VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Azzie Manor
15611 Keelers Mill Road
Dewitt, VA 23840
(804) 469-3703

Current Inspector: Tamara Watkins (804) 662-7422

Inspection Date: May 12, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

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 monitoring inspection was initiated on 5/12/2020 and concluded on 5/14/2020. A self-reported incident was received by the department on 5/12/2020 regarding Personal Care Services and General Supervision and Care. Staff #1 was contacted by telephone to conduct the investigation. The evidence gathered during the investigation supported the self-report of non-compliance with standards or law, and violations were issued. Areas of non-compliance are identified in the Violation Notice. The facility has 10 calendar days from receipt of the inspection reports to complete a plan of correction, sign the inspection report and return them to the licensing office. A copy of the inspection reports shall be retained and posted at the facility. Results of the inspection are subject to public disclosure and will be posted on the VDSS website within 15 calendar days, regardless of whether the plan or correction is completed. The plan of correction shall include the following: (1) Step(s) the facility will take to correct the violations cited; (2) Measures that will be put in place to prevent recurrence of each violation; (3) Person(s) responsible for implementation and monitoring of preventive measures; and (4) Date by which each violation will be corrected

Violations:

Standard #:	22VAC40-73-70-A
Description:	The facility did not notify the licensing office within 24 hours after a major incident that had the potential to threaten the life, health, safety, or welfare of a resident. Evidence: Resident #1 did not return to the facility within 24 hours after he left on 5/9/2020. The incident was not reported to the licensing office until 5/12/2020.
Plan of Correction:	If the facility staff cannot determine a resident's location regardless of the resident's history and/or past behaviors after 18 hours has passed, the administrator or assistant administrator will contact the licensing specialist to inform them verbally, or by email, of the possible missing resident incident and the intent of a full written report will follow. If the facility staff cannot determine a resident's location regardless of the resident's history and/or past behaviors after 24 hours has passed, the facility staff will file a missing person report with the local police department and give them a complete description of the resident to include: a description of the resident, diagnoses and current list of medications.
Standard #:	22VAC40-73-460-D
Description:	Based on documents obtained during the inspection and interviews with facility staff, information provided by the facilty the facility failed to provide supervision of the resident 's schedule, care, or activites, including prevention of wandering from the premises. Evidence: The facility failed to take action after discovering that resident #1 had not returned home with the other residents from the day support program on 5/9/2020. 1. Based on a self-report on 5/12/2020 resident #1 went missing from the facility on 5/9/2020. 2. On the morning of 5/9/2020 resident #1 was outside with the other residents waiting to be transported to the day support program when he walked away. There were no staff outside providing supervision. 3. He did not attend the day suppport program. The facility was unaware that resident #1 did not attend the day program.Staff thought he got off the van in the afternoon and walked to the store when the van returned from the day program. 4. The facility was contacted by the Sheriff's Department on 5/13/2020 to notify them that the resident was located at a hospital in Richmond.
Plan of Correction:	The facility administrator will review the current "Missing Resident Policy and Procedure Plan" and update it if warranted. The facility administrator will review the facility "Missing Resident Policy and Procedure Plan" with all staff, to ensure all staff understand, utilize and follow the current facility "Missing Resident Policy and Procedure Plan". The facility administrator will designate staff to stay outside with the residents to ensure all residents get on their designated day support van. In the event a resident decides they will not be attending their day support, it will be the responsibility of the designated staff to notify the assistant administrator for further guidance.