VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Runk & Pratt of Forest
208 Gristmill Drive
Forest, VA 24551
(434) 385-0297

Current Inspector: Jennifer Stokes (540) 589-5216

Inspection Date: Sept. 28, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Technical Assistance:

To ensure that the facility had a thorough understanding of standards, the LI and the Administrator had a discussion regarding standard 450 C.

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 09/28/2020 and concluded on 10/05/2020 in conjunction with local Adult Protective Services. A self-reported incident was received by the department regarding allegations in the areas of resident care and related services. The Administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the Administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation did not support the self-report of non-compliance with standards or law. Any violations not related to the self-report but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-450-E
Description:	Based on resident record review and staff interview, the facility failed to ensure the individualized service plan (ISP) was signed by the resident or his legal representative. EVIDENCE: 1. The ISP for resident 1, dated 02/02/2020, did not contain a signature by the resident or the resident's legal representative. Interview with staff 1 revealed that the ISP was not signed by the resident's legal representative.
Plan of Correction:	ISP shall be signed by the licensee, Administrator of his designee, and by the resident or his legal representative.