VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Sandy Valley
4350 Sandy Valley Road
Mechanicsville, VA 23111
(804) 779-3154

Current Inspector: Shelby Haskins (804) 305-4876

Inspection Date: Feb. 28, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-80 THE LICENSE.

Comments:

The assigned inspector was on site at the faciilty on 02/28/2020 to conduct a follow up of previously cited violations. Based on the review of facility records and interviews conducted repeat violation was cited and is contained within this report. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return to the Inspector within 10 calendar days from today. 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(s), 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). Please contact me at (804) 662-9774 or by e-mail at Angela.r.reaves@dss.virginia.gov., if you have any questions. The inspection was conducted between the approximate hours of 10:20a.m and 11:42a.m

Violations:

Standard #:	22VAC40-73-680-H
Description:	Based on the review of facility records and interviews conducted with facility staff on 02/28/2020, the facility failed to ensure that at the time medication is administered, the facility documented on a medication administration record (MAR) all medications administered to residents, including over-the-counter medications and dietary supplements. EVIDENCE: As evidence by the photographs taken on 02/28/2020 the facility?s medication administration records (MARs) charting for February 2020 revealed the following: Facility staff #1 did not document whether she administered five different medications to resident #1 on 02/27/2020 during the 3-11 shifts and one medication to the resident on 02/27/2020 during the 7-3 shift. Facility staff #1 also did not document on the facility?s MAR charting for February 2020 whether blood glucose levels were checked and if insulin was administered to resident #1 on 02/27/2020 at 8:00a.m; 12:00p.m and 5:00p.m. During interviews facility staff #1 stated that she was the staff person responsible for medication administration to the residents on 02/27/2020.
Plan of Correction:	FACILITY RESPONSE- "The caregiver/med tech documented on the MAR while inspector was on site the care staff/medtech was retrained by the administrator on proper documentation of medication administration."
Standard #:	22VAC40-80-120-E-2
Description:	Based on observation and interviews with facility staff on 02/28/2020, the facility failed to post the findings of the most recent inspection report at the facility. Evidence: A walk through of the interior of the physical plant and interviews with four different facility staff members revealed that the 09/26, 27/2019 inspection report was not posted at the facility.
Plan of Correction:	FACILITY RESPONSE -"A copy was posted at the facility The administrator will ensure copy is posted ina timely manner."