VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Avalon House in McLean
1503 Oakview Drive
Mc lean, VA 22101
(301) 656-8823

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: May 27, 2020 and May 28, 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 EMERGENCY PREPAREDNESS 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.

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A renewal inspection was initiated on 5/27/20 and concluded on 5/28/20. The licensee was contacted by telephone to initiate the inspection. The licensee reported that the current census was six. The inspector emailed the licensee a list of items required to complete the inspection. The inspector reviewed two resident records, two staff records, medication administration records, local fire and health inspections and other documentation submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-320-A
Description:	Based on record review, the facility failed to ensure that each resident's physical examination contained all of the required information. Evidence: The physical examination for Resident #1, dated 7/24/19, was observed during the inspection. The physical examination form stated that the resident was allergic to: aspirin, ibuprofen, and NSAIDs. The form did not list Resident #1's reactions to the allergens.
Plan of Correction:	Prior to admission, Administrator will check documents for allergic reactions. If they are not included, they will contact the physician to have that clarified and updated.