soda was gotten up. Housekeeping and maintenance will monitor hallways for spills. Spills will be gotten up promptly. [sic]