|
3
|
1
|
Walls and ceilings cleanable, clean, good repair |
No |
No
|
No |
Observed water damaged/stained ceiling especially in laundry room. Some peeling wallpaper.Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. |
|
5
|
1
|
Ambient air temperature 65 to 85 F, equipment clean |
No |
No
|
No |
HVAC vents observed soiled throughout the facility.Observed dust buildup on the wall fan in laundry.Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). |
|
10
|
0.50
|
Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected |
No |
No
|
No |
Observed unlabeled urinal in room W14.Observed bed pan with name and no date in room S32.All bedpans/urinals/emesis basins shall be cleaned after each use. 15A NCAC 18A .1312 (c).Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). |
|
18
|
1
|
Drinking utensils properly handled |
No |
No
|
No |
Observed soiled spout on the water cooler dispenser at West Wing nursing station. Observed soiled drinking straw for water pitcher in room E30.Disposable water pitchers shall be disposed of and replaced when visibly soiled. 15A NCAC 18A .1314 (a).All multi-use drinking water utensils shall be cleaned and sanitized between users. 15A NCAC 18A .1314 (a). |
|
30
|
1
|
Medication carts clean, sharps containers affixed, food and utensils handled properly |
No |
No
|
No |
Observed soiled pill crushers on med carts. Observed soiled drawers on med carts.Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).Cups on the med cart observed with mouth portion exposed due to being stacked above the ziploc bag opening.Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c). |
|
32
|
1
|
Furniture clean and in good repair. Mattresses clean, dry, odor free |
No |
No
|
No |
Observed drawer knobs missing on patient closet drawer units throughout the facility.Observed loose wall shelf in the restroom of room S5.Observed tape residue on the chair in South Parlor.Minor stain on the couch in front lobby area.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). |
|
34
|
1
|
Laundry area and equipment clean, linen disinfected, clean laundry stored and handled separately |
No |
No
|
No |
Observed briefs/diapers and cleaning spray stored on the cart with clean linen.Observed clean linen not properly covered in linen storage rooms.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). |