Premises Information


	Return to Inspections

Name

BROOKDALE CARRIAGE CLUB PROVIDENCE

Address

5804 OLD PROVIDENCE RD

City/State/ZIP

CHARLOTTE

28226

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

10/30/2019

Final Score @ Grade

General Comments

NO POINTS: #3: Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed some wet ceiling tiles on 1st floor. Have leak or roof repaired and replace ceiling tile. #15: Cross-connections with sewage lines, non-potable water supplies, or other potential sources of contamination are prohibited. 15A NCAC 18A .1313 (d). Observed shower wands do not have backflow preventers. Provide documentation that there are internal backflow/check valves or need external backflow prevention installed. #30: Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c). Observed cups stacked above edge of baggie. One drawer had a spill. #32: All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutions shall be kept clean and in good repair. 15A NCAC 18A .1319 (a). Observed beauty salon sinks, cabinets need cleaning #43: All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed no thermometer in refrigerator in room 230?

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
8	1	Facilities conveniently located, clean and in good repair	No	No	No	Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed lifting of non-slip strips in showers and leftover residue from non-slip strips. Loose or sticky areas need cleaning or repair. Shower drains with build-up, several bathrooms. Handwashing sinks shall be accessible to all areas where personnel may be exposed to bodily excretions or secretions. 15A NCAC 18A .1312 (d). Observed blocked hand sink in biohazard room.
10	0.50	Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected	No	No	No	Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). Observed unlabeled bedpan in room 216 All bedpans/urinals/emesis basins shall be cleaned after each use. 15A NCAC 18A .1312 (c). Observed bedpan with dried urine in it. Staff said they wash them in the showers. Bedpans and other soiled equipment must go to the soiled utility room from cleaning and disinfection
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed interior and exterior drain soiled on ice cart. Kitchen needs to throughly clean it each day. Run through dishmachine if possible
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed soiled bed linens in room 230. Observed torn and soiled pillows and pillow protectors, several rooms
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Non-food contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. See rule .1320 (c). Observed refrigerators need cleaning in med room and activities kitchen.
40	0.50	Food brought by employees or visitors handled properly	No	No	No	Food brought from home by employees or visitors of patients or residents shall be kept only as long as it is clean, and free from spoilage. 15A NCAC 18A .1321 (b). Observed unlabeled personal food in activities refrigerator.