VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Golden Homestead
120 Fourth Street
Coeburn, VA 24230
(276) 395-2808

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Aug. 13, 2019

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 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS.

Technical Assistance:

In reviewing resident records there was one resident in care that did not have the admitting physical exam and tuberculosis risk assessment screening located in her file. As part of the inspection protocol the licensing inspector is required to look at the admitting physical exam and tuberculosis screening form. Please ensure the admitting physical exam and tuberculosis risk assessment are maintained in the resident files along with the most current tuberculosis risk assessment.

Comments:

Two licensing inspectors conducted a one day unannounced mandated renewal inspection at Golden Homestead on 08/13/2019. The inspection started at 9:45 am and concluded at 1:23 pm. The facility is licensed to provide care for 19 residential and assisted rated residents and 18 residents were found to be in care on the day of inspection. A sample of resident and staff files were reviewed. Required posting's were checked. The building was observed. The noon medication pass was observed and residents were interviewed. Medication cart audits were conducted, lunch and snacks were observed being served. Staff interactions with residents were observed throughout the inspection. An exit meeting was held with the administrator and other key staff on 08/13/2019 and at that time opportunity was given to find items not available in files. As a result of this inspection 4 violations are being cited. Please develop a plan of correction for each of the cited violations along with a date of correction and return a signed and dated copy to the licensing office within 10 calendar days (08/24/2019) of receipt. If you have any questions or concerns please contact your inspector at 276-608-3514. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-73-290-B
Description:	Based on observations made during the tour of the building on 08/13/2019, the facility failed to develop and implement a procedure for posting the name of the current on-site person in charge, in a place in the facility that is conspicuous to the residents and the public. EVIDENCE: 1. The Licensing Inspector did not observe a posting of the on-site person in charge. When the Licensing Inspector asked staff about the posting, Staff # 4 stated it was posted on the employee work schedule, which was only posted in the medication room, not conspicuous to the residents and to the public.
Plan of Correction:	The posting has been moved to the main hall, conspicuous to the residents and public. Administrator will monitor for compliance. [sic]
Standard #:	22VAC40-73-870-A
Description:	Based on observations made during the tour of the building on 08/13/2019, the facility failed to maintain all areas of the interior and exterior of the building clean and in good repair. EVIDENCE: 1. The new wood on the exterior window sills are in need of painting.
Plan of Correction:	Exterior window sills will be painted. Administrator will monitor for compliance. [sic]
Standard #:	22VAC40-73-920-C
Description:	Based on observations made during the tour of the building on 08/13/2019, the facility failed to have ventilation to the outside available in the bathrooms to eliminate foul odors. EVIDENCE: 1. When licensing inspector turned on the overhead light in the common bathroom across from Room #3 the ventilation system, which is on the same switch, did not turn on and did not operate. Licensing Inspector asked Staff # 4 about this and he confirmed there was one power switch which operated both functions.
Plan of Correction:	Vent/fan will be repaired or replaced. Administrator will monitor for compliance. [sic]
Standard #:	22VAC40-73-920-D
Description:	Based on observations made during the tour of the building on 08/13/2019, the facility failed to comply with the Virginia Uniform Statewide Building Code. EVIDENCE: 1. In the bathroom located across from Room # 3 there were no grab bars by the toilet. 2. In the bathroom located near the entrance to the dining area, there were no grab bars by the toilet and no handrails by the bathtub.
Plan of Correction:	All toilet and bath areas will be assessed and bars will be added as required. Administrator will monitor for compliance. [sic]