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THE PAVILION AT WILLIAMSBURG PLACE
COVID-19 Vaccination of Facility Staff
Tag No.: A0792
Based on document review and interview, it was determined that the facility failed to ensure that all staff are fully vaccinated for Covid-19, except for those staff who have been granted exemptions to the vaccination requirements or those staff for whom Covid-19 vaccination are temporarily delayed.
Five (5) of eleven (11) Staff Members (Staff Members # 4, # 6, # 7, # 8 and # 12) reviewed were not fully vaccinated.
The findings include:
On April 4 and 5, 2022 observations revealed Staff compliance with PPE (Personal Protective Equipment) and the screening process for Covid-19.
On April 5, 2022 at approximately 2:00 p.m., document review revealed five (5) Staff Members (Staff Members # 4, # 6, # 7, # 8 and # 12) not fully vaccinated and without an exemption or temporary delay. Staff Members # 4, # 6, # 7, # 8 and # 12 had one dose each of a two-dose vaccine. The facility total staff vaccination rate was 96%.
A review of the facility policy provided by Staff Member # 2 titled "Covid - 19 Mandatory Vaccination Policy" reads in part "All current facility staff must be fully vaccinated no later than March 15, 2022. All new hire staff hired by the facility must be fully vaccinated before beginning employment with the facility. To be fully vaccinated by March 15, 2022 staff must: obtain the first dose of a two-dose vaccine no later than February 14, 2022; and the second dose no later than March 15, 2022; or Obtain one dose of a single dose vaccine on later than March 15, 2022."
At 2:30 p.m., interview with Staff Member # 2 confirmed Staff Members # 4, # 6, # 7, # 8 and # 12 only had one vaccine of a two-dose vaccine.
At 2:45 p.m. interview with Staff Member # 1 revealed the HR (Human Resources) Director had resigned and left the facility on February 10, 2022 and the new HR director started on March 3, 2022. The facility is working on some areas that need attention including Covid-19 vaccinations.
The findings were discussed with Staff Members # 1 and # 2 on April 5, 2022 during the exit interview.