VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Residences at Lynn House
4400 W. Braddock Road
Alexandria, VA 22304
(703) 379-6000

Current Inspector: Nina Wilson (703) 635-6074

Inspection Date: Jan. 30, 2024

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 63.2 General Provisions 63.2 Protection of adults and reporting 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Technical Assistance:

Documentation was discussed with the provider.

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: 1/30/24 (8:55 AM - 2:00 PM). Number of residents present at the facility at the beginning of the inspection: Four The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: Four Number of interviews conducted with staff: Two Observations by licensing inspector: Meal, activity An exit meeting was held. 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. 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 #:	22VAC40-73-210-B
Description:	Based on record review, the facility failed to ensure that each direct care staff member attends at least 18 hours of training annually. Evidence: One out of three staff records (Staff #3) failed to contain documentation of at least 18 hours of training within the past year. The record for Staff #3, hired March 2022 as a Resident Assistant, contained nine hours of training that were completed within her first year of working at the facility (March 2022 - March 2023). Facility staff confirmed that Staff #3 had completed nine hours of training within the review period (March 2022 - March 2023).
Plan of Correction:	To ensure that each direct care staff member attends at least 18 hours of training annually, the Assistant Residential Program Manager (ARPM) will review the Staff Training Chart in our Training Notebook at the beginning of each month. For anyone who does not have the 18 hours, the ARPM will arrange for them to receive the necessary training. All staff records will be reviewed by 2/27/2024 and staff members needing additional hours will have earned them.
Standard #:	22VAC40-73-390-B
Description:	Based on record review, the facility failed to ensure that a copy of the signed resident agreement/acknowledgment is retained in the resident record. Evidence: The record for Resident #1, admitted 1/17/24, was reviewed during the inspection. Resident #1's record did not contain a written agreement/acknowledgment of notification that was signed by the resident, or her legal representative, and by the licensee or administrator. Facility staff confirmed that Resident #1's signed resident agreement/acknowledgment was not present in the resident record.
Plan of Correction:	To ensure that the signed resident agreement is retained in the resident record, the Assistant Residential Program Manager will review the resident record prior to (or on) move-in day and confirm that all required documents are in place. All current records will be reviewed by 2/15/2024, and going forward we will follow this plan.