VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Harbour View
5871 Harbour View Boulevard
Suffolk, VA 23435
(757) 214-6279

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: July 30, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS

Comments:

Two Licensing Representatives conducted the initial inspection on July 30, 2019. Administrative and Regional Operations staff were present during the inspection and a tour of physical plant was completed. Related standards were discussed and suggestions provided on the following areas: license posting, ensuring equipment is locked up and secured, resident rights postings, maintenance of facility, medications in rooms, expired food, food menus, and fire exits. Please submit your ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it within 10 calendar days. The plan of correct must indicate how the violation will be or has been corrected. Just writing the word ?corrected? is not acceptable. The plan of correction must include: 1. Step(s) to correct the noncompliance with the standard(s) 2. Measures to prevent reoccurrence 3. Person(s) responsible for implementing each step and/or monitoring any preventative measures. If you have any questions, please contact your inspector Alexandra Poulter at 757-613-5133 or alexandra.poulter@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-860-I
Description:	Based on observation, the facility failed to ensure that cleaning supplies and other hazardous materials were stored in a locked area. Evidence: 1. On the fourth floor located by Room 420, a housekeeping cart was observed unlocked and unsupervised at 10:16 a.m. The following items were observed in the cart: a. Fabuloso (multipurpose cleaner), b. NABC concentrate (non-acid disinfectant bathroom cleaner), c. Goof Off (adhesive remover), d. Airlift Tropical (deodorant concentrate), e. Zep concentrate (glass cleaner), and f. Reliable (stainless steel cleaner). 2. Four rooms identified as ?Mechanical/Electrical? were unlocked in the facility. They were located in the following places with hazardous items inside: a. 4th floor behind nurses? station; contained wires and other electrical items, b. 4th floor across room A-404; contained wires and other electrical items, c. 3rd floor across A-304; contained wires chemicals including Peroxide Multi Surface Cleaner and Disinfectant and Acid Bathroom Cleaner and other electrical items, and d. 1st floor Main Breaker room; contained the power sources to the entire building, along with several wires and electrical boxes. 3. Staff #1, 2, and 3 were present and observed the unlocked housekeeping cart and unlocked rooms. Staff #4 observed and confirmed that the Mechanical/Electrical closets were supposed to be locked.
Plan of Correction:	What Has Been Done to Correct? Housekeeping staff locked the cart in the presence of the licensing inspector. The maintenance director removed all items and locked the mechanical room doors on the day of inspection. How Will Recurrence Be Prevented? The Executive Director/Designee will conduct a training for all housekeeping and maintenance staff and emphasis the adherence to standard 860I. Person Responsible: Executive Director/Designee
Standard #:	22VAC40-73-870-A
Description:	Based on observation, the facility failed to ensure that the interior of the building was kept clean. Evidence: 1. The following rooms were observed to contain dusty surfaces in the rooms, and/or dead bugs in the windowsills: a. A-317; bedside table and television stand both had dust on surfaces, as well as stained carpet, b. A-307; window sills contained dust, c. A-402; window sills contained dust and dead bugs, d. A-405; window sills contained dead bugs, and e. A-418; dust on surfaces. 2. The following doors had black scuff marks covering the bottom surface of the door, spanning the width of the door: a. Room A-314, b. Room A-310, and c. Room A-319. 3. Staff #1, #2, and #3 observed and confirmed the aforementioned areas.
Plan of Correction:	What Has Been Done to Correct? Housekeeping dusted and cleaned and painting is scheduled. How Will Recurrence Be Prevented? Weekly monitoring of housekeeping and touch up painting will be completed. Person Responsible: Maintenance Director/Designee
Standard #:	22VAC40-73-960-B
Description:	Based on observation, the facility failed to ensure that the fire and emergency evacuation drawing that was posted showed secondary escape routes, areas of refuge, and assembly areas. Evidence: 1. The fire and emergency evacuation drawing that was located on the first floor hallway next to the dining area was missing the secondary escape routes, areas of refuge, and assembly areas. 2. Staff #1 and #2 observed and confirmed the missing details on the drawing.
Plan of Correction:	What Has Been Done to Correct? The maintenance director updated the drawing to reflect the missing information. How Will Recurrence Be Prevented? The drawing will be reviewed quarterly. Person Responsible: Maintenance Director/Designee