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Assisted Living

Eugene H. Bloom Retirement Center

308 Weaver Avenue, Emporia, VA 2384765 bedsLicensed & Active
Google rating
4.3/5

based on 4 Google reviews

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State Inspection History

State Inspections

Source: VA State Licensing Agency

5total
26deficiencies
Jul 23, 2025Routine

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: 7/23/2025 from 9:45 am to 2:55 pm. 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: 28 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4 Number of staff records reviewed:3 Number of interviews conducted with residents:7 Number of interviews conducted with staff: 3 Observations by licensing inspector: Lunch and an activity was observed. A medication pass observation was completed for four residents. The following was reviewed: liability insurance, resident and staff records, emergency preparedness drills, resident fire and resident emergency drills, medication carts, fire inspection report, health inspection report, and a staffing schedule. Water temperature was measured, and the call bell system was monitored. 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. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lanesha Allen, Licensing Inspector at 757-715-1499 or by email at Lanesha.allen@dss.virginia.gov

22VAC40-73-320-A

Based on record reviewed and staff interviewed, the facility did not ensure the physical examination report of such examination contain a statement that specifies whether the individual is or is not capable of self- administering medication. Evidence: 1. The ISP

22VAC40-73-640-A

Based on observation, a review of the facility?s medication plan and interview, it was determined that the facility shall have, keep current, and implement a written plan for medication management. The facility's medication plan shall address procedures for administering medication and shall include A plan for proper disposal of medication. Evidence: 1. During the medication cart inspection, Refresh 0.5% Eyedrops for resident #9 were found on the cart with an expiration date of 07/03/2025. 2. Staff #2 confirmed the medication for resident #5 was expired.

Nov 18, 2024Routine

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: 11/18/24 from 9:30 am to 2:30 pm. 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: 30 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 5 Number of staff records reviewed:3 Number of interviews conducted with residents:2 Number of interviews conducted with staff: 2 Observations by licensing inspector: Lunch and an activity was observed. A medication pass observation was completed for two residents. The following was reviewed: resident and staff records, emergency preparedness drills, resident fire and resident emergency drills, medication carts, fire inspection report, health inspection report, and a staffing schedule. Water temperature was measured, and the call bell system was monitored. 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. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lanesha Allen, Licensing Inspector at 757-715-1499 or by email at Lanesha.allen@dss.virginia.gov

22VAC40-73-450-E

Based on record reviewed and staff interviewed, the facility did not ensure the individualized service plan shall be signed and dated by the licensee, administrator, or his designee, (i.e., the person who has developed the plan), and by the resident or his legal representative. These requirements shall also apply to reviews and updates of the plan. Evidence: 1. The ISP

22VAC40-73-640-A

Based on observation, a review of the facility?s medication plan and interview, it was determined that the facility shall have, keep current, and implement a written plan for medication management. The facility's medication plan shall address procedures for administering medication and shall include A plan for proper disposal of medication. Evidence: 1. During the medication cart inspection, Farxiga 10mg tabs for resident #5 were found with an expiration date of 04/11/24. 2. Staff #2 confirmed the medication for resident #5 was expired.

Aug 8, 2023Routine

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: 08/08/2023. 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: 30 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 8 Number of staff records reviewed: 3 Number of interviews conducted with residents: 3 Number of interviews conducted with staff: 2 Observations by licensing inspector: Lunch and an activity were observed. A medication pass observation was completed for 3 residents. The following were reviewed: resident and staff records, emergency preparedness drills, resident fire and resident emergency drills, medication carts, and the staff schedule. Water temperature was measured, and the call bell system was monitored. 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. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact M. Tess Pittman, Licensing Inspector at (757) 641-0984 or by email at tess.pittman@dss.virginia.gov.

22VAC40-73-250-C

Based on record review, the facility failed to ensure personal and social data be maintained on staff and included in the staff record. Evidence: 1. Staff #3?s record does not include verification that the staff person has received a copy of their current job description.

