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

11/13/2019

Final Score @ Grade

General Comments

No points were deducted for the following: 12. Provide liquid soap and disposable towels at all hand washing sinks. 15A NCAC 18A .1312 (d). Observed no soap at the handsink in the laundry room on mallard way hall. 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 couch with staining in room 26D.

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	Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed a stained ceiling tile in the laundry room on blue jay hall. Repeat Observed hole in wall of spa room on cardinal place and wall peeling in the laundry room on mallard way.
13	1	Lavatory and bathing hot water between 100 and 116 F	No	No	No	Maintain the hot water at all resident accessible hand washing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e). Observed water temperature between 82-92F on cardinal hall and water temperatures between 117-122F on mallard way hall.