Premises Information


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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

4/22/2021

Final Score @ Grade

91.50

General Comments

NO POINTS- #2- Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed flooring in storage areas with debris behind bins/boxes. Keep floor accessible or move bins for routine cleaning. #3- Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed stained ceiling tiles in several areas. Most looked dry. Facility has new roof as of 12/20. Walls needed wiping down in med room. #12- Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). Observed no soap in activities kitchen. No paper towels at one dispenser in beauty salon. #17-Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a). Observed scale build-up in nozzle of water fountain near front door. #21- All solid wastes containing food scraps or other decomposable materials shall, prior to disposal, be kept in leak-proof, non-absorbent containers, which shall be kept covered with tight fitting lids when filled or stored, or not in continual use. 15A NCAC 18A .1316 (a). Observed door to compactor open. Keep ground around compactor clean. #36- 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 soiled microwave in PT and soiled freezer in activities kitchen.

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	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. Keep hand sink accessible. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed spa tub with splash at bottom, keep clean even if not used. Observed loose non-slip appliques in shower, room 221. Observed cracked and soiled shower chair, room 232. Soiled shower chair, room 229. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed rusted toilet chair, room 221.
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Ice machines, buckets, other containers, and scoops shall be protected from the elements, splash, drip, dust, vermin, other contamination, and from use by unauthorized personnel. 15A NCAC 18A .1314 (b). Observed ice dispensing unit unattended in activities room near door.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Suitable rooms or spaces shall be provided for the storage of all necessary equipment, furniture, and supplies, and kept clean. 15A NCAC 18A .1318 (a). Observed storage on floor in med room. Patient supplies must be 8 inches above floor.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	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 stains on common furniture, keep clean. Headboard in disrepair, room 229.
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 bedding on beds in rooms 232, 229, Carts used for soiled laundry shall be labeled for soiled laundry use only. 15A NCAC 18A .1319 (b). Observed several soiled linen carts not labeled.
34	1	Laundry area and equipment clean, linen disinfected, clean laundry stored and handled separately	No	No	No	Clean linen shall be stored and handled in a separate room or area, or in another manner that will prevent contamination of clean linen. 15A NCAC 18A .1319 (b). Observed non linens stored with linens in clean linen room and laundry room.
35	1	Patient contact items in good repair, properly stored, cleaned and disinfected	No	No	No	Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). Repeat-Observed rollers and roller bins in beauty salon soiled.
42	2	Food protected. Potentially hazardous food maintained at 45 F or below, or 140 F for above, consumed or discarded within 2 hours of being removed from temperature control	No	No	No	Potentially hazardous foods served shall be either consumed or discarded within two hours of being removed from temperature control. 15A NCAC 18A .1323 (a) Observed partially eaten pizza on counter in activities room, presumably from last night. Dispose of food left out of temp control within 2 hours.