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Guardian Assisted Living
99 Culbertson Lane
Castlewood, VA 24224
(276) 794-9569

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Aug. 15, 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 Criminal History Record Report

Comments:
Two Licensing Inspectors conducted an unannounced mandated licensing renewal inspection at Guardian Assisted Living on 08/15/2019. The inspection began at 9:20 am and concluded at12:05 pm. A tour of the building and grounds was conducted. Residents were interviewed. Resident and staff interactions were observed. The noon meal and medication pass were observed. Resident and staff files were reviewed. Medications and Medication Administration Records were observed. The facility is licensed to provide care to 25 residents, and 23 residents were found to be in care at the time of the inspection. Required postings and the previous inspection were observed to be in place. An exit meeting was conducted with the administrator on 08/15/2019 and at that time the opportunity was given to find items that were not readily available in the records. As a result of this inspection, four violations are being cited. A corrective action plan should be developed addressing steps to correct the noncompliance of each standard, measures to prevent the reoccurrence, and person(s) responsible for implementing each step and/or monitoring and prevention measures. The "description of each action to be taken" for each violation, along with the "date to be corrected" must be returned to this office signed and dated within 10 calendar days (08/25/2019) of receipt. If you have any questions or concerns please contact your inspector at 276-608-1067. Thank you for your cooperation and assistance in this matter.

Violations:
Standard #: 22VAC40-73-460-H
Description: Based on observations made of residents during the morning tour of the building, the facility failed to ensure all residents were appropriately groomed and fingernails trimmed. EVIDENCE: 1. The Licensing inspector observed Resident # 3 to have long fingernails with dirt caked under each fingernail. His thumb on his right hand was discolored from tobacco. 2. Staff # 5 stated staff have a hard time keeping his fingernails neat and clean as he likes to mess with cigarette butts and ashes.

Plan of Correction: Direct care staff will encourage resident #3 to keep fingernails cut and groomed and encourage resident #3 to wash hands several times daily. Staff will continue to discourage resident #3 from messing in cigarette butts and ashes administrator will monitor weekly. [sic]

Standard #: 22VAC40-73-860-G
Description: Based on measurements of water temperature during the morning tour of the building, the facility failed to maintain hot water at taps available to residents within a range of 105 degrees Fahrenheit and 120 degrees Fahrenheit. EVIDENCE: 1. The water temperature in the sink used for hand washing in the common bathroom located off of the dining room in house # 2 measured 124.8 degrees. 2. The common bathroom located across from the medication room in house # 1 had a water temperature measuring 124.6 degrees in the sink used for hand washing. 3. The common bathroom located downstairs off of the dining room in house # 1 had a water temperature measuring 123.7 degrees in the sink used for hand washing. 4. According to Staff # 5 the facility recently had an element changed in the water heater and the water temperature needed to be adjusted.

Plan of Correction: Maintenance has adjusted water heater temperature so that all common bathrooms in house #1 and house #2 are within the range of 105 degrees Fahrenheit and 120 degrees Fahrenheit. Administrator will monitor water temperatures in house #1 and house #2 weekly for 2 weeks and then monthly. [sic]

Standard #: 22VAC40-73-870-E
Description: Based on observations made during the morning tour of the building, the facility failed to ensure all furnishings and fixtures were in good repair and condition. EVIDENCE: 1. The sink in the common bathroom located across from resident room #3 in house # 2 filled quickly almost overflowing and then was slow to drain.

Plan of Correction: Maintenance has serviced drain in bathroom sink in house #2 where male residents shave. Administrator will monitor weekly and notify maintenance of an slow drains that are in need of servicing. [sic]

Standard #: 22VAC40-90-40-F
Description: Based on observations made while reviewing staff records, the facility failed to ensure the criminal history record report issued by the State Police was not dated more than 90 days prior to the date of employment in a sample of one out of three staff files. EVIDENCE: 1. Staff #4's hire date was 04/15/2019. The criminal history report issued by the State police was received by the facility on 01/08/2019.

Plan of Correction: Administrator will monitor that all future employees criminal report issued by the state police are received no more than 90 days prior to date of employment. [sic]

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.

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