VIRGINIA DEPARTMENT OF SOCIAL SERVICES

District Home Assisted Living at Birmingham Green
8605 Centreville Road
Manassas, VA 20110-5265
(703) 257-0935

Current Inspector: Laura Lunceford (540) 219-9264

Inspection Date: Oct. 11, 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

Comments:

Date of Inspection: October 11, 2019; 9am to 3:30pm Type of Inspection: Renewal Census 31 11 resident charts reviewed, 11 staff charts reviewed and 15 interviews If you have any questions or email changes, please do not hesitate to contact me at ken.koontz@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection or regulation, you can find the information on the internet: www.dss.virginia.gov. All previous self-reported incidents were reviewed at this time

Violations:

Standard #:	22VAC40-73-580-A
Description:	Based on observations and interviews as part of a renewal inspection, it was determined the facility failed to the facility was not in compliance with obtaining an annual inspection from the Virginia Department of Health Evidence: The last inspection from the Department of Health was dated 5/24/2018 A review of the storage area for the emergency food supply was observed having multiple items out of date.
Plan of Correction:	A review of the storage area for the emergency food supply was observed having multiple items out of date. The Director of Food Service will develop and implement a plan of correction to ensure food items are rotated in an appropriate manner. An audit system will developed and implemented to ensure compliance with the plan, and a copy of the audit will provided to the administrator on monthly basis. The food storage area will be audited this week and expired items will be discarded.