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

4/24/2019

Final Score @ Grade

General Comments

No points were taken for the following: 24. Observed dead insects in the light shield in the soiled linen room 1059. **Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises. 15A NCAC 18A .1317 (a). 32. Observed stained chair in 32D. Needs to be cleaned. **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). 33. Observed stained linen in 13D and 25D. Needs to be cleaned. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). 36. Observed interior of microwave peeling in the satellite kitchen in Oriole Place. **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).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Observed water stained ceiling tiles on Orioles Place and Laundry Room in Cardinal Trail and Cardinal Trail. Ensure leaks are not going. Repeat. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.