VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Sunrise at Countryside
45800 Jona Drive
Sterling, VA 20165
(703) 430-0681

Current Inspector: Laura Lunceford (540) 219-9264

Inspection Date: May 19, 2021 and May 21, 2021

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 32.1 Reported by persons other than physicians 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 monitoring inspection was initiated on 5/19/2021 and concluded on 5/21/2021. The administrator was contacted by email to initiate the inspection. The administrator reported that the current census was 22. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed three resident records, three staff records, annual fire and health inspections, fire drill reports, dietary and healthcare oversight reports, staff schedule submitted by the facility to ensure documentation was complete. Criminal Background Checks of all staff hired since the previous inspection conducted on 2/26/2021 were reviewed. Interview with the administrator was conducted on 5/21/2021 via telephone. The information gathered during the inspection determined no violations with applicable standards or law. The exit interview was conducted with the administrator on 5/21/2021 via telephone. No violations were issued.