VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Avalon House on Dolley Madison
829 Dolley Madison Boulevard
Mc lean, VA 22101
(301) 656-8823

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: Aug. 21, 2021 and Aug. 23, 0220

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.

Comments:

A renewal inspection was initiated on 8/16/2021 and concluded on 8/17/2021. The Administrator was contacted by telephone to initiate the inspection and reported that the current census was 15. The Licensing Inspector (LI) emailed the Administrator a list of items required to complete the remote documentation review portion of the inspection. The LI reviewed two resident records, two staff records, staff schedules, health care oversight, fire and emergency drills, Fire Inspection, Health Inspection, activity calendar, menu and the most recent dietary oversight submitted by the facility to ensure documentation was complete. Background Checks of all staff hired since the previous inspection were reviewed. The LI conducted the on-site portion of the inspection on 8/17/2021. An exit interview was conducted with the Administrator on the date of inspection, where findings were reviewed and an opportunity was given for questions. The information gathered during the inspection determined no violations with applicable standards or law. No violations were issued. Thank you for your cooperation and if you have any questions please call 703-479-4708 or contact me via e-mail at lynette.storr@dss.virginia.gov.