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Hunters Woods at Trails Edge
2222 Colts Neck Road
Reston, VA 20191
(703) 429-1130

Current Inspector: Marshall G Massenberg (703) 431-4247

Inspection Date: Feb. 3, 2020

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
22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS

Article 1
Subjectivity
32.1 Reported by persons other than physicians
63.2 General Provisions.
63.2 Protection of adults and reporting.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
22VAC40-90 Background Checks for Assisted Living Facilities
22VAC40-90 The Sworn Statement or Affirmation
22VAC40-90 The Criminal History Record Report
22VAC40-80 THE LICENSE.
22VAC40-80 THE LICENSING PROCESS.
22VAC40-80 SANCTIONS.

Comments:
An unannounced monitoring inspection was conducted on 2/3/2020. At the time of entrance twelve residents were in care. The sample size consisted of four resident records, three staff records and one individual interview. Resident and staff records and other documentation were reviewed. Virginia State Police background checks were reviewed for all new staff hired since the previous inspection conducted on 10/7/2019. Residents were observed eating breakfast. Violation notice issued, risk ratings reviewed and the 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 lynette.storr@dss.virginia.gov.

Violations:
Standard #: 22VAC40-73-250-C
Description: Staff #2's sworn disclosure dated 1/3/2020 does not include information regarding pending charges.

Plan of Correction: Administrative Services Director will review all current sworn disclosures for completion and ensure that all new staff have completed all of the required information on the sworn disclosure.

Standard #: 22VAC40-73-250-D
Description: Facility failed to ensure that each staff person on or within seven days prior to the first day of work at the facility and each household member prior to coming in contact with residents shall submit the results of a risk assessment, documenting the absence of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it.

Evidence: Staff #3's (hired 11/11/19) most recent documentation of a TB screening is a chest x-ray dated 8/7/18 and Staff #1's (hired 1/13/2020) most recent documentation of a TB screening is a chest x-ray dated 9/27/19.

Plan of Correction: Administrator to work with Business Office Manager to ensure TB screening are up to date prior to staff being hired.

Standard #: 22VAC40-73-290-B
Description: Facility failed to ensure that the name of the current on-site person in charge, as provided for in this chapter, is posted in a place in the facility that is conspicuous to the residents and the public.

Evidence: Upon Licensing Inspectors' arrival the person in charge was not posted.

Plan of Correction: Administrator shall in-service concierge staff regarding the posting of the person in charge.

Standard #: 22VAC40-73-320-A
Description: Facility failed to ensure that within the 30 days preceding admission, a person shall have a physical examination by an independent physician. The report of such examination shall be on file at the assisted living facility and shall contain Height, weight, and blood pressure and any recommendations for care including medication, diet, and therapy.

Evidence: Resident #1, admitted on 1/13/12020 admission physical dated 1/9/2020 did not include the resident's height, Resident #2 admitted on 12/23/19 admission physical dated 12/17/19 does not include the resident's medication and Resident #3 admitted on 11/8/19 admission physical dated 10/8/19 does not include medications and diet recommendations.

Plan of Correction: Resident Wellness Director (RWD) will review all current resident records for completion and ensure that all new residents have physicals including all required documentation.

Standard #: 22VAC40-73-325-A
Description: Facility failed to ensure that for residents who meet the criteria for assisted living care, by the time the comprehensive ISP is completed, a written fall risk rating shall be completed.

Evidence: 3/3 resident records did not include documentation that a fall risk rating was conducted by the time the comprehensive ISP was completed .

Plan of Correction: RWD will ensure that all residents fall risk ratings are documented by the time the comprehensive ISP is completed. Current resident charts will be reviewed to ensure the fall risk rating is documented.

Standard #: 22VAC40-73-440-D
Description: Facility failed to ensure that for private pay individuals, the assisted living facility shall ensure that the Uniform Assessment Instrument (UAI) is completed as required by 22VAC30-110.

Evidence: 3/3 resident UAIs were not signed by the Administrator or designee.

Plan of Correction: RWD will review all current resident records and obtain the Administrator or designee's signature and ensure that all UAIs for new residents are signed as appropriate.

Standard #: 22VAC40-73-450-E
Description: Facility failed to ensure that the Individualized Service Plan (ISP) shall be signed and dated by the licensee, administrator, or his designee, (i.e., the person who has developed the plan), and by the resident or his legal representative. The plan shall also indicate any other individuals who contributed to the development of the plan, with a notation of the date of contribution. The title or relationship to the resident of each person who was involved in the development of the plan shall be included .

Evidence: Resident #1's ISP dated 1/16/2020 is not signed by the resident.

Plan of Correction: RWD will ensure that all ISPs are signed by the resident.

Standard #: 22VAC40-73-580-C
Description: Facility failed to ensure that personnel shall be available to help any resident who may need assistance in reaching the dining room or when eating.

Evidence: Upon Licensing Inspector's arrival to the Assisted Living Dining Room staff were not available in the dining room while residents were eating.

Plan of Correction: Administrator and Dining Experience Director will conduct in-service training with dining staff to ensure staff are available in the dining room at all times when residents are eating.

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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