The Hillside House Memory Care Assisted Living Community
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State Inspection History
State Inspections
Source: VA State Licensing Agency
Mar 4, 2026Routine
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: 03/04/2026 2:45 PM to 4:15 PM 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 12/10/2026 regarding allegations in the area(s) of: 1. Buildings and Grounds Number of residents present at the facility at the beginning of the inspection: 16 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 3 Observations by licensing inspector: Areas of building affected by previous infestation Additional Comments/Discussion: N/A 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. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). 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 these 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. Refer to General Procedures and Information for Licensure, 22VAC40-80-260-B for information on requesting a problem solving conference. 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 Amanda ?AJ? Velasco, Licensing Inspector at (703) 397 4587 or by email at amanda.velasco@dss.virginia.gov.
Based on facility document review and direct observation, the facility failed to ensure the building was kept free of infestations of insects and vermin. Evidence: 1. On 12/10/2025, the facility submitted an incident report as all residents were required to evacuate the building due to a raccoon infestation. The residents returned to the building on 01/05/2026. 2. Staff 1 and Staff 2 provided related invoices and documentation of the infestation and relocation of residents. The invoices indicated that pest control provider was on premises treating the infestation on 11/25/2025. The invoice indicated that the traps needed to be checked daily for five days. Staff 1 stated that pest control provider was on site daily; however, no documentation was provided for those daily visits. The next invoice is dated 12/08/2025 and 12/18/2025. 3. The documentation provided included an incident narrative. The narrative contained the following events: a. December 05th, 2025: A raccoon fell from a ceiling tile near the great room and ran into the occupied room of Resident 1. b. December 06th: A raccoon fell from the same ceiling tile and entered the occupied room of Resident 2. c. December 7th: Raccoons were observed loitering at the front of the property. Another racoon fell through the same ceiling tile. d. December 09th: A trap containing a raccoon fell through the same ceiling area, injuring the raccoon. The trap was moved to a closet area. The injured raccoon escaped the cage, and blood was seen in the closet area. 4. In an interview with two LI?s on 03/04/2026, Staff 1 and Staff 2 confirmed that facility failed to ensure the building was free of infestations.
Mar 4, 2026Routine
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: 03/04/2026 1:50 PM to 2:45 PM 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 02/10/2026 regarding allegations in the area(s) of: 1. Buildings and Grounds Number of residents present at the facility at the beginning of the inspection: 16 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 3 Observations by licensing inspector: Areas of building affected by previous infestation Additional Comments/Discussion: N/A 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. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). 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 these 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. Refer to General Procedures and Information for Licensure, 22VAC40-80-260-B for information on requesting a problem solving conference. 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 Amanda ?AJ? Velasco, Licensing Inspector at (703) 397 4587 or by email at amanda.velasco@dss.virginia.gov.
Based on facility document review and direct observation, the facility failed to ensure the interior and exterior of all buildings were maintained in good repair and kept clean and free of rubbish. Evidence: 1. On 02/10/2026, the facility submitted an incident report as eight (8) residents were required to evacuate the building due to a sprinkler system leak. The residents returned to the building on 02/24/2026. 2. During a tour of the building, two LI?s observed a large stain on the ceiling next to the great room that was actively leaking. At the time of inspection, it was being mopped up and cleaned with paper towels. 3. In an interview with two LI?s on 03/04/2026, Staff 2 stated that it was being contracted out but the repairs were not scheduled yet. The invoice was provided, and the contractor had been requested on 02/04/2026. 4. In an interview with two LI?s on 03/04/2026, Staff 1 and Staff 2 confirmed that buildings were not maintained in good repair. 5. Photo evidence obtained.
Jul 23, 2025Routine
Type of inspection: Renewal Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 07/23/2025 9:40 AM to 1:45 PM 07/24/2025 9:15 AM to 11:30 AM 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: 15 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 residents: 2 Number of interviews conducted with staff: 5 Observations by licensing inspector: Breakfast and Lunch Meals, Activities, Medication Pass Additional Comments/Discussion: N/A 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 Amanda Velasco, Licensing Inspector at (703) 397-4587 or by email at Amanda.Velasco@dss.virginia.gov
Based on resident record review and staff interview, the facility failed to ensure that a review of the appropriateness of each resident?s continued residence in the special care unit was completed six months after placement and annually thereafter. Evidence: 1. Resident 1, admitted 05/30/2024, and Resident 2, 06/27/2024, reside in a safe secure unit. 2. Resident 1 and Resident 2?s records did not contain a review of the appropriateness of each resident?s continued residence in the Safe, Secure unit. 3. In an interview with the LI on 07/24/2025, Staff 1 and Staff 2 confirmed the review of the appropriateness for Resident 1 and Resident 2 was not completed.
