VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Chantilly
2980 Centreville Road
Herndon, VA 20171
(703) 994-4561

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: June 23, 2023 , July 7, 2023 and July 14, 2023

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Unannounced complaint inspections were conducted on 6/23/23, 7/7/23, and 7/14/23; in response to a complaint that was received by the licensing office on 6/8/23 regarding: Resident Care and Related Services. Interviews were conducted and facility documentation was observed. The violation was discussed and an exit meeting was held. The evidence gathered during the investigation did not support the allegation of non-compliance with standard(s) or law. However, violation(s) not related to the complaint but identified during the course of the investigation can 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 #:	22VAC40-73-450-G
Complaint related:	No
Description:	Based on observation and interview, the facility failed to ensure that the master service plan is filed in the resident record. A current copy shall be provided to the resident and shall also be maintained in a location accessible at all times to direct care staff, but that protects the confidentiality of the contents of the service plan. Evidence: Resident #1?s individualized service plan (ISP) was requested during the 6/23/23 and 7/7/23 visits, but the ISP was not available for review. Facility staff reported that Resident #1?s ISP was not present at the facility on 6/23/23. On 7/7/23, facility staff reported that the ISP was locked in the administrator?s office and the administrator was not at the facility to retrieve it.
Plan of Correction:	The facility shall ensure that the master service plan is filed in the resident record and maintained in a location accessible at all times to direct care staff while protecting the confidentiality of the contents of the ISP.