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: Dec. 10, 2019 and Dec. 18, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 BUILDING AND GROUNDS

Comments:

Two Licensing Representatives conducted an unannounced mandated monitoring inspection on December 10, 2019 from 9:26 a.m. to 4:10 p.m. A Licensing Representative completed the monitoring inspection on December 18, 2019 from 10:58 a.m. to 2:30 p.m.. There were 69 residents in care on both dates. The following was discussed: Healthcare oversight dates, Mechanical/Electrical rooms being locked, Justification for placement by administrator for residents in the Safe, Secure Environment, First Aid/CPR staff credentials, and UAI/ISP care services. 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 correction must indicate how the violation will be or has been corrected. 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 #:	22VAC40-73-680-G
Description:	Based on observation and interview, the facility failed to ensure over-the-counter medication was labeled with the resident?s name until administered. Evidence: 1. A review of the medication cart on 12-10-19 on the Special Care Unit contained the following medications unlabeled with the resident?s name: a. Three Chocolate Glucerna, belonging to resident #4, and b. Sea Aloe, belonging to resident #5, and c. Aloe Vesta. 2. Staff #1 identified which medications belonged to the aforementioned residents. Staff #4 observed and confirmed medications were unlabeled during the review of the medication cart.
Plan of Correction:	What Has Been Done to Correct? Medications were reviewed and labeled as applicable. Resident Care Director and Memory Care Director in-serviced all medication staff on documentation guidelines for Medication Administration and proper labeling techniques, along with labeling procedures for Supplemental/Nutritional replacement drinks in the medication cart and or designated area. How Will Recurrence Be Prevented? Healthcare Director/designee will perform random medication audits monthly to ensure compliance and accuracy of documentation and proper labeling. Person Responsible: Health Care Director/Designee
Standard #:	22VAC40-73-870-A
Description:	Based on observation and interview, the facility failed to ensure the interior of the building was maintained in good repair and kept clean. Evidence: 1. Activity Room on the second floor contained black scuff marks along the perimeter of the room around the center of the wall. 2. Room A-319 on the outside of the door contained black scuff marks on the bottom of the door spanning the width of the door, and wood chips on the floor where the wall trim outside of the resident?s room had been damaged. 3. Rooms A-209, A-210, A-211, A-213, A-214, and A-314 contained black scuff marks covering the bottom surface of the doors, spanning the width of the doors. 4. In front of Room A-208 was a circular red stain on the carpet approximately 4 inches in diameter that was identified by staff #5 as a ?Kool-Aid stain?. 5. Staff #4 and staff #5 observed and confirmed the aforementioned areas were not maintained in good repair and kept clean.
Plan of Correction:	What Has Been Done to Correct? Doors have been cleaned/painted. How Will Recurrence Be Prevented? Our Housekeeping Department will continue to clean said areas with continued weekly monitoring. Person Responsible: Maintenance Director/Designee