VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Evermore Senior Living
4358 Prince William Parkway
Woodbridge, VA 22192
(703) 249-9128

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: Jan. 8, 2024

Complaint Related: No

Areas Reviewed:

Administration and Administrative Services Personnel Staffing and Supervision Admission, Retention and Discharge of Residents Resident Care and Related Services Resident Accommodations and Related Provisions Building and Grounds Emergency Preparedness Background Checks for Assisted Living Facilities Sworn Statement

Comments:

Date of Inspection: January 8, 2024 Type of Inspection: Monitoring inspection Census: 7 Number of records reviewed and interviews conducted- 6 records, 5 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The Licensing Inspector observed residents participating in activity programs and eating lunch. Licensing Inspector observed medication administration and compared physician orders to the medications that were available. If you have any questions or email changes, please do not hesitate to contact me at sarah.pearson@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection or regulation, you can find the information on the internet: www.dss.virginia.gov. The Licensing Inspector and the Administrator discussed the risk assessment ratings for the violations for this inspection. Please complete the ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and returned it to the office. You will need to specify how the deficient practice will be or has been corrected. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s).

Violations:

Standard #:	22VAC40-73-320-A
Description:	Based on resident records review and staff interview, it was determined that the facility failed to have a physical examination by an independent physician completed within 30 days of admission. Evidence: Resident A did not have a completed physical examination on file and was admitted on 1/3/24.
Plan of Correction:	Resident physical examination by an independent physician is in progress with the admission team in the facility. In the event a resident is admitted, the resident must have had a physical examination by an independent physician within 30 days of admission and the completed examination should be on file, signed and dated by the physician.
Standard #:	22VAC40-73-690-B
Description:	Based on resident records review and staff interview, it was determined that the facility failed to conduct a medication review for each resident every six months. Evidence: Residents A, B, and C did not have a medication review on file within the last six months.
Plan of Correction:	The medication review for each resident every six months is in progress in the facility. In the event a resident has a medication review or a recommendation to be made either by an independent physician or Nurse Practitioner, the document of the review will be signed and dated.