Premises Information


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Name

PINES AT DAVIDSON, THE

Address

400 AVINGER LN

City/State/ZIP

DAVIDSON

28036

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

12/6/2013

Final Score @ Grade

General Comments

1. Observed hard debris on spa floor in spa near 165. Floors in intensive care units, bathrooms, showers, hydrotherapy areas, operating rooms, soiled utility rooms and laundry areas shall be of smooth, non-absorbent materials and so constructed as to be easy to clean. 15A NCAC 18A .1309 (a). 2.Observed residue on floor drain in Skilled Nursing nourishment room.Keep all flooring clean. 15A NCAC 18A .1309 (a).28. Observed gauss stored within 8 inches of floor in Skilled Nursing storage roomAll patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).34. Observed linen bed pads on floor in storage closet in Skilled Nursing.Clean linen shall be stored and handled in a separate room or area, or in another manner that will prevent contamination of clean linen. 15A NCAC 18A .1319 (b).

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 damaged to baseboard throughout Skilled area. Observed wall damage 184 and 191. Observed damaged tiles in spa at shower area in spa near 192.Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Repeat non compliance: Observed shower chairs in skilled spay near 192 collecting hair in caster, residue on under sections, and one with damaged side guard. Observed sink in spa restroom near 192 with damaged caulk along side of sink and wall. Observed curtain in Purcell spa collecting residue. Observed mildew collecting on anti-slip mat in room 287.Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b)