Monticello Ridge Crossing Residential Alf, LLC
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State Inspection History
State Inspections
Source: VA State Licensing Agency
Feb 18, 2025Routine
Comments/Discussion: 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: 02/18/2025 arrival time: 11:48am departure time: 2:45pm 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: 5 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 2 Number of staff records reviewed:2 Number of interviews conducted with staff: 1 Observations by licensing inspector: A tour of the facility was conducted to include inside and outside building grounds. Lunch, weekly menu and resident activities were observed. Observed physicians orders, observed Medication Administration Records and observed pharmacy review. 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. Residents were observed watching game shows on TV and having lunch. 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 Shelby Haskins, Licensing Inspector at (804) 305-4876 or by email at Shelby.Haskins@dss.virginia.gov. Violation Notice Issued: Yes A copy of this document will be sent to the licensee/provider for signature. Inspector Name: Shelby Haskins Date Inspection Summary Issued: 3/4/2025
Based on a review of the facility?s records and an interview with Administrator, it was determined that the facility does not have Liability Insurance. Evidence: 1. Administrator informed inspector during the inspection that the facility was not insured.
Based on a review of staff records, it was determined that the facility did not ensure that all staff had a signed Sworn Disclosure. Evidence: 1. The record for staff #1 did not contain a signed Sworn Disclosure. 2. Staff #2 confirmed that staff #1 did not have a signed Sworn Disclosure on file.
Based on a review of resident records, it was determined that the facility did not ensure that the resident file included the initial physical and the initial tuberculosis (TB) screening. Evidence: 1. The record for resident #1 and resident #2 did not include an initial physical. 2. Staff #2 confirmed that there was not an initial physical in the record of resident #1 and resident #2. 3. The record for resident #1 and resident #2 did not include an initial tuberculosis (TB) test. 4. Staff #2 confirmed that there was not an initial tuberculosis (TB) test in the record of resident #1 and resident #2.
Based on a review of resident records, it was determined that the facility did not ensure that a sex offender screening completed by Virginia State Police was completed and in the resident record. Evidence: 1. The record for resident #2 did not have a sex offender screening completed by Virginia State Police. 2. Staff #2 confirmed that there was not a sex offender screening completed by Virginia State Police.
Based on a review of resident records, it was determined that the facility did not ensure that the resident had a current Individualized Service Plan ( ISP
Based on a review of resident and staff records, it was determined that the facility did not ensure that the annual resident rights were signed by the staff or residents. Evidence: 1. The records for staff #1 and staff #2 did not have a signed annual copy of the Residents Rights. 2. Staff #2 confirmed that there was not a signed annual copy of the Residents Rights in the records for staff #1 or staff #2. 3. The records for resident #1 and resident #2 did not contain a signed annual copy of the Residents Rights. 4. Staff #2 confirmed that there was not a signed annual copy of the Residents Rights in records for resident #1 and resident #2.
Jul 8, 2024ComplaintCleanReport
Type of inspection: Complaint Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 7/8/24, 10:30 am to 12:00 pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint/) was received by VDSS Division of Licensing on 6/13/24 regarding allegations in the area(s) of: Administration; Personnel; Admission, Retention and Discharge Number of residents present at the facility at the beginning of the inspection: 5 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of interviews conducted with staff: 1 Number of interviews conducted with residents: 1 Observations by licensing inspector: building and grounds, resident rooms, Additional Comments/Discussion: Two licensing inspectors were present during the inspection. Building and grounds, sell of the building and building maintenance discussed, Licensee to follow up with building owner this week and will update licensing staff on the status of the sale. An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation did not support the allegations of non-compliance with standard(s) or law. The inspection summary will be posted to the VDSS website within 5 business days of your receipt of the inspection summary. 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. Use the following last two statements on every Inspection Summary: For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Yvonne Randolph, Licensing Inspector at 804-662-7454 or by email at yvonne.randolph@dss.virginia.gov or Shelby Haskins, Licensing Inspector at 804-305-4876 or by email at Shelby.Haskins@dss.virginia,gov
Aug 21, 2023RoutineCleanReport
Type of inspection: Mandated Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 8/21/23, 12:30 pm to 2:00 pm The Acknowledgement of Inspection form was signed and left at the facility on date of the inspection. The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of residents present at the facility at the beginning of the inspection: 5 Number of staff records reviewed: 2 Number of interviews conducted with residents: 2 Number of interviews conducted with staff: 2 Observations by licensing inspector: Postings, medication storage and administration, resident- staff interactions, lunch meal Additional Comments/Discussion: The building is for sale and there are problems with cooling/heating on the top floor . Portable heating/cooling units have been install on the top floor by the licensee and have been approved by a local fire official. Temperatures are being maintained in compliance with the standards. An exit meeting was conducted to review the inspection findings. The evidence gathered during the inspection determined no violations with applicable standard(s) or law. The inspection summary will be posted to the VDSS website within five (5) business days of your receipt of the inspection summary. 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 Yvonne Randolph, Licensing Inspector at (804) 662-7454 or by email at Yvonne.randolph@dss.virginia.gov
Feb 6, 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: 2/6/2023, 1:15 -3:00 pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. 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: 1 Number of interviews conducted with staff: 1 Observations by licensing inspector: medication storage and administration, postings, food preparation, infection control 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 Yvonne Randolph, Licensing Inspector at 804-662-7454 or by email at yvonne.randolph@dss.virginia.gov
Based on the review of three staff files, one staff did not have an annual tuberculosis screening. Evidence: An annual screening for tuberculosis was not found during a review of the file of staff # 3
Based on a review of the files for four residents, a risk assessment for tuberculosis was not completed on each resident annually. Evidence: An annual risk assessment for tuberculosis was not found during the review of files for residents # 1, # 2, # 3 and # 4.
