VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Spring Hill
8350 Mountain Larkspur Drive
Fairfax, VA 22079
(571) 348-4970

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: July 2, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

Comments:

A non-mandated complaint inspection was initiated on 7/2/21 and concluded on 9/16/21. A complaint was received by the department regarding allegations in the area of: Safe, Secure Environment. The administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the administrator a list of documentation required to complete the investigation. The licensing inspector conducted on-site observations at the facility on 7/2/21 and 7/13/21. The evidence gathered during the investigation supported the allegation of non-compliance with standards or law, and a violation was issued. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-1100-A
Complaint related:	Yes
Description:	Based on record review, the facility failed to obtain the written approval of the guardian or legal representative of a resident, prior to placing the resident in the safe, secure environment. Evidence: Resident #1 was admitted to the facility on 4/19/21, in an assisted living room. A facility incident report states that Resident #1 was placed in the safe, secure environment, because of an elopement that occurred on 6/29/21. A progress note, dated 6/30/21, states that Resident #1 keeps asking to return to her previous room. A therapy note, dated 7/1/21, states that Resident #1's daughter is not pleased that the resident is in memory care. Resident #1's legal guardian signed the written approval for the resident to be placed in the safe, secure environment on 7/2/21. The form states that the approval was given on a temporary basis until the resident could be diagnosed and treated. Resident #1 was placed in the safe, secure environment before written approval was provided by her legal guardian.
Plan of Correction:	Not available online. Contact Inspector for more information.