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

10/16/2018

Final Score @ Grade

97.50

General Comments

No points were deducted for the following: 12. Observed laundry room without handwashing soap. Ensure that soap is located at all handwashing sinks. **Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). 32. Observed dresser missing handle in room 42D. Needs to be repaired. **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).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
3	1	Walls and ceilings cleanable, clean, good repair	No	No	No	Observed water stained ceiling tiles in the housekeeping closet on the Blue Jay wing and the laundry room. Observed wall stain in bathroom in room 42D and wall damage in laundry room. Needs to be repaired. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Observed clothing stored in the shower in room 12D. Ensure that clothing is not stored in the shower. **Toilet rooms shall not be used for storage. See rule .1312 (b).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed stained mattress cover on the bed in room 22D. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).