VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Acadia Care LLC
9285 Critzers Shop Road
Afton, VA 22920
(434) 989-5020

Current Inspector: Coy Stevenson (804) 972-4700

Inspection Date: June 15, 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 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 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. 22VAC40-80 COMPLAINT INVESTIGATION. 22VAC40-80 SANCTIONS.

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 June 15,2021 and concluded on June 24, 2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was (4). The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed (2) resident records, (2) staff records, other items reviewed were medication administration records, fire and health inspection reports staff schedules, and other required documents were submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-310-H
Description:	Based on a review of the admission physical examination report the facility failed to ensure that the resident did not have any conditions or care needs that might prohibit his admission to an assisted living facility. Evidence: A review of the admission physical examination report dated 6/28/2019 for resident #2 did not address whether the resident had any of the prohibited conditions listed in this standard prior to their admission to the facility.
Plan of Correction:	Facility will use state form ?Report of resident physical examination? without exception to assess individuals care needs prior to admission. All residents requesting admission to the facility will be required to receive a physical prior to admission and to submit the physical examination form for review prior to official acceptance to the facility. The administrator will review all physical examination forms to ensure the potential resident does not have any of the prohibited conditions listed in the standard.
Standard #:	22VAC40-73-320-A
Description:	Based on a review of resident records one of the records reviewed did not have a physical examination that was dated thirty days preceding admission. Evidence: Resident #1 was admitted to the facility on 5/1/21 and the physical examination form reviewed titled "Progress Notes" is dated 6/28/2019. The resident was admitted prior to the facility becoming licensed but an updated physical examination or medical systems review was not obtained to ensure there were no changes in the resident's care needs.
Plan of Correction:	Facility will use state form ?Report of resident physical examination? without exception to assess individuals care needs prior to admission. All residents will be required to submit a complete physical with all state licensing required information for review within the 30 days prior to admission. No resident will be admitted to the facility if they are unable to submit a complete physical examination form for review.