VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Mayfair House Senior Living
901 Enterprise Way
Portsmouth, VA 23704
(757) 397-3411

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: June 28, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation

Comments:

An initial inspection was initiated on 06-28-2021 and concluded on 06-28-2021. The Administrator was contacted by telephone to initiate the inspection. The Administrator reported that the current census was 18. The inspector emailed the Administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed criminal background checks submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 06-28-2021. An exit interview was conducted with the Administrator on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-870-A
Description:	Based on observation and interview, the facility failed to ensure the interior of the building was kept in good repair. Evidence: 1. During the facility tour with staff #1, staff #2, and staff #3, the following areas observed were not in good repair: A. The vaulted ceiling in the dining room had an octagon shaped opening that was discolored with black spots and markings that surrounded the area of the opening; B. The ceiling located near the kitchen in the dining room was discolored and had a crack that was approximately 12? in length; C. The ceiling tile located in the bathroom of room #407 had a brown circular stain that was approximately the size of a baseball; and D. Three ceiling tiles located in room #417 were discolored. One of the tiles had brown spots approximately 7? in length, and the other tile had a brown circular stain that was approximately the size of a baseball. 2. Staff #1, staff #2, and staff #3 acknowledged aforementioned areas were not in good repair.
Plan of Correction:	A. Vaulted ceiling will be cleaned, primed, and painted B. Ceiling area with crack will be repaired and painted. C & D. Ceiling tiled will be replaced or painted.
Standard #:	22VAC40-73-920-C
Description:	Based on observation and interview, the facility failed to ensure that all bathrooms had ventilation to the outside in order to eliminate foul odors. Evidence: 1. During the facility tour with staff #1, staff #2, and staff #3, the bathroom vent in room #205 was observed inoperable. When the switch was placed in the on position, the fan did not come on. In addition, the bathroom in room #210 did not have a ventilation system. 2. Staff #1, staff #2, and staff #3 acknowledged aforementioned bathrooms did not ventilate to the outside.
Plan of Correction:	Contractor will be engaged to install fans in bathrooms. Residents will not be admitted to these rooms until complete.
Standard #:	22VAC40-73-960-B
Description:	Based on observation and interview, the facility failed to ensure the posted fire and emergency evacuation drawing showed the assembly areas. Evidence: 1. During the facility tour with staff #1, staff #2, and staff #3 the posted fire and emergency evacuation drawings observed near rooms #405, #102, #415, #427, and #202 did not include the assemble areas. 2. Staff #1, staff #2, and staff #3 acknowledged the posted fire and emergency evacuation drawings did not include the assemble areas.
Plan of Correction:	All posted fire and emergency evacuation drawings will have assembly area indicated on drawings.