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

11/7/2022

Final Score @ Grade

General Comments

No Points: #2- Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed lint/debris behind washer/dryer on Bluejay Ln. Laundry detergent spill behind washer on Cardinal wing. Carpet needs vacuuming in office on Oriole Place. #3- Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed damaged walls in soiled laundry rooms. Observed walls need cleaning in resident rooms by toilets and beds. #4- All areas shall have sufficient illumination. Maintain 10 foot candles of light at 30 inches above the floor in all areas other than food service areas. 15A NCAC 18A .1311 (a). Observed low lighting in laundry room on Cardinal Trail. #33- Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed a couple sheets with holes. Sheets very thin throughout. Leak at backflow preventer at hair wash station in salon.

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	Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed loose toilet seat R11D, underside of toilet seat soiled R201D. Observed toilet seats needing to be replaced, surfaces damaged and not easily cleanable. 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 laundry on Cardinal Trail. Keep hand sinks accessible. Hopper needs more frequent cleaning on Oriole Place.
12	1.50	Lavatories have mixing faucet or tempered water, soap hand towel and hand drying device	No	No	No	Observed several areas without paper towels. On Cardinal Trail provide paper towel dispenser or basket for paper towels. Repeat-Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a). Observed items for use in hair salon stored under hand sink. 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 dirty supply rooms/clean linen rooms used for storage such as vases, furniture dollies, hand carts, etc.
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 several cracked/frayed mattresses. Bed frame needs cleaning in R31D. 3-tier shelf in hall in disrepair. Common couches soiled/stained. Several common armchairs and resident armchairs in poor repair and need replacing. Several stained pillows, recommend pillow protectors that can be laundered instead of the pillow.