VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Stevenson Place
4113 Stevenson Street
Fairfax, VA 22030
(703) 460-6200

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: Oct. 30, 2023

Complaint Related: Yes

Areas Reviewed:

Admission, Retention and Discharge of Residents Resident Care and Related Services Resident Accommodations and Related Provisions

Comments:

Date of Inspection: October 30, 2023 Type of Inspection: Complaint inspection Standards Investigated: As stated above Complaint was determined valid If you have any questions, please do not hesitate to contact me at (540) 680-9469 or sarah.pearson@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection, you can find the information on the internet: www.dss.virginia.gov The Administrator and the Licensing Inspector discussed the risk assessment ratings for the violations for this inspection.

Violations:

Standard #:	22VAC40-73-460-A
Complaint related:	Yes
Description:	Based on resident record review and staff interview, it was determined that facility staff failed to assume general responsibility for the safety and well-being of the residents. Evidence: On 9/6/2023 Resident A, who has a diagnosis of dementia, was found unresponsive on the back patio. Staff called 911 and the resident was taken to the hospital and was diagnosed with heat stroke and hyperthermia.
Plan of Correction:	1. Request a long-term care screen for the resident. 2. Hold the cigarettes in the office and the resident will need to get them so we know that she is going outside. 3. Resident will be on hourly checks, however, when resident is outside, they will be placed on 30-minute checks. We will also put other systems in place to include the following: 1. Work with out county therapists to formalize an assessment tool to determine cognitive deficiencies. (ex: MMSE) 2. Work to formalize a tool to determine if a resident is being safe in the community. 3. Work on a elopement risk assessment.