VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Oakmont at Gordon Park
401 Gordon Ave
Bristol, VA 24201
(276) 644-4800

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: March 27, 2024 and March 28, 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 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

Comments:

Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 03/27/2024 10:05am to 3:26pm and 03/28/2024 12:15pm to 4:10pm 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: 99 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 9 Number of staff records reviewed: 5 Number of interviews conducted with residents: 4 Number of interviews conducted with staff: 4 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. 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 Becky Berry, Licensing Inspector at 276-608-3514 or by email at rebecca.berry@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-870-A
Description:	Based on observations made during the tour of the building, the facility failed to ensure the interior and exterior of all buildings shall be maintained in good repair and kept clean and free of rubbish. EVIDENCE: 1. In resident room #1211, the licensing inspector (LI) observed a large dark stain on the carpeting near the stainless-steel trash can, and several smaller stains on the carpeting near the red recliner. 2. The entry door to resident room #1234 had dark lines on the lower portion, left side, and areas of chipped paint on the lower portion of the door frame. There was a dark stain on the carpet in the main living area. 3. The door to laundry room #0021 had a dark line across the width of the door, approx. six inches below the doorknob, and chipped paint in two small areas on the lower left portion of the door frame. 4. In the hallway near exit door #1 there was a dark line above the baseboard approximately 24 inches in length, and the baseboard below the dark line was discolored in places. At the corner where the baseboards meet, there were dark marks on the baseboards and three small areas of chipped paint on the wall just above the baseboards. 5. In resident room #1223 there were several small stains on the carpeting in front of the red recliner. 6. In resident room #1226, dark lines were observed on the lower portion of the closet door and the adjacent baseboard, are areas of chipped paint on the right lower portion of the door frame as you exit the room to the hallway. 7. In resident room #1002, dark lines were observed across the lower portion of the entry door. 8. Water stains were observed on ceiling tiles by the activity area/library. 9. The entry door to resident room #1005 had a dark line approximately 6 inches long on the bottom right portion, and two small areas of chipped paint along the bottom portion of the door fame.
Plan of Correction:	1. Stains on carpet in #1211 are being cleaned. 2. #1234 door was repainted and stain cleaned. 3. #0021 door was repainted 4. Baseboard in hallway near exit door #1 was repaired/repainted. 5. #1223 carpet was cleaned. 6. #1226 door was painted. 7. #1002 door was painted. 8. Ceiling tiles were replaced. 9. #1005 door was painted. Director of Plant Operations will do an audit of doors and repaint any with issue by 04/30/2024. He will continue this audit monthly for 6 months. Director of Plant Operations keeps an ongoing list of apartments who need commercial carpet cleaning. Housekeeping employees will be retrained on reporting carpets that require commercial attention by 4/12/24. [SIC]
Standard #:	22VAC40-73-870-B
Description:	Based on observations made during the tour of the building, the facility failed to ensure all buildings shall be well-ventilated and free from foul, stale, and musty odors. EVIDENCE: 1. The licensing inspector observed an odor resembling urine upon entering the main living area of resident room #1208 on both 03/27/2024 and 03/28/2024.
Plan of Correction:	Apartment #1208 was deep cleaned. Director of Plant Operations will monitor cleanliness of apartment #1208 living area weekly for 4 weeks. [SIC]