VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Dijon
6171 Dijon Drive
Mechanicsville, VA 23116
(804) 803-0038

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: Feb. 18, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 BUILDING AND GROUNDS

Comments:

An unannounced monitoring inspection was conducted at the facility on 2/18/2020 by two licensing representatives. Four resident and two staff files were reviewed. Program and file documentation was also reviewed for compliance. All new personnel records were reviewed since the last inspection for criminal history record reports and all were in compliance. Please complete the "plan of correction" and "date to be corrected" for the violation cited on the violation notice and return to the Inspector within 10 days. You will need to specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. Your plan of correction must contain: 1) steps to correct the non-compliance with the standard, 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). See violation notice for non-compliance

Violations:

Standard #:	22VAC40-73-440-A
Description:	Based on a review of four resident files on 2/18/2020, the uniform assessment instrument for one resident was not complete. Evidence: A review of the UAI for resident # 1 found the following sections had not been completed: 1. Level of Care Approved 2.Assessment Completed By 3. Assessment Summary 4 Psycho-Social Status 5. Medication Administration 6. Functional Status
Plan of Correction:	UAI was completed same day for resident.
Standard #:	22VAC40-73-870-A
Description:	Based on an observation and inspection of the facility, the exterior of the facility has not been maintained in good repair. Evidence: The patio/porch at the back entrance of the facility was observed to have peeling paint. The middle step leading to the patio/porch was wobbly and not stable.
Plan of Correction:	Facility is scheduled to have maintenance repairs done.