VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony on the Peninsula
3540 Victory Boulevard
Yorktown, VA 23693
(757) 447-3544

Current Inspector: Alyshia E Walker (757) 670-0504

Inspection Date: Sept. 14, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS

Comments:

A renewal inspection was initiated on 09/14/2020 and concluded on 09/14/2020. The Administrator was contacted by telephone to initiate the inspection. The Administrator reported that the current census. The inspector emailed the Administrator a list of items required to complete the inspection. The inspector reviewed 4 resident records, 4 staff records, and additional documentation submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-450-C
Description:	Based on resident record review the facility failed to ensure the comprehensive individualized service plan shall include description of identified needs and date identified. Evidence: On 09/14/2020 while reviewing the Insidvidualized Service Plan for resident #1 dated 08/28/2019. The need for resident #1 reads, "Regular diet" dated 10/08/2020. Resident #1's Physician Diet Order Request form dated 12/31/2019 indicated resident #1's consistency, " Mechanical soft (Dysphagia Level 3). The Diet Order Request form was not updated to resident #1's Individualized Service Plan.
Plan of Correction:	Resident #1's individualized service plan updated to reflect correct diet of mechanical soft. The individualized service plan will be updated upon receipt of any new diet orders. Person responsible: Healthcare Coordintaor and/or ISP certified staff.