VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Blue Ridge Senior Living
12411 Gayton Road
Richmond, VA 23238
(804) 741-9494

Current Inspector: Angela Rodgers-Reaves (804) 662-9774

Inspection Date: July 10, 2023

Complaint Related: No

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 07/10/2023 Beginning approximately 10:15a.m-3:01p.m 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: 89. The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 10 Number of staff records reviewed: 5 Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 5 Observations by licensing inspector: Additional Comments/Discussion: 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 Angela Rodgers-Reaves, Licensing Inspector at (804) 840-0253 or by email at Angela.r.reaves@dss.virginia.gov Violation Notice Issued: Yes

Violations:

Standard #:	22VAC40-73-450-D
Description:	Based on the review of facility records and interviews conducted the facility failed to ensure that when hospice care is provided to a resident, the assisted living facility and the licensed hospice organization must communicate and establish an agreed upon coordinated plan of care for the resident. The services provided by each must be included on the individualized service plan (ISP). Evidence: #1 The resident?s 05/10/2023 ISP that was submitted for the inspector?s review does not identify the services that the hospice agency will be providing.
Plan of Correction:	FACILITY'S RESPONSE: "All ISPs will be reviewed by the DON to ensure that all services are added or removed as needed at the time services are ordered or discontinued. ED will audit as needed to ensure ISPs are correct."
Standard #:	22VAC40-73-860-G
Description:	Based on observation the facility failed to ensure that the building hot water at taps available to residents is be maintained within a range of 105?F to 120?F. Evidence: 07/10/2023: During the walk through of the interior of the physical accompanied by the Administrator the resident in room 126 reported the water not getting hot. The water temperature in the living room basin and the shower registered below 105 degree.
Plan of Correction:	FACILITY'S RESPONSE: "Blue Ridge Maintenance Team will work with outside contractors to determine source of problem and resolution/repair."
Standard #:	22VAC40-73-870-A
Description:	Based on observation the facility failed to ensure that the building is free from foul, stale and musty odors. Evidence: Accompanied by the facility Administrator the inspector encountered a foul odor during the walk through of the second floor near room #s 206 and 217.
Plan of Correction:	FACILITY'S RESPONSE: "Blue Ridge Senior Living Management will be retraining all Nursing and Housekeeping staff on basic housekeeping practices and odor elimination."