VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Emilia Assisted Living Home
5501 Brookland Road
Alexandria, VA 22310
(703) 971-5205

Current Inspector: Nina Wilson (703) 635-6074

Inspection Date: March 4, 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 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 COMPLAINT INVESTIGATION. 22VAC40-80 SANCTIONS.

Technical Assistance:

Please be vigilant in ensuring that the resident rooms and sitting areas remain home-like by storing equipment and hygiene supplies appropriately.

Comments:

An unannounced monitoring inspection was conducted on 3/4/2020. At the time of entrance seven residents were in care with two staff providing care. The sample size consisted of four resident records, two staff records and two individual interviews. Resident and staff records and other documentation were reviewed. No new staff have been hired since the previous inspection conducted on 4/3/19. Residents were observed eating breakfast and engaging in activities including current events and music appreciation. Medication administration was observed. Violations cited and risk rating reviewed during the exit interview. 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 #:	22VAC40-73-325-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: 4/4 resident records did not have documentation of a fall risk rating.
Plan of Correction:	Manager will contact the consulting nurse to assist in completing fall risk ratings for all of the residents.
Standard #:	22VAC40-73-450-C
Description:	Facility failed to ensure that the comprehensive ISP included the description of identified needs and date identified based upon the (i) UAI; (ii) admission physical examination; (iii) interview with resident; (iv) fall risk rating, if appropriate; (v) assessment of psychological, behavioral, and emotional functioning, if appropriate; and (vi) other sources. Evidence: Resident #4's ISP dated 1/28/2020 did not include documentation of her identified behavioral needs.
Plan of Correction:	Manager will review the ISP and update it to include prevention and intervention for the resident's behavioral needs.
Standard #:	22VAC40-73-480-E
Description:	The facility failed to ensure that services provided, evaluations of progress, and other pertinent information regarding hospice services shall be recorded in the resident's record. Evidence: Resident #2 receives hospice services. There is no documentation in the resident record regarding these services.
Plan of Correction:	Manager will contact hospice nurse to ensure hospice notes are left at the facility after every visit.