VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Crystal Gardens Assisted Living, LLC
6712 Bostwick Drive
Springfield, VA 22151
(703) 642-5329

Current Inspector: Alexandra Roberts

Inspection Date: Sept. 21, 2022

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced focused monitoring inspection was conducted on 9/21/22 to follow-up on a high-risk violation that was cited on 5/6/22. Medication administration and resident records were observed. Violation was discussed and an exit meeting was held. Areas of non-compliance are identified on the violation notice. Please complete the 'plan of correction' and 'date to be corrected' for each violation cited on the violation notice and return to the licensing office within five business days. Please specify how the deficient practice will be or has been corrected. Just writing the word 'corrected' is not acceptable. The 'plan of correction' must contain: 1) Steps to correct the non-compliance with the standards, 2) Measures to prevent the non-compliance from occurring again, and 3) Person responsible for implementing each step and/or monitoring any preventative measures. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Marshall Massenberg, Licensing Inspector at (703) 431-4247 or by email at m.massenberg@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-680-D
Description:	Based observation and documentation, the facility failed to ensure that medications are administered in accordance with the physician's or other prescriber?s instructions and consistent with the standards of practice outlines in the current medication aide curriculum approved by the Virginia Board of Nursing. Evidence: The morning medication administration, for Resident #1, was observed during the inspection. Resident #1?s medications were placed in a container to be crushed. Before the medication was crushed, the licensing inspector inquired about Resident #1?s crushable medication. Among the medications that were going to be crushed were Resident #1?s Protonix and Aspirin EC. Medication documentation for those medications indicated that they should not be crushed.
Plan of Correction:	We will sit down with all medication aides and review the importance of following instructions for crushed ad non-crushed medications. A list of Medications not allowed to be crushed will be printed out and put on the back of our MARs book. We will reach out to Resident #1?s doctor to see if there are alternative medication to Protonix and Aspirin EC that may be crushed. Measures to prevent the non-compliance from occurring again: The MAR will be adjusted to clearly state that Protonix and Aspirin EC for Resident #1 is not allowed to be crushed. A special label will be placed on medication bottles for tablets or capsules that are not to be crushed. Medicine for Resident #1 and all future residents will be separated in 2 medicine cups for crushed and non-crushed medications. Person(s) responsible for implementing each step and/or monitoring any preventive measures: Judy Campanilla, RN