VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Memory Care at Chesapeake
130 Great Bridge Boulevard
Chesapeake, VA 23320
(757) 436-2109

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: July 9, 2021 , July 12, 2021 and July 21, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

Comments:

A non-mandated, self-report, inspection was initiated on 7-9-21 and concluded on 8-10-21. A self-reported incident was received by the departed on 7-1-21 and revised on report received on 7-9-21 regarding allegations in the area of resident care on serious cognitive unit. The assistant resident care director 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 supported the self-report of non-compliance with standards or law, and violations were issued. Any violations not related to the self-report but determined during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-1180-B
Description:	Based on record review and staff interview, the facility failed to ensue when there are indications that ordinary material or objects may be harmful to a resident, these materials or objects shall be inaccessible to the resident except under the staff supervision. Evidence 1. On 7-1-21 an incident report was received documenting resident #1, was observed by staff #4, "with a pink creamy substance around mouth." 2. Interview with staff #4, staff stated the pink creamy substance was Resident #2?s calmoseptine barrier cream. According to staff #4, resident #1 had entered resident #2?s room while staff and resident were in the bathroom and retrieved the cream from the night stand. 3. Staff #5 came and took resident #1 back to his unit. Staff #5 stated observing cream on resident?s hand. 4. Collateral #1, instructed staff #5 to contact poison control, push fluids and monitor resident. 5. On 8-10-21, during exit with staff #1, staff acknowledged resident obtained access to substance that should not have been accessible to resident #1.
Plan of Correction:	Resident Care Director, Assistant Resident Care Director and /or designee to perform room sweeps daily and continuously to ensure materials or objects that may be harmful, are inaccessible to residents except under the supervision of direct care staff. All direct care staff will be inserviced on materials and objects not permitted in resident rooms or within harms ways of resident. 07/26/2021 Ongoing