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: Dec. 21, 2022

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced focused monitoring inspection was conducted to follow-up on a high-risk violation that was cited on 9/21/22. Medication administration and resident records were observed. Violation discussed and an exit meeting was held. 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. 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 #:	22VAC40-73-650-A
Description:	Based on observation and record review, the facility failed to ensure that no medication, dietary supplement, diet, medical procedure, or treatment is started, changed, or discontinued by the facility without a valid order from a physician or other prescriber. Evidence: Resident #1?s morning medication administration was observed during the inspection. Resident #1 was administered one 5mg tablet of Midodrine, during the medication pass. Resident #1?s MAR called for the resident to receive 10mg of Midodrine twice per day. The Midodrine order in Resident #1?s record, dated 12/7/22, states that the resident should receive ?Midodrine 10mg PO twice daily.? Resident #1?s record did not contain an order for Midodrine 5mg, at the time of the morning medication administration.
Plan of Correction:	Steps made to correct non-compliance: We called the doctor's office to clarify the order for the said Midodrine, and order was faxed to our office the same day (12/21/22). Measure to prevent the non-compliance from occurring again: Nurse and Medication Aide: When in doubt of the doctor's order, will call the doctor's office for clarification. Person(s) responsible for implementing each step and monitoring any preventative measures: Judy Campanilla, RN, and all Medication Aides