VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Youth for Tomorrow-New Life Center
11835 Hazel Circle Drive
Bristow, VA 20136
(703) 368-7995

Current Inspector: Michele Freeman (804) 662-7062

Inspection Date: June 5, 2019 and June 6, 2019

Complaint Related: Yes

Areas Reviewed:

22VAC40-151 PROGRAMS AND SERVICES 22VAC40-151 PROGRAMS AND SERVICES

Comments:

The Licensing Inspector conducted an unannounced complaint investigation in response to a complaint that was received by the licensing office on May 21, 2019. The complaint investigation was conducted at the same time as an unannounced renewal inspection from 11:16 a.m. to 4:46 p.m. on June 5, 2019 and from 9:30 a.m. to 4:24 p.m. on June 6, 2019. The complaint investigation occurred due to an allegation regarding health care procedures and recreation for residents. Records were reviewed, other documentation reviewed, and interviews were conducted with staff and a resident. Information gathered during the investigation does not support the allegation. A violation was cited but the violation was not directly in relation to this complaint. Therefore, the complaint is determined to be "not valid".

Violations:

Standard #:	22VAC40-151-960-C
Complaint related:	No
Description:	Violation: Based on review of a Serious Incident Report (SIR) written for Resident, R1, and discussion with Staff S2, the provider failed to notify the Department of the incident within 24 hours. Finding: 1. A Serious Incident Report, dated 05/20/19, documents an incident involving resident R1 that resulted in hospitalization. The Department was not notified. 2. The Serious Incident Report does not document notification of the Department. 3. According to Department records, Licensing representatives were not notified of the incident. 4. During an interview, S2 was asked about notification to the Department of the serious incident. S2 was not able to provide documentation of notification to the Department.
Plan of Correction:	Agency will revise internal SIR form to include Quality Assurance as a party to notify. The Director of QA or designee will be required to notify licensing. This will ensure that licensing is notified of all incidents involving CPS.