Premises Information


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Name

WHITE OAK MANOR - CHARLOTTE

Address

4009 CRAIG AV

City/State/ZIP

CHARLOTTE

28211

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

5/17/2019

Final Score @ Grade

General Comments

NO POINTS WERE TAKEN FOR THE FOLLOWING: #27 - Maintain adequate vet records for all animals. 15A NCAC 18A .1317 (f). Observed several therapy animals (Jet, Desi, Allie, Aaron, Abbie, Archer, Brindle, Brisket, Cheyanne, Luke, Carol, Nelson, Nicky, Rita, and Roxyanne) with expired rabies vaccine records. PIC stated most of them may not visit the facility anymore. #6 - Moisture shall be controlled such that there is no evidence of microbial growth on interior surfaces and objects. 15A NCAC 18A .1311 (d). Observed mold in cabinet under sink in both West unit clean work room and East unit soiled work room. #3 - Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed soiled and dusty walls in central laundry room behind dryers and washing machines.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Repeat. Observed soiled shower and buildup on shower curtain in room E30.
32	2	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). Repeat. Observed stained window curtain in room S26