VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Countryside Assisted Living, LLC
1240 Orange Road
Pratts, VA 22731
(540) 948-6318

Current Inspector: Jeffrey Marnien (540) 571-0189

Inspection Date: June 3, 2021 and June 9, 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 EMERGENCY PREPAREDNESS 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Technical Assistance:

Will need to update agreement and disclosure - information to be forwarded by licensing to facility for update.

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 6/3/2021 and concluded on 6/9/2021. The administrator was contacted by email to initiate the inspection. The current census was reported to be 15. The inspector emailed the new administrator a list of items required to complete the inspection. The inspector reviewed 2 resident records 2 staff records. No additional background checks were required since the last inspection. Documentation related to fire and health inspections, health care over site, emergency drills, pharmacy review, dietary oversight, staff schedules and additional training records and certification for staff as applicable to their positions. The information gathered during the inspection determined no violations and applicable standards or law. No violations were issued. Thank you to the staff for your assistance and cooperation during this remote inspection process. Should you have questions or additional concerns please call (540) 332-2330 or email this inspector at sharon.deboever@dss.virginia.gov.