VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Cambridge Crossing Assisted Living
251 Patriot Lane
Williamsburg, VA 23185
(757) 220-4014

Current Inspector: Willie Barnes (757) 439-6815

Inspection Date: July 25, 2023 and Aug. 2, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS

Comments:

Type of inspection: Initial An initial announced inspection was conducted on 7-25-23 (Ar 09:05/ Dep 10:45). The facility currently has a census of 15. A tour of the building and grounds was conducted, emergency first aid kit was checked, signaling system check, water temperature checked and floor measurements were conducted. Policy and Procedures clarifications needed or needed to be submit, requested clarification of capacity being requested. 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: 15 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: N/A Number of staff records reviewed: N/A Number of interviews conducted with residents: N/A Number of interviews conducted with staff: 3 Observations by licensing inspector: emergency food supplies Additional Comments/Discussion: A unit in the facility observed, closed and under repair due to water damage. An exit meeting will be conducted to review the inspection findings. The evidence gathered during the initial inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The applicant has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to maintain future compliance with applicable standard(s) or law. If the applicant 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 should the facility be issued a license to operate. 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 a licensed facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact (Willie Barnes), Licensing Inspector at (757) 439-6815 or by email at willie.barnes@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-870-G
Description:	Based on observation and interviews, the facility failed to ensure the grounds was properly maintained to include mowing of grass. Evidence: 1. On 7-25-23, during a tour of the facility with individuals #1, #2, and #3, the grass area in the inner courtyard located off the dining room, was observed to not maintained and needing mowing. The plants and shrubbery located in the inner courtyard was also observed not maintained. 2. Individuals #1, #2, and #3 acknowledged the grounds was not maintained and the grass needed mowing.
Plan of Correction:	Community will set up landscaping to include mowing grass, edging walkways and sidewalks, cleaning flower bed (weeding), rake back old mulch where necessary to all area on property. Executive Director and Regional Director of Operations will monitor landscaping monthly to ensure compliance with state regulations. Date completion: 8/15/2023 and ongoing
Standard #:	22VAC40-73-960-A
Description:	Based on interviews, the facility failed to ensure it had a written plan for fire and emergency evacuation that is to be followed in the event of a fire or other emergency. Evidence: 1. On 7-25-23, the facility did not have documentation of a written plan for fire and emergency plan that is to be followed in the event of a fire or emergency.
Plan of Correction:	Community sent fire policy to DSS on 8/1/2023. The community is working on updating the written plan for fire and emergency evacuation procedures. Once plan has been updated Plan will be sent to Fire Marshall for review. Executive Director, Regional Director of Operations and Maintenance Director will review fire and emergency evacuation procedures on an annual basis and submit to Fire Marshall for review. Date completion: 9/2/2023
Standard #:	22VAC40-73-980-H
Description:	Based on observation and interviews, the facility failed to ensure the availability of a 96-hours supply of emergency food and drinking water. At least 48 hours of the supply must be on site at any given time, of which the facility?s rotating stock may be used. Evidence: 1. On 7-25-23, during a tour of the facility?s kitchen, the 48-hour supply of emergency food was observed. The metal shelf identified as the emergency supply did not have the 48-hour on-site supply of emergency food. 2. Individual #1 acknowledged there was not a 48-hour supply of emergency food present. Interviewee stated the food is supplied by a caterer. The current licensed facility did not staff the kitchen and did not purchase food.
Plan of Correction:	Catering services have ordered 96- hours of emergency food and drinking water. Catering service provided invoice for emergency food and drinking water to be delivered on 08/03/2023. Catering services have provided an Emergency Menu for 96 hours, along with their Emergency Preparedness Plan. Executive Director, Regional Director of Operations, Catering Manager and Maintenance Director will monitor monthly to ensure compliance with state regulations and rotation of current food supply. Date completion: 08/4/2023 and ongoing