VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Potomac Place
2133 Montgomery Place
Woodbridge, VA 22191-2655
(703) 494-3817

Current Inspector: Laura Lunceford (540) 219-9264

Inspection Date: March 23, 2023 and March 24, 2023

Complaint Related: No

Areas Reviewed:

Administrative and Administrative Services Personnel Staffing and Supervision Admission, Retention and Discharge of Residents Resident Care and Related Services Buildings and Grounds Emergency Preparedness Mixed Population Save, Secure Environment

Comments:

Date of Inspection: March 23 and 24, 2023 Type of Inspection: Renewal Inspection If you have any questions or email changes, please do not hesitate to contact me at laura.lunceford@dss.virginia.gov. If you need a copy of any of the DSS Model forms or to review any inspection or regulation, you can find the information on the internet: www.dss.virginia.gov. Census 85 Number of records reviewed and interviews conducted- 17 records (both staff and residents), 12 interviews. All facility self-reported incidents since the last inspection were reviewed on this date. The Licensing Inspector observed the residents during meal times and activities. The Licensing Inspector reviewed the following during the inspection: dietician report, auxiliary grant records, menus, healthcare oversight, pharmacy review, resident rights reviews, and activity calendars.