VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Anthology of Charlottesville
343 Archer Avenue
Charlottesville, VA 22911
(434) 218-5035

Current Inspector: Tamara Watkins (804) 662-7422

Inspection Date: April 26, 2022

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:

An unannounced monitoring inspection was conducted from 11:30a - 1:20p on this date by two licensing representatives . At the time of the inspection there were 35 residents in care. Four resident and four staff files were reviewed as well as other required documentation. All new personnel records were reviewed for criminal history record reports and all were in compliance. Building and grounds were inspected. An exit meeting was held with the Administrator, Director of Health and Wellness, HR representative and the Administrator of Anthology (Tuckahoe) in Richmond. 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. Areas of non-compliance are identified in the Violation Notice. The facility has 10 calendar days from receipt of the inspection reports to complete a plan of correction, sign the inspection report and return them to the licensing office. A copy of the inspection reports shall be retained and posted at the facility. Results of the inspection are subject to public disclosure and will be posted on the VDSS website within 15 calendar days, regardless of whether the plan or correction is completed. The plan of correction shall include the following: (1) Step(s) the facility will take to correct the violations cited; (2) Measures that will be put in place to prevent recurrence of each violation; (3) Person(s) responsible for implementation and monitoring of preventive measures; and (4) Date by which each violation will be corrected.

Violations:

Standard #:	22VAC40-73-1100-A
Description:	Based on a review of resident records the facility failed to obtain written approval prior to placing a resident with a serious cognitive impairment in a safe, secure environment. Evidence: The following individuals were placed in the secure memory care unit without the written approval of their guardian or representative based on the order of priority. A written approval form was in the record for resident #2 who was admitted on 4/1/2022 but was not completed or signed. A written approval form was in the record for resident #4 who was admitted on 3/28/2022 but was not completed or signed.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-50-B
Description:	Based on a review of documentation provided the facility failed to retain written acknowledgment of receipt of the disclosure by the resident or his legal representative in the resident record. Evidence: A copy of receipt of the disclosure document was not present in the record for resident #3.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-320-A
Description:	Based on a review of resident records results of a risk assessment documenting the absence of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it was not retained in the residents record. Evidence: The resident record for resident #3 did not contain evidence of a tuberculosis risk assessment screening.
Plan of Correction:	Not available online. Contact Inspector for more information.