VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Benchmark at Alexandria
3440 Berkeley Street
Alexandria, VA 22302
(571) 386-2200

Current Inspector: Nina Wilson (703) 635-6074

Inspection Date: Jan. 17, 2025 and Jan. 23, 2025

Complaint Related: No

Areas Reviewed:

22VAC40-73 PERSONNEL

Technical Assistance:

None

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 1/17/2025 Time in: 9:39 a.m. Time out: 11:00 a.m. 1/23/2025 Time in: 10:14 a.m. Time out: 11:45 a.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self-reported incident was received by VDSS Division of Licensing on 10/18/2024 regarding allegations in the area(s) of: Personnel Number of residents present at the facility at the beginning of the inspection: 43 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 5 Observations by licensing inspector: Licensing inspector (LI) toured the safe, secure environment unit. LI observed residents interacting with peers and staff, participating in physical therapy, and dining for breakfast. Additional Comments/Discussion: None An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the self-report of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the self-report 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. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov. Should you have any questions, please contact Nina Wilson, Licensing Inspector at (703) 635-6074 or by email at nina.wilson@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-1130-A
Description:	Based on record reviews and staff interview, the facility failed to ensure that at least two direct care staff members were awake and on duty at all times in each special care unit, who were responsible for the care and supervision of the residents Evidence: 1. The October 2024 staff schedule indicated that there was one staff scheduled one each shift (10/18/2024), 7:00 a.m. through 3 p.m., 3:00 p.m. through 11:00 p.m., and 11:00 p.m. through 7:00 a.m. 2. The October 2024 employee timecard indicated that one direct care staff clock into work 7:00 a.m. through 3 p.m., 3:00 p.m. through 11:00 p.m., and 11:00 p.m. through 7:00 a.m. on 11/29/2024. 3. On 1/17/2025, LI interviewed staff 3 who confirmed there was only one direct care staff scheduled to work on the safe, secure environment unit on 10/18/2024.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-220-B
Description:	Based on private duty personnel review and staff interview, the facility failed to ensure that information on the type and frequency of the services delivered to the resident and a review of an original criminal history record report were obtained. Evidence: 1. Private duty personnel 6?s record did not include a criminal history report or information on the type and frequency of services delivered to resident 2. 2. On 1/17/2025, LI interviewed staff 2 who confirmed that private duty personnel 6?s record did not include a criminal history report of information on the type and frequency of services delivered to resident 2.
Plan of Correction:	Not available online. Contact Inspector for more information.