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Source: VA State Licensing Agency
Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 11/25/2025 Begin: 10:30am End: 2:45pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 11 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 3 Number of staff records reviewed: 2 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 3 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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 Crystal B. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov
Based on observations made during the tour of the building, the facility failed to keep clean and in good repair all furnishings, fixtures, and equipment. EVIDENCE: 1. The mirror above the sink in the common bathroom downstairs near the dining area was found to have what appeared to be dried water splashes/spots scattered all about the surface of the mirror. 2. The sink in the common bathroom downstairs near the dining area was found to have dried toothpaste stuck to the surface of the sink bowl. 3. The mirror above the sink in the common bathroom on the upstairs level of the facility on the right was found to have dried water splashes or spots scattered all about the surface of the mirror.
Based on resident record review and staff interview, the facility failed to include identification of the residents for whom the dietitian oversight was provided. EVIDENCE: 1. The last dietitian oversights for this facility were provided on: 03/1/25 and 10/30/25. 2. Neither of the two dates mentioned above included any way to identify the residents for whom the dietitian provided the oversight for
Based on physician order, staff interview, and Medication Administration Record ( MAR
Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 01/16/2025 Begin: 10:30am End: 11:56am The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 12/18/2024 regarding allegations in the area(s) of: resident care Number of residents present at the facility at the beginning of the inspection: did not gather The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: none-not a resident Number of staff records reviewed: none Number of interviews conducted with residents: none Number of interviews conducted with staff: 1 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. 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. The evidence gathered during the investigation did not support the allegations 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. 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 Crystal B. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov
Based on observations made during the tour of the building, the facility failed to ensure they were using a space heater only in the event of a power failure or similar emergency. EVIDENCE: 1. On the date of inspection (01/16/2025) when the LI was leaving the facility the LI observed a small space heater in the common room used by two residents.
Based on observations made during the tour of the building and staff interviews, the facility failed to ensure that pets living on the assisted living facility premises have regular examination and immunizations, appropriate for the species and by a licensed veterinarian. EVIDENCE: 1. Upon the LI arriving at the facility the LI observed a chicken not in the pen with the others, this one was out and about freely roaming around the parking and entrance area to the facility. 2. Corn to feed a chicken was observed in the entrance/exit walkway of the facility. 3. Staff #1 stated she told the residents not to be feeding the chickens there at that specific location and stated that the chicken was not seen by a veterinarian.
Type of inspection: Renewal Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 11/15/2024 Begin: 11:00am End: 2:40pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 11 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 2 Number of staff records reviewed:2 Number of interviews conducted with residents:2 Number of interviews conducted with staff: 3 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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 Crystal B. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov
Based on observations made during the tour of the building, the facility failed to ensure all furnishings, fixtures, and equipment are in good repair. EVIDENCE: 1. The folding door beside of the freezer in the hallway located off of the dining area was found to be off the track, propped up in the corner, and not in working order.
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: 09/24/20224 Begin: 10:00am End: 2:00pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: Number of staff records reviewed: Number of interviews conducted with residents: Number of interviews conducted with staff: Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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 Crystal B. Henson, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov
Based on observations made during the tour of the building, the facility failed to keep the interior and exterior of all buildings in good repair and kept clean and free of rubbish. EVIDENCE: 1. The trashcan in the common bathroom closest to Room #5 was found to be full. 2. In the common area upstairs near Room #5 there was a silver knife and spoon found under the common use telephone and a pink plastic knife found on the common table for two. 3. Outside of back entrance to the facility, LI discovered a Styrofoam cup, a soda can and a small plastic container (looks to have contained apple sauce) laying on the ground near the trashcan.
Type of inspection: Initial Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 06/06/2024 Begin: 10:30 am End: 12:48pm The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 0 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed:0 Number of interviews conducted with residents:0 Number of interviews conducted with staff: 2 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the initial inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The applicant has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to maintain future compliance with applicable standard(s) or law. If the applicant 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 should the facility be issued a license to operate. 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 a licensed facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Crystal B. Mullins, Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov
Based on observations made during the tour of the building, the facility failed to include all required safeguards in accordance with the Virginia Statewide Building Code. EVIDNECE: 1. The common bathroom located upstairs did not have grab bars by the toilet. 2. The common bathroom located downstairs did not have grab bars at the toilet. 3. The common bathroom located beside Room #5 upstairs did not have grab bars at the toilet.
Based on the tour of the facility, the facility failed to ensure all operable windows were effectively screened. EVIDENCE: 1. Rooms # 5 and #8 had windows that were not effectively screened.
Based on observations made during the tour of the building, the facility failed to keep all hazardous materials in a locked area. EVIDENCE: 1. Upstairs bedroom near room #9 contained Triple Antibiotic Ointment, sore throat spray, first aid antiseptic, hydrogen peroxide, topical solution for treatment of minor cuts and abrasions. 2. Room #9 contained a fox of enemas, berry antacid bites, Ibuprofen, Gorilla Glue and Calamine lotion.
Based on observations made during the tour of the building, the facility failed to keep all areas of all buildings in good repair and kept clean. EVIDENCE: 1. The downstairs common bathroom was found to have an area of water damage to the ceiling tiles approximately four feet by two feet in size. 2. The transition strip in both hallways on upstairs and downstairs floors leading to bathroom areas were raised from the existing floor and could present a trip hazard. 3. Room #9 was found to have a bed frame sticking out approximately six inches from the length of the mattress. This could present a trip hazard or an area which would result easily in injury. 4. Room #4 had no bars or rods for hanging clothes nor was there any shelving space to fold and store clothing. 5. Room #1 had a missing door knob tot he closet and the vent was found to be hanging down from the ceiling approximately one to two inches. 6. Three door hinges and screws were found to be exposed in the downstairs hallway. It appeared the door had been removed. This area was near the steps to go upstairs.
Based on observations made during the tour of the building, the facility failed to have the fire and emergency evacuation drawing posted in a conspicuous place on each floor used by the residents. The drawing should show primary and secondary escape routes, areas of refuge, assembly areas, telephones, fire alarm boxes, and fire extinguishers. EVIDENCE: 1. The fire drawing displayed in the facility on the first and second floor did not display the areas of refuge, assembly areas, telephones, primary and secondary escape routes, and fire extinguishers.
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