VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Senior Living at Cedar Manor
1324 Cedar Road
Chesapeake, VA 23222
(757) 548-4192

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: April 12, 2022 and April 13, 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

Comments:

An unannounced mandated renewal inspection was conducted by two Licensing Inspectors on 4/12/22 and 4/13/22. A tour of the facility was conducted and activities were observed. Medication passes were observed and staff and resident files were reviewed. Information gathered during the inspection determined non-compliances with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-310-D
Description:	Based on documentation review, the facility failed to provide written assurance to the resident or legal representative that the facility has the appropriate license to meet the care needs at the time of admission, this document shall be signed and kept in the resident's record. Evidence: 1. Resident #2 was admitted 9/23/21 and the written assurance was signed on 2/24/22. 2. Resident #4 was admitted 2/10/22 and the written assurance was signed on 3/30/22.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-350-B
Description:	Based on record review, the facility failed to ascertain, prior to admission, whether a potential resident was a registered sex offender and failed to document that this was ascertained and the dated the information was obtained. Evidence: 1. Resident #1 was admitted 1/13/22 and the Sex Offender screening was completed on 2/8/22. 2. Resident #2 was admitted 9/23/21 and the Sex Offender screening was completed on 9/27/21.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-410-A
Description:	Based on record review, the facility failed to provide an orientation for new residents and their legal representatives, including emergency response procedures, mealtimes, and use of the call system upon admission. Evidence: Resident #1 (admitted 1/13/22), Resident #2 (admitted 9/23/21), and Resident #4 (admitted 2/10/22) did not have acknowledgement of having received orientation in their records.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-640-A
Description:	Based on observations made during the inspection of the medication cart, the facility failed to adhere to methods to prevent the use of outdated, damaged, or contaminated medications. Evidence: 1. Resident #6's Venlafaxine Hcl Er Caps 75mg had an expiration date of 2/2/22, Memantine Hcl Er Caps 28mg had an expiration date of 7/12/21, and the Donepzil Hcl Tabs 10mg had an expiration date of 4/9/21; 2. Resident #7's Ondansetron tab 4mg had an expiration date of 1/18/22; and 3. Resident #8's Acetaminophen 325mg had an expiration date of 12/15/21.
Plan of Correction:	Not available online. Contact Inspector for more information.