VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Virginian
9229 Arlington Boulevard
Fairfax, VA 22031
(703) 385-0555

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: Aug. 18, 2023

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 BUILDINGS AND GROUND

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 8/18/23 (1:05pm ? 5:50 pm). The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by the licensing office on 7/21/23; regarding Staffing and Supervision, Resident Care and Related Services, and Building and Grounds. Building and grounds were inspected, interviews were conducted and facility documentation was reviewed. The evidence gathered during the investigation supported some, but not all of the allegations; the area of non-compliance was: Resident Care and Related Services. A violation notice was issued; any violation(s) not related to the complaint but identified during the course of the investigation can also be found on the violation notice. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Marshall Massenberg, Licensing Inspector at (703) 431-4247 or by email at m.massenberg@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-460-B
Complaint related:	Yes
Description:	Based on documentation, the facility failed to ensure a prompt response by staff to resident needs as reasonable to the circumstances. Evidence: August call bell reports were reviewed for Residents #1, #2, #3, and #4. Resident # 1's call bell report indicated that there was one occasion when it took staff at least 20 minutes to respond to the resident's call bell (out of one call alarm). Resident #2?s call bell report indicated that there were 14 occasions when it took staff at least 20 minutes to respond to the resident?s call bell (out of 20 call alarms). Resident #3?s call bell report indicated that there were eight occasions when it took staff at least 20 minutes to respond to the resident?s call bell (out of 37 call alarms). Resident #4?s call bell report indicated that there were two occasions when it took staff at least 20 minutes to respond to the resident?s call bell (out of 16 call alarms).
Plan of Correction:	Not available online. Contact Inspector for more information.