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: July 16, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-151 22VAC40-151 PROGRAMS AND SERVICES

Comments:

An unannounced focused inspection was conducted on July 16, 2019 from 10:03 a.m. to approximately 1:00 p.m. This inspection was conducted in response to a self-reported incident received on July 12, 2019 involving an interaction between staff and resident. This was a joint investigation with local agency representatives. Interviews with the resident and a staff member were conducted. Documentation reviewed included the serious incident report, personnel record, and policies and procedures. Acknowledgement form was signed and left at the facility. Exit meeting was held via telephone on August 8, 2019 with Staff S3. Please complete the plan of correction and date to be corrected for each violation cited on the violation notice and return to the Licensing Office within 5 business days from receipt of the inspection documentation. You will need to specify how the deficient practice will be or has been corrected (merely writing the word corrected is not acceptable). Your plan of correction must contain the steps to correct the noncompliance with the standard(s), the measures to prevent the noncompliance from occurring again; and the position responsible for implementing each step and/or monitoring any preventive measure(s). The licensee should retain a copy to be posted at the facility. Results of the inspection documentation are subject to public disclosure and will be posted on the VDSS web site within 5 days, regardless of whether the Plan of Correction is completed.

Violations:

Standard #:	22VAC40-151-250-B-1
Description:	Based on review of the personnel record for Staff S1 and interview with Staff S2, annual training, required by these standards, was not completed. Findings: 1. Review of the training record for Staff S1 did not document annual refresher training in the following training requirement: - Emergency preparedness and response training. It was due to be completed by 06/20/19. 2. Staff S2 confirmed that the annual training was late and stated that a training reminder e-mail had been sent to Staff S1.
Plan of Correction:	Staff S1 attempted to take the emergency preparedness training and did not pass the course quiz. Staff S1 is in the process of retaking the course and quiz.
Standard #:	22VAC40-151-250-B-4
Description:	Violation: Based on review of the personnel record for Staff S1 and interview with Staff S2, annual training, required by these standards, was not completed. Findings: 1. Review of the training record for Staff S1 did not document annual training in the following training requirements: - Child abuse and neglect and mandatory reporting training. It was due to be completed by 06/20/19. - Suicide prevention training. It was due to be completed by 06/20/19. 2. Staff S2 confirmed that the annual training was late and stated that a training reminder e-mail had been sent to Staff S1.
Plan of Correction:	Staff S1 completed the child abuse and suicide prevention training on 07/17/19.
Standard #:	22VAC40-151-820-11
Description:	Violation: Based on review of the Serious Incident Report and interview with Staff S1 and Resident R1, Staff S1 used aversive stimuli, a prohibited action, to prod R1 awake. Findings: 1. Staff S1 acknowledged that she used a pair of flip flops to tap Resident R1 while R1 remained in bed with the covers over her head, after S1 gave R1 verbal prompts to wake up for the morning. 2. During an interview with an agency representative, via an interpreter, Resident R1 said, "I felt when she hit me". R1 was asked if she had any discomfort?? R1 replied, "si".
Plan of Correction:	Staff S1 will receive a written counseling form in regard to the incident.