VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Gray Ridge Village LLC
155 Ridgefield Rd
Marion, VA 24354
(276) 521-0784

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: Oct. 20, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 BUILDING AND GROUNDS

Comments:

One licensing inspector and the local ombudsmen conducted an unannounced non-mandated complaint inspection on 01/26/2022 at Gray Ridge Village. The Licensing office received a complaint on 10/20/2021 regarding allegations of issues with resident care and the physical plant. The inspection started at 9:30 am and concluded at 1:10 pm. As a result of this inspection the complaint was determined to be valid and 2 violations are being cited. An IPOC will be scheduled to allow the facility the opportunity to develop a detailed plan of correction . If you have any questions or concerns please contact your inspector at 276-608-3514. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-73-100-C-1
Complaint related:	No
Description:	Based on observations made during the inspection of the physical plant, the facility failed to maintain an effective pest control program. EVIDENCE: 1. A complaint was received by the licensing department on October 20, 2021 regarding allegations of mice in the facility. 2. In resident room # 20 mice droppings were observed in the bottom drawer of the wardrobe. 3. Mice droppings were observed in resident #28?s bottom night stand drawer and in the bottom of his closet. 4. A sticky mouse trap was observed on the floor in the closet with droppings around it in resident #4?s room. 5. There were mice droppings observed in the bottom drawer of the night stand on the right side of resident #11?s room. 6. The bottom drawer of the nightstand belonging to resident #15 was covered in mice droppings. 7. There were mice droppings observed on the floor in the closet along with three sticky mouse traps in resident #16?s room. 8. There were mice droppings and a sticky mouse trap observed in the floor of the closet in resident #18?s room. There were also mice droppings observed in the bottom drawer of his nightstand. 9. Staff # 1& 2 stated they have seen mice droppings in the laundry room area and some of the residents feed the mice. 10. Mice droppings were observed in the top drawer on socks and underwear of the chest of drawers belonging to resident #19. 11. There were mice droppings and a sticky mouse trap on the floor of the closet belonging to residents #21 & 22. 12. Mice droppings were observed in the bottom drawer of the chest of drawers belonging to resident #23. 13. There was a sticky mouse trap observed in the floor of resident #25?s room and mice droppings on the window sill. 14. In resident room #31 there were mice droppings in the bottom drawer of the night stand as well as on the window sill. 15. There was a sticky mouse trap observed in the top drawer of the night stand and mice droppings on the window sill in resident room #32. 16. There were mice droppings observed on the corner near the closet in resident #26?s room. 17. There was a sticky mouse trap observed on the left side of resident #27?s room with mice droppings around it. Resident # 27 told the LI she used to have candy in her nightstand drawer and the mice had eaten through the bag. 18. There was a sticky mouse trap observed under resident #12?s bed. There were mice droppings observed on the corner of the window sill and on the floor in front of the bathroom door as well.
Plan of Correction:	See Intensive Plan of Correction.
Standard #:	22VAC40-73-870-D
Complaint related:	No
Description:	Based on observations made during the inspection of the physical plant and interviews with staff and residents, the facility failed to ensure buildings be kept free of infestations of insects and vermin and shall be kept free of their breeding places. EVIDENCE: 1. The administrator reported she has seen mice under the pop machine in the dining room and there are sticky mouse traps set up throughout the facility. She also reported that bedbugs were found in resident room # 31 and a local pest control company was coming out to take care of the problem with infestations. According to the invoice dated 12/21/2021 provided by the administrator the local pest company was treating ants, centipedes, crickets, earwigs, millipedes, pillbugs, roaches, silverfish and spiders. Mice were not listed on the invoice. 2. Resident 4 stated ?he has seen mice in the kitchen and the laundry room.? 3. Resident # 5, 6 & 7 stated ?they have seen mice in the dining room.? 4. Resident # 9 stated ?she has seen mice up front near the office, and have also seen gnats and roaches throughout the facility.? The LI observed gnats in the bathroom in resident #9?s room. 5. Resident # 17 stated ?he has seen several mice in his room and in other rooms too.? He also stated ? there have been mice droppings beside my bed.? 6. Resident # 24 stated ?he has seen mice in his room.? 7. Resident #25 stated ?she has seen mice in her room.? 8. Resident # 26 stated ?he has seen mice in his room.? 9. Resident # 27 stated ?she has seen mice in her room and in the living room area and in the kitchen.? 10. Resident # 12 stated ?she was in the first room on B hall and she saw several mice in that room and requested to be moved to A hall for that reason.? She also stated ?she has seen a mouse on A hall.?
Plan of Correction:	See Intensive Plan of Correction.