22VAC40-73-440-L

Based on record review, the facility failed to maintain the completed UAI

22VAC40-73-450-C

Based on record review, the facility failed to ensure the comprehensive individualized service plan include description of identified needs based upon the fall risk rating. Evidence: 1. Per progress notes, Resident #1 fell on the following days: 08/01/2023, 07/26/2023, 06/09/2023, 06/07/2023, and 05/04/2023. The fall risk ratings completed for Resident #1 following the falls indicates the ISP

22VAC40-73-550-G

Based on record review, the facility failed to annually review the rights and responsibilities of residents with each resident, or his legal representative or responsible individual as stipulated in subsection H of this section and each staff person. Evidence: 1. The last review of the rights and responsibilities of residents for Staff #1 was completed on 06/26/2022. 2. The last review of the rights and responsibilities of residents for Staff #2 was completed on 08/04/2022.

Jul 18, 2022Routine

Type of inspection: Renewal On 7-18-22 an unannounced renewal inspection was conducted. (AR 07:10/dep 5:45 p.m.) The facility census was 39. The administrator was present, A medication pass observation was conducted, breakfast meal observer, a tour of the facility was conducted, staff and resident interviews and records were reviewed, emergency preparedness documents were reviewed, 48 hours supply observed, first aid kit checked, and other licensing requirements checked during inspection. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. 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. 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

22VAC40-73-210-B

Based on record reviewed and staff interviewed, the facility failed to ensure a direct care staff attended at least 18 hours of training annually. Evidence: 1. On 7-18-22, staff #3, had 13.5 hours of annual training. Staff?s date of hire was documented as 5-5-22. 2. On 7-18-22 and 7-25-22, staff #1 acknowledged the aforementioned staff did not have the required 18 hours of training.

22VAC40-73-260-C

Based on observation and staff interviewed, the facility failed to ensure a listing of all staff who have current certification in first aid or CPR, was posted in the facility so that the information is readily available to all staff at all times. Evidence: 1. On 7-18-22, during a tour of the facility, the inspector inquired where the first aid and CPR posting was located. Staff #1 and #5 stated the listing was not posted. 2. On 7-18-22 and 7-25-22, staff #1 acknowledged the facility did not post the first aid and CPR listing.

22VAC40-73-290-B

Based on observation and staff interviewed, the facility failed to ensure it posted the name of the current on-site person in charge, in a place in the facility that is conspicuous to the residents and the public. Evidence: 1. On 7-18-22, the inspector inquired of staff #1 where the staff person in charge information was posted. Staff stated it was on the staff schedule. Staff #1 was informed that the inspector was not looking for the posted staff schedule but the staff-person in charge posting. 2. On 7-18-22 and 7-25-22, staff #1 acknowledged the staff in-charge posting was not available.

22VAC40-73-440-D

Based on record reviewed and staff interviewed, the facility failed to ensure the uniformed assessment instrument ( UAI

22VAC40-73-450-C

Based on record review and staff interview and the facility failed to ensure the resident?s individualized service plan ( ISP

22VAC40-73-450-E

Based on record reviewed and staff interviewed, the facility failed to ensure the individualized service plan ( ISP

22VAC40-73-580-A

Based on document reviewed and staff interviewed, the facility failed to ensure when any portion of the facility is subject to inspection by the Virginia Department of Health, the facility shall be in compliance with those regulations, as evidenced by subsequent annual reports from the Virginia Department of Health. Evidence: 1. On 7-18-22, the facility?s health inspection was last completed on 2-24-20. 2. Staff #1 acknowledged the facility did not have a current health inspection.

22VAC40-73-660-A

Based on observation and staff interviewed, the facility failed to ensure medications was stored in a manner consistent with current standards of practice. Evidence: 1. On 7-18-22 during a tour to facility, the call bell in resident #9?s room was pulled. Staff #6 responded and shown the following medications in the room: (a) Metamucil and Cortizone cream was located on the night stand, (b) Aquaphor cream and Cortizone cream located in the bathroom and (c) Triple antibiotic was located on the dresser. The physician?s order dated 5-1-22 did not include a bedside or self-administration order. 2. On 7-18-22, staff #6 acknowledged, the aforementioned medications were in resident #9?s room. 3. Staff #1 acknowledged the resident?s medication did not have a prescriber?s order and or bedside/ self-administration order.

22VAC40-73-680-D

Based on record reviewed, observation and staff interviewed, the facility failed to ensure medications was administered in accordance with the physician?s or other prescriber?s instructions and consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing. Evidence: 1. On 7-18-22, during the medication pass observation with staff #2, three tablets of resident #3?s Prednisone prescribed for 10 days remained on the medication cart. The July 2022 medication administration record ( MAR

22VAC40-73-680-M

Based on observation, document reviewed and staff interviewed, the facility failed to ensure medications ordered for PRN

22VAC40-73-700-2

Based on observation and staff interviewed, the facility failed to ensure it posted the ?No Smoking -Oxygen in Use? sign was posted on the door of any room where oxygen was in use. Evidence: 1. On 7-18-22, during a tour of the facility, resident #2?s room was observed with several oxygen tanks and a concentrator. The door to the room did not have a ?No Smoking- Oxygen in Use? sign posted. The inspector took staff #6 to resident #2?s room who also saw the room door did not have the ?No-Smoking- Oxygen in Use? sign. 2. On 7-18-22, staff #6 acknowledged the aforementioned posting was not on resident #2?s door.

22VAC40-73-940-A

Based on document reviewed and staff interviewed, the facility failed to ensure it complied with the Virginia Statewide Fire Prevention Code as determined by at least an annual inspection by the appropriate fire official. Evidence: 1. On 7-18-22, the fire inspection report provided to the inspector was dated 1-16-20. 2. Staff #1 acknowledged the facility did not have a current annual fire inspection

22VAC40-80-120-E-2

Based on observation and staff interview, the facility failed to ensure the findings of the most recent inspection of the facility was posted . Evidence: 1. On 7-18-22 during a tour of the facility, the most recent inspection posted in the facility was dated 8-21-20. 2. On 7-18-22 and 7-25-22, staff #1 acknowledged the most recent inspection was not posted in the facility.

Nov 8, 2021Routine

A monitoring inspection was initiated on 11-9-21 and concluded on 11-19-21. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 42. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed four resident records, four staff records and new hire records, activities calendar, staff schedules, fire and emergency procedures, healthcare oversight, nutrition report and pharmacy report submitted by the facility to ensure documentation was complete. The inspector conducted on-site portion of the inspection on 11-18-21. An exit interview was conducted with the administrator on 11-15-21; 11-18-21 and 11-19-21 where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliances with applicable standards or law, and violations were documented on the violation notice issued to the facility.

22VAC40-73-250-D

Based on record review and staff interview, the facility failed to ensure, each staff person shall annually submit the results of a risk assessment, documenting that the individual is free of tuberculosis (TB) in a communicative form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it. Evidence: 1. Staff #6?s record documented the last tuberculosis date as 10-4-20. Staff?s date of hire is documented as 10-1-20. There was no current TB screening presented during the monitoring. 2. Staff #1 acknowledged, the TB screening was not updated.

22VAC40-73-310-H

Based on record reviewed, document reviewed and staff interviewed, the provider failed to ensure it did not retain anyone prescribed a psychotropic medication without a treatment plan for two of four sample residents. Evidence: 1. Resident #2?s October 2021 medication administration record ( MAR

22VAC40-73-450-C

Based on record review and staff interview and the facility failed to ensure the resident?s individualized service plan ( ISP

22VAC40-73-650-A

Based on record review and staff interview, the facility failed to ensure no medication, dietary supplement, diet, medical procedure, or treatment shall be started, changed, or discontinued without a valid order from a physician or other prescriber. Medications include prescription, over-the-counter, and sample medications. Evidence: 1. Resident #1?s October 2021 medication administration record ( MAR

22VAC40-73-690-G

Based on record review and staff interview, the facility failed to ensure it followed up on recommendation by the pharmacy for a resident. Evidence: 1. Resident #3?s pharmacy review dated 8-4-21 documented weekly blood pressure while on Lisinopril and Metoprolol and daily pulse while on Metoprolol and thyroid levels every six months. There was no documentation in the resident?s record of this information being forwarded to the resident?s physician for a response. 2. Staff #1 acknowledged the recent 8-4-21 pharmacy review recommendation was not follow-up with the resident?s physician.

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