Based on a review of files for four residents, an annual reassessment using the uniform assessment instrument ( UAI
Based on a interview with the administrator of the facility on 2/6/23, on-site health care oversight has not been provided annually to the residents. Evidence: The administrator of the facility reported that health care oversight had not been completed for the residents.
Based on observation and an interview with the administrator of the facility on 2/6/23, the facility does not have at least one pharmacy reference book, drug guide or medication handbook for nurses that is no more than two years old as a reference book for staff who administer medications. Evidence: The drug guide on-site on 2/6/23 was dated 2015. The administrator confirmed the facility did not have a drug guide that is no more than two years old.
Based on an interview with the administrator on 2/6/23, the facility has not secured an annual fire inspection by the local fire official. Evidence: When requested by the licensing inspector, the administrator reported that a written annual fire inspection report was not available.
Mar 10, 2022Follow-up
A visit was made to the facility on 3/10/2022 to follow-up on a complaint received by the department regarding allegations in the areas of Resident Care and Related Services and Administration and Administrative Services. The evidence gathered during the investigation supported the allegation of non-compliance with standards or law, and a violation was issued. Any violations not related to the complaint but identified during the course of the investigation can be also found on the violation notice. During the exit interview, the administrator/licensee expressed her intent to dispute the findings/violations.
Based on a review of the facility's infection control policy, the facility's infection control policy fails to address the surveillance, prevention, and control of disease and infection that is consistent with the federal Centers for Disease Control and Prevention (CDC) guidelines. Evidence: The facility's COVID policy is inconsistent with the CDC COVID guidelines. 1.The facility's infection control policy in regards to COVID states: (a) " No visitors should come inside the facility, not even to go to the bathroom"; (b) "Your loved ones and friends can come to visit you outside, sit at the table and eat with you"; (c) "Another suggestion is that your family and family members can come and bring food to the common area (only) and have time with you, if they are fully vaccinated with the booster shot and wear a mask inside the facility or they can sit outside at the table"; and (d) "If you decide to go out of the facility with your family members and spend time with them you can, but you will need to stay with them for five days and take a COVID test showing that you are not infected before you can return into the community". The CDC COVID guidelines for long term care facilities dated 9/17/20 and revised 3/10/2022 state: (a) Facilities shall not restrict visitation without a reasonable clinical or safety cause, consistent with 42 CFR ? 483.10(f)(4)(v) of the Federal Disability Rights Laws and Protection & Advocacy (P&A) Programs; (b) Facilities must allow indoor visitation at all times and for all residents as permitted under the regulations. While previously acceptable during the PHE, facilities can no longer limit the frequency and length of visits for residents, the number of visitors, or require advance scheduling of visits; and (c) Facilities must permit residents to leave the facility as they choose.
Based on a review of the facility's infection control policy for COVID and an interview with the facility's administrator, it was determined that one resident who does not have a serious cognitive impairment cannot freely leave the facility. Evidence: An allegation was received that Resident # 1 is not being allowed to freely leave the facility. The facility's owner confirmed in-person on 3/10/2022 that the resident's movement in the community is being limited due to the resident's inability to "safely" maintain social distancing, performed handwashing and wear a mask. The facility's COVID policy documents that the resident can leave to visit family but must "stay with them for five days and have a COVID test showing that you are not infected before returning to the community". The policy as written places restrictions/barriers on the resident's freedom of movement and decision-making.
Dec 1, 2021Routine
A monitoring inspection was completed on 12/1/2021. The administrator reported that the current census is 10 residents. The inspection included a sample review of information for three (3) residents and two (2) staff along with a review of medication administration, required postings, resident care, emergency food supply, etc. An exit interview was conducted with the Administrator on the date of inspection, 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-compliance(s) with applicable standards or law, and violations are documented on the violation notice issued to the facility.
Based on an inspection of the medication cart on 12/1/2021, single-use and dedicated equipment for one resident is not appropriately labeled. Evidence: During an inspection of the medication administration/cart, it was found that blood glucose monitoring equipment for resident # 1 was not labeled.
Based on an inspection of the medication cart on 12/1/2021, over-the counter medications for one resident are not labeled with the resident's name. Evidence: During an inspection of the medication administration/cart, two over-the -counter medications for resident # 1 were not labeled (metamucil and senna)
Aug 9, 2021ComplaintCleanReport
A non-mandated complaint investigation was initiated and concluded remotely on 8/9/20219. A complaint was received by the department regarding allegations in the areas of Admission Retention and Discharge of Residents. The administrator was contacted by telephone to conduct the investigation. The licensing inspector completed interviews and reviewed file documentation (resident agreement) to complete the investigation . The evidence gathered during the investigation did not support the allegations of non-compliance with standards or law.
May 8, 2021ComplaintCleanReport
This inspection was conducted by licensing staff using an alternate remote protocol necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A complaint investigation was initiated on 5/5/2021 and concluded on 5/7/2021 regarding visits to residents at the facility and residents being able to freely leave the facility. The inspector communicated with the facility's administrator and the complainant regarding the concerns. The licensee reports that procedures regarding resident's movement and visitation had to be put in place to ensure residents' health, safety and welfare due to the COVID pandemic. The administrator reports further that visitation with families have occurred and that window visits and Zoom visits are being encouraged/and have occurred. According to the administrator, there are limitations on visitation at the home due to the pandemic, staffing, and resident safety. There were no violations cited. The licensing inspector will provide T/A to the facility's administrator regarding developing a written visitation plan for the facility taking into consideration staffing, physical space and the building limitations.
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