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Hills Home for Adults
1443 Commerce Avenue
Chesapeake, VA 23324
(757) 545-8797

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: July 18, 2022 and July 28, 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 ACCOMMODATIONS AND RELATED PROVISIONS
22VAC40-73 BUILDINGS AND GROUND
22VAC40-73 EMERGENCY PREPAREDNESS
22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS
ARTICLE 1 ? SUBJECTIVITY
63.2 GENERAL PROVISIONS
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

Comments:
Type of inspection: Renewal
Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 7/18/22, 7/28/22

The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection.

Number of residents present at the facility at the beginning of the inspection: 44
The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility.
Number of resident records reviewed: 6
Number of staff records reviewed: 5
Number of interviews conducted with residents: 2
Number of interviews conducted with staff: 2

An exit meeting will be conducted to review the inspection findings.

The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility.

The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law.

If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview.

Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected.

Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area.

Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice.

The department's inspection findings are subject to public disclosure.

Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility.

For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov

Should you have any questions, please contact Alyshia E. Walker, Licensing Inspector at 757-670-0504 or by email at Alyshia.Walker@dss.virginia.gov

Violations:
Standard #: 22VAC40-73-50-A
Description: Based on resident record review, the facility failed to prepare and provide to the prospective resident a disclosure which contains all the required components.

Evidence:

1. The records reviewed for Resident # 3 and Resident #4 contained Disclosure statements that did not include: general information about the facility, accommodations, services and fees, admission, transfer and discharge criteria, general number, functions and qualification of staff on each shift, and activities provided for residents.
2. Records for Residents #1 and #2 did not include disclosure statements.
3. Staff #2 acknowledged the disclosures for Residents #3 and #4 did not contain all of the required components, and that records for Residents #1 and #2 did not include disclosure statements.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-160-A
Description: Based on record review the facility failed to ensure the administrator attended at least 20 hours of training related to management or operation of a residential facility for adults or relevant to the population in care annually.

Evidence:

1. On 7/18/22, during the review of Staff#1?s training record, the record documented 1 hour of training for 2021.
2. Staff #2 acknowledged the facility did not have documentation of the administrator having the required 20 hours of annual training.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-210-B
Description: Based on staff record review the facility failed to ensure in a facility licensed for both residential and assisted living care, all direct care staff shall attend at least 18 hours of training annually.

Evidence:

1. A review of Staff # 4?s record did not contain the required number of annual training hours.
2. Staff #2 acknowledged the staff record for Staff #4 did not contain the required amount of annual training.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-260-A
Description: Based on document review, the facility failed to ensure each direct care staff member shall maintain current certification in First Aid. Each direct care staff member who does not have current certification in first aid shall receive certification within 60 days of employment.

Evidence:

1. Staff #3 (D.O.H. 3/29/22) is a direct staff member who does not current have current First Aid certification.
2. Staff #2 acknowledged that Staff #3 does not currently have First Aid certification.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-260-C
Description: Based on staff interview and observation, the facility failed to have a listing of all staff who have current certification in First Aid and CPR posted in the facility readily available to staff.

Evidence:

During the 7/18/22 inspection of the facility, there was no posting of staff members who had certification in First Aid and CPR.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-290-B
Description: Based on observation, the facility failed to ensure
the posting of the name of the current on-site
person in charge.

Evidence:

1. During the on-site inspection on 7/28/22, the Manager on Duty sign contained information for 7/26/22.
2. Staff #2 acknowledged the sign had not been updated to reflect the current day.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-310-H
Description: Based on record review and staff interview, the facility failed to ensure it did not admit or retain individuals with psychotropic medications without a treatment plan.

Evidence:

1. Resident #3 was admitted to the facility on 4/4/22 with physician orders for psychotropic medications.
2. Staff #2 acknowledged a psychotropic treatment plan for Resident # 3 was not present in the resident?s record for the inspector to review.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-390-A
Description: Based upon documentation review, the facility failed to ensure at or prior to the time of admission, there shall be a written agreement signed by the resident.

Evidence:

1. Resident #4 was admitted to the facility on 5/6/22. The resident agreement was not signed by Resident #4 until 7/18/22.
2. Staff #2 acknowledged the resident agreement for Resident #4 was not signed prior to or at the time of the resident?s admission to the facility.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-410-A
Description: Based on documentation review, the facility failed to document the resident?s orientation to the facility.

Evidence:

1. Resident #4 was admitted to the facility on 5/6/22 and the acknowledgement of orientation in the resident?s file was not signed or dated by the resident or his legal representative.
2. Staff #2 acknowledged the acknowledgement of orientation form in the resident?s filed was not signed by the resident or his legal representative.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-430-H-1
Description: Based on review of resident record, the facility failed to ensure that a discharge stated included all of the required information listed in the standards to be provided to the resident and as appropriate, his legal representative and designated contact person at the time of discharge.

Evidence:

Resident # 6?s discharge statement dated 6/1/22 was blank in the following areas: method of discharge notification to resident, date and method of discharge notification to legal representative, reason for discharge, actions taken by the facility to assist the resident in the discharge, date of the discharge, and destination.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-610-B
Description: Based on observations made during the tour of the facility on 7/28/22, the facility failed to have the menu for the current week posted.

Evidence:

On 7/28/22, the menu posted was for the week of July 16, 2022- July 22, 2022.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-620-A
Description: Based on documentation review and interview, the facility failed to ensure dietary oversight was conducted every six months for specials diets by a dietitian or nutritionist.

Evidence:

1. The last oversight review for special diets was dated 9/19/21.
2. Staff #2 acknowledged dietary oversight had not been conducted every six months by a dietitian or nutritionist for residents with a special diet.

Plan of Correction: Not available online. Contact Inspector for more information.

Standard #: 22VAC40-73-870-A
Description: Based on observation and interview, the facility failed to maintain the interior and exterior of the building in good repair and keep it clean and free of rubbish.

Evidence:

1. During a tour of the facility on 7/18/22, the back bedroom was observed to contain various building supplies and a grocery cart full of maintenance supplies.
2. The men?s tub was observed to be peeling.
3. Staff #2 acknowledged these items were in need of cleaning and repair.

Plan of Correction: Not available online. Contact Inspector for more information.

Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.

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