Based on staff record review and staff interview, the facility failed to ensure that at least four of the required annual training hours focused on topics related to resident?s? mental impairments when adults with mental impairments reside in the facility. Evidence: 1. On 07/23/2025, Staff 5 was working as a Med Tech on the Safe, Secure Unit. 2. Staff 5?s, hired on 06/12/2012, record does not contain the required four hours of annual training hours related to resident?s mental impairments. 3. On 07/23/2025, Staff 6 was working as a Certified Nursing Assistant on the Safe, Secure Unit. 4. Staff 6?s, hired on 02/26/2024, record does not contain the required four hours of annual training hours related to resident?s mental impairments. 5. In an interview with the LI on 07/24/2025, Staff 1 and 2 confirmed that Staff 5 and Staff 6 do not have the required four hours of annual training hours related to residents? mental impairments.
Based on staff record review and staff interview, the facility failed to ensure that all staff records were retained at the facility. Evidence: 1. In an interview with the LI on 07/23/2025, Staff 1 confirmed that all staff records are retained at the main campus of Falcon?s landing, not at the licensed facility location.
Based on resident record review and staff interview, the facility failed to ensure that the assisted living administrator provided written assurance that the facility has the appropriate license to meet his care needs at the time of admission based upon review of the Uniform Assessment Instrument ( UAI
Based on resident record review and staff interview, the facility failed to ensure that the individualized service plan ( ISP
May 7, 2025Routine
Type of inspection: Monitoring Date of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 05/07/2025 9:30 AM to 3:00 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: 14 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 residents: 0 Number of interviews conducted with staff: 3 Observations by licensing inspector: Meals, Activities, Medication Administration, Staff interactions with Residents and Visitors Additional Comments/Discussion: N/A 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 Amanda Velasco, Licensing Inspector at (703) 397-4587 or by email at Amanda.Velasco@dss.virginia.gov
Based on staff record review and staff interview, the facility failed to ensure that direct care staff have 10 hours of training in cognitive impairment within four (4) months of starting employment in a safe, secure unit. Evidence: 1. Staff 4?s, hired 03/18/2024, record contained one (1) hour of training in cognitive impairment. 2. In an interview with the LI on 05/07/2025, Staff 1 confirmed that Staff 4 did not have the required 4 hours of training in cognitive impairment within four (4) months of employment.
Based on staff record review and staff interview, the facility failed to ensure that all direct care staff attend 18 hours of training annually. Evidence: 1. Staff 5?s, hired 03/03/2024, record contained 7.25 hours of documented training. 2. In an interview with the LI on 05/07/2025, Staff 1 confirmed Staff 5 did not have the required 18 hours of annual training.
Based on direct observation and staff interviews, the facility failed to ensure that the on-site person in charge was posted. Evidence: 1. During a tour of the facility on 05/07/2025, the LI did not observe a posted on-site person in charge. 2. In an interview with the LI on 05/07/2025, Staff 2 confirmed the on-site person in charge was not posted.
Based on direct observation and staff interview, the facility failed to ensure the posted menu included all meals and snacks. Evidence: 1. During a tour of the facility on 05/07/2025, the LI observed the posted menu in the dining area. The menu did not include snacks or breakfast. 2. In an interview with the LI on 05/07/2025, Staff 2 stated that the breakfast menu remains the same. Staff 2 confirmed the breakfast and snack menu was not posted. 3. Photo evidence obtained.
Based on facility document review and staff interview, the facility failed to ensure that the dietician oversight contained certification that the requirements of standards were met. Evidence: 1. The Special Diet Oversight for 05/06/2025, 04/07/2025, 03/07/2025, 02/07/2025, and 01/08/2025 were reviewed. They did not contain the required certification that standards were met. 2. In an interview with the LI on 05/07/2025, Staff 1 confirmed the oversight did not contain the required certification.
Based on facility document review and staff interview, the facility failed to ensure the medication management plan contained all the required components. Evidence: 1. In an interview with the LI on 05/07/2025, Staff 1 and Staff 2 provided the Medication Management Plan. The Medication Management Plan did not contain the following components: a. Methods to prevent the use of outdated, damage, or contaminated medications b. Methods to ensure MAR
Based on facility document review and staff interview, the facility failed to ensure to conduct a semi-annual review of the emergency preparedness plan for residents with an emphasis placed on the individual?s respective responsibilities. Evidence: 1. In an interview with the LI on 05/07/2025, the LI requested the semi-annual review of the emergency preparedness plan for residents. Staff 1 stated that the review was not completed with residents.
Based on direct observation and staff interview, the facility failed to ensure each resident was accorded respect for privacy in every aspect of daily living. Evidence: 1. On 05/07/2025, the LI observed Staff 3 administer eye drops to a resident during a trivia activity around 11:30 AM. There were nine (9) other residents, and three (3) other staff present in the room at the time of administration. At the time of the administration, the staff member conducting activities paused while Staff 3 was speaking to the residents, and multiple residents began watching Staff 3 administer the eye drops. 2. In an interview with the LI on 05/07/2025, Staff 3 stated that they administer medication where the resident is at the time medication is due. Staff 3 stated that moving residents away from the area that they want to be in can cause behavior or resistance to care. 3. In an interview with the LI, Staff 1 acknowledged that privacy was not maintained when the eye drops were administered, and the activity was stopped.
Jul 11, 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: LI entered the facility at 8:30 am on 7/11/2023 and exited at 4:20 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: 10 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 6 Number of staff records reviewed: 3 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: LI observed medication administration. LI observed residents eating breakfast and lunch and engaging in activities. 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 Jamie Eddy, Licensing Inspector at (703) 479-5247 or by email at jamie.eddy@dss.virginia.gov
Based upon a review of records, the facility failed to ensure that six months after placement of the resident in the safe, secure environment the licensee, administrator, or designee shall perform a review of the appropriateness of each resident in the special care unit. Evidence: 1. During the renewal inspection conducted on 7/11/2023, LI reviewed resident records and observed that the six-month review of appropriateness for continued residence for Resident #3, who was admitted to the safe and secure unit on 11/7/2022, had not been completed. 2. During the renewal inspection conducted on 7/11/2023, LI reviewed resident records and observed that the six-month review of appropriateness for continued residence for Resident #6, who was admitted to the safe and secure unit on 10/20/2022, had not been completed.
Based upon a review of documents, the facility failed to ensure that for each direct care staff member who does not have current certification in first aid, shall receive certification in first aid within 60 days of employment. Evidence: 1. During renewal inspection conducted on 7/11/2023, LI reviewed the staff records and did not observe documentation of first aid certification for Staff #2, who was hired as a certified nurse assistant effective 5/8/2023. 2. On 7/14/2023, LI received an email from the administrator confirming that Staff #2 ?is not first aid certified.?
Based upon a review of records, the facility failed to ensure the physical that within the 30 days preceding admission, a person shall have a physical examination by an independent physician. The report of such exam shall contain the following information: ? A statement that the individual does not have any of the conditions or care needs prohibited by 22VAC40-73-310 H; ? A statement that specifies whether the individual is considered to be ambulatory or nonambulatory as defined in this chapter; ? A statement that specifies whether the individual is or is not capable of self-administering medications Evidence: 1. During renewal inspection conducted on 7/11/2023 during renewal inspection, LI reviewed resident records and observed that the physician exam report for Residents #1 and #4 did not include the following: ? a statement that the residents did not have any of the conditions prohibited by 22VAC73-310; ? a statement that specified whether the resident is ambulatory or nonambulatory; ? a statement that specifies whether the individual is capable of self-administering medications
Apr 14, 2023Routine
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: LI entered the facility at 11:15 am on 4/14/2023 and exited at 12:50 pm on 4/14/2023. 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 2/21/2023 and 3/27/2023 regarding allegations in the area(s) of resident care and related services and additional requirements for facilities that care for adults with serious cognitive impairments. Number of residents present at the facility at the beginning of the inspection: 8 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: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: LI observed the door where a resident attempted to exit to inspect the locking mechanisms and security feature. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation did not support the self-reports of non-compliance with standard(s) or law. However, violation(s) not related to the self-reports but identified during the course of the investigation can 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 Jamie Eddy, Licensing Inspector at (703) 479-5247 or by email at jamie.eddy@dss.virginia.gov
Based upon a review of records and interviews, the facility failed to ensure that for each resident with an inability to use the signaling device, in addition to any other services, the following shall be met: 1. This inability shall be included in the resident?s individualized service plan. 2. The plan shall specify a minimal frequency of daily rounds to be made by direct care staff to monitor for emergencies or other unanticipated resident needs. Evidence:1. LI interviewed the administrator on 4/14/2023. According to the administrator, only Resident #2 ?has the ability to use a call bell pendant.? 2. The Individualized Service Plans ( ISP
Feb 15, 2023RoutineCleanReport
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: LI entered the facility at 10:49 am on 2/15/2023 and exited at 11:10 am on 2/15/2023. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection signed. The inspection was a follow up on a B-2
Nov 23, 2022Routine
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: LI entered the facility at 10:49 am on 11/23/2022 and exited the facility at 1:00pm on 11/23/2022. 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 11/15/2022 and 11/19/2022 regarding allegations in the area(s) of: staffing and supervision, resident care and related services, and additional requirements for facilities that care for adults with serious cognitive impairments. Number of residents present at the facility at the beginning of the inspection: 7 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: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: LI observed the exits that led to residents leaving the building. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported some, but not all of the self-report area(s) of non-compliance with standard(s) or law were: additional requirements for facilities that care for adults with serious cognitive impairments. A violation notice was 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 Jamie Eddy, Licensing Inspector at (703)-479-5247 or by email at jamie.eddy@dss.virginia.gov
Based upon a interviews and observation of the physical building, the facility failed to ensure that doors that lead to unprotected areas shall be monitored or secured. Evidence: 1. Licensing Inspector (LI) observed on 11/23/2022 that the door located inside of the kitchen area that leads directly to an unprotected area outside of the building does not have a lock or monitoring system to prevent residents on the secured care unit from exiting. 2. According to the interview conducted on 11/23/2022 with the administrator, Resident #1 was able to exit the common area/serving at approximately 1:35 pm on 11/13/2002 due to a door located in the serving area of the kitchen being ?propped open.? The administrator indicated that the door that was propped open, ?when shut, is locked and can only be unlocked with the use of an electronic key.? According to the administrator, Resident #1 then exited the building through a door that ?does not have a lock? and that the door allowed Resident #1 to exit the facility and enter an area outside of the building that is unprotected.
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