VIRGINIA DEPARTMENT OF SOCIAL SERVICES

DLM Corporation
3502 Chamberlayne Avenue
Richmond, VA 23227
(804) 357-6743

Current Inspector: Yvonne Randolph (804) 662-7454

Inspection Date: June 20, 2023

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 6/20/23 2p-3p The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 6/16/23 regarding allegations in the area of: Resident Care and Related Services Number of resident records reviewed: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Postings, building and grounds, medication administration , physician orders An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the allegations of non-compliance with standards or law, and violations were issued. The licensee has the opportunity to submit a plan of correction to indicate how the cited violations will be addressed in order to return the facility to compliance and maintain future compliance with applicable standards 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 Yvonne Randolph, Licensing Inspector at 804-662-7454 or by email at yvonne.randolph@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-680-D
Complaint related:	Yes
Description:	Based on a review of the medication administration records (MAR) and physician orders on 6/20/23, medication was not administered in accordance with the physician or other prescriber instructions for one resident. Evidence: 1. The June 2023 physician order for Ketorolac (instill 1 drop into right eye 4 times a day) for resident # 1 documented an administration schedule ? Daily at 0800, 1300. 1700, 2000. The MAR documented Ketorolac administered at 8 am and 8 pm (two times a day) on June 1-2, June 5-9, June12-16 and June 19. 2. The June 2023 MAR for resident # 1 documented a physician order for Dorzolamide-Timolol (instill 1 drop into both eyes two times a day).
Plan of Correction:	The facility has notified the ophthalmologist that any changes in eye drops should be sent to Family Care Pharmacy. The family has been notified that any discharge paperwork should be given to the facility so it can be properly documented. The patient was seeing two opthalmologists, now he is seeing an ophthalmologist at the Virginia Eye Institute of Richmond. The doctor was made aware to send all new orders to the Family Care Pharmacy. The facility will follow up with Day Support on any changes in eye drops. The facility will make sure that eye drops be given at the Day Support Center, as well as the facility. Note: Th facility coordinated training from the opthamologist on administering eye drops- the training was completed with facility and Day Center staff who administers eye drops to the resident.