VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Greenspring Village
7470 Spring Village Dr
Springfield, VA 22150
(703) 923-4663

Current Inspector: Alexandra Roberts

Inspection Date: Aug. 19, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES

Comments:

On 8/19/2019 Licensing Inspector (LI) conducted unannounced inspection in response to an incident that was self-reported on 7/12/2019. Reviewed correspondences, training and other documentation related to the incident and conducted interview with Administrator and Director of Nursing. Violation notice issued and assessed risk assigned to violations reviewed during the exit interview. Thank you for your cooperation and if you have any questions please call (703) 895-5627 or contact me via e-mail at jeannette.zaykowski@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-70-A
Description:	Based on documentation review and interview, facility failed to ensure that each facility shall report to the regional licensing office within 24 hours any major incident that has negatively affected or that threatens the life, health, safety, or welfare of any resident. Evidence: On 7/11/2019, Licensing Inspector was advised of reports related to a respiratory outbreak and had not yet received an incident report from the facility; self-reported incident report was received on 7/12/2019 and communications with the facility confirmed that the community had reported the outbreak to the Fairfax County Health Department on 7/08/2019 related to the tracking of residents with onset of symptoms dated 7/1/2019 through 7/11/2019.
Plan of Correction:	1. Administrator was notified by the Licensing Inspector of the requirement to notify DSS "by rapid means" of disease outbreak in the facility. The Administrator notified the Licensing Inspector on 7/12/19 of the respiratory outbreak followed by a written Facility Reported Incident. 2. Any resident has the potential to be impacted. 3. the Administrator in-serviced the Director of Nursing and 2 Assistant Administrators onhthis requirement (22 VAC 40-73-100) 4. In the event of a respiratory outbreak the Administrator/Designee of the DON/Designee will notify DSS within the prescribed time frame for reporting incidents.