VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Heatherwood Independent and Assisted Living
9642 Burke Lake Road
Burke, VA 22015
(703) 425-1698

Current Inspector: Jacquelyn Kabiri (703) 397-3017

Inspection Date: June 17, 2020 , June 18, 2020 and June 19, 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 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 6/17/20 and concluded on 6/19/20. The wellness director was contacted by telephone to initiate the inspection. The wellness director reported that the current census was 101. The inspector emailed the wellness director a list of items required to complete the inspection. The inspector reviewed five resident records, five 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 #:	22VAC40-73-250-C
Description:	Based on record review, the facility failed to ensure that the required personal and social data is included in the staff record. Evidence: Documentation of orientation training, completed within seven days of hire, was not found in the records of Staff #2 or Staff #5. Staff #2 was hired on 7/16/19. Staff #5 was hired on 5/1/20.
Plan of Correction:	An audit of all staff files will be conducted to ensure all required documentation is in place. Additional training to be completed with dept. heads on required documents. The ED and Dept. head will review each new staff file prior to employee's first shift.
Standard #:	22VAC40-73-260-A
Description:	Based on record review, the facility failed to ensure that each direct care staff member maintains current first aid certification. Each direct care staff member who does not have current certification in first aid, shall receive certification in first aid within 60 days of employment Evidence: The record for Staff #2, hired 7/16/19, was reviewed during the inspection. No documentation was provided, during the inspection, to indicate that Staff #2 has current first aid certification.
Plan of Correction:	An audit of all direct care staff will be conducted to ensure that CPR and first aid documents are on file and current. Tracking spreadsheet will be audited for accuracy and reviewed monthly. WD will remind staff who are approaching expiration date. If an employee fails to renew on time they will be removed from the schedule.