Premises Information


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Name

CUTHBERTSON VILLAGE

Address

3200 BISHOPS WAY LN

City/State/ZIP

CHARLOTTE

28215

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

2/26/2015

Final Score @ Grade

General Comments

Mary Ellison, Kerry Alexander, and Tonia Brewer were present during the inspection.#18 - Two ccare givers stated the water pitchers were cleaned at the kitchenette sinks. **Ensure that all drink water pitcher are washed, rinsed, and sanitized properly in the main kitchen.#28 - Observed the exterior storage areas with floors (A, B, and C halls) dirty. **Keep all storage areas clean.#40 - Observed a box of ice cream bars only labeled with the resident's name. **label all food brought by visitors with the resident's name and date.#43 - Observed the refrigerator thermometers were damaged/not working in the Soda Shop and the kitchenette on A hall. **All food storage units must have an accurate thermometer.

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	Observed sinks and hoppers were not clean in the soiled utiltiy rooms. **Keep all sinks, toilets, hoppers clean and inn good repair.
27	1	Pet areas clean, veterinary records available	No	No	No	Observed the bird cage in the Town Square was in need of cleaning. Keep all pet areas clean. Provide vet records for all pets.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed a chair in the Theater Room was soiled, and a lamp shade in room 43D was damaged, and the clothing wardrobe was dusty inside (room 43D).**Keep all furniture clean and in good repair.