VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Haven Assisted Living @ Dijon
6171 Dijon Drive
Mechanicsville, VA 23116
(804) 803-0038

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: Feb. 28, 2022

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Technical Assistance:

550 - Activities shall be varied and mixed 100 - Infection Control (masks)

Comments:

INSPECTION SUMMARY A complaint inspection was conducted on 2/28/2022 by two licensing inspectors. Concerns were received by the department in the areas of Resident Care And Related Services and Administration and Administration and Administrative Services. Resident files were reviewed along with the menu, activity schedule, medication storage. A meal was observed along with the implementation of any scheduled activities. The evidence gathered during the investigation supported one allegation of non-compliance with standards or law, and a violation was issued. A violation not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-610-D
Complaint related:	No
Description:	Based on a file review of discharge physician orders on 2/28/2022, the facility failed to prepare and serve a diet for one resident according to the physician's orders. Evidence: Physician orders for resident # 1 dated 2/11/22021 state ". Glucerna two times a day as supplement". There was no documentation to support that the facility is preparing or serving this supplement (i,e ISP, interview with staff). There was no documentation that the order was discontinued.
Plan of Correction:	Glucerna was not stopped. Resident still takes glucerna that family supplies. Glucerna is listed as a dietary supplement not under her current medications 2/28/22
Standard #:	22VAC40-73-650-A
Complaint related:	Yes
Description:	Based on a review of the admission physical examination and rehabilitation discharge paperwork. a diet was changed and discontinued by the facility without a valid order from the physician or other prescriber. Evidence: The admission physical examination for resident # 1 dated 11/11/2020 state "diabetic diet". Facility staff reported that the resident was not on a special diet. Staff # 1 and # 2 submitted discharge paperwork from a rehabilitation facility dated 2/11/2021 that documented "regular diet, regular texture, regular liquids" to support that the resident was not on a special diet. There was no documentation of a valid physician's order to change/discontinue the diabetic diet from 11/20/2020 to 2/11/2021.
Plan of Correction:	As of admission on 11/20/20, resident was on a diabetic diet as stated on the ISP and physicians orders. As of 2/1/22 after being discharged from rehab, order stated regular diet including regular texture and liquids. Well balanced meals are provided. Meals are comprised of lean meats, whole grains, vegetables, and fruits. Water is provided with every meal as well as ensures as ordered by her physician.