VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Senior Living at Georgian Manor
651 River Walk Parkway
Chesapeake, VA 23320
(757) 436-9618

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: Feb. 15, 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 ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

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: An unannounced monitoring inspection took place on 02/15/24 at 10:42 am to 12:10. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self- reported incident was received by VDSS Division of Licensing on 01/11/2024 regarding allegations in the area of: Personnel Number of residents present at the facility at the beginning of the inspection: 61 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: An observation of residents, and lunch was completed in the safe, secure environment. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the self-report of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the self-report but identified during the course of the investigation can also be found on the violation notice. 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 (Donesia Peoples) Licensing Inspector at (757) 353-0430 or by email at donesia.peoples@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-110-1
Description:	Based on the onsite record review the facility failed to ensure all staff be considerate and respectful of the rights, dignity, and sensitivities of persons who are aged, infirmed, or disabled. Evidence: 1. Resident?s #1 incident report dated 01/11/24 includes the following statement written by staff #1, ?resident #1 spit in staff #1?s face, staff #1 wiped the spit with resident?s #1 hand and mushed it back into resident?s #1 face?. Resident #1?s incident report includes ?resident #1 was assessed by staff #4 upon staff #4 arrival to the community, resident #1 had bruising to the left side of resident #1?s face. Staff #1 was terminated from employment with the facility.? 2. Staff #2?s written statement dated 01/11/24 includes the following: ?Staff #1 reported to staff #2 that staff #1 grabbed resident #1?s hands wiped the spit back on resident #1?s face, mushed resident #1?s own hand in resident #1?s face. Staff #2 went to go check resident #1 and noticed the whole left side of resident #1?s face was red.? 3. During an interview on 02/09/24 with collateral contact (CC) #1, CC#1 observed resident #1 on 01/17/24 and observed the resident?s left cheek to be red.
Plan of Correction:	What Has Been Done to Correct? Staff #1 was immediately terminated. ED/RCD/BOM conducted re-education to associates on Resident Abuse and Neglect beginning on 1/11/24 at our All-Staff Meeting. Additionally, 1:1 re-education was completed with associates who were not able to attend that all staff training on 1/11/24. ED/RCD/BOM will continue to re-educate associates on Abuse and Neglect at our monthly all staff meetings through December 2024. How Will Recurrence Be Prevented? 1. Re-education by management of Resident Abuse and Neglect of Residents. 2. Ensuring background checks do not contain barrier crimes for any associates. 3. Management to follow up with any Abuse and Neglect allegations immediately as mandated reporters and report to DSS and APS. 5. Signs of Abuse is reviewed in Jump Start by RCD/ARCD. 6. Resident Abuse and neglect is taught in 6 hour dementia training as well. PersonResponsible: ED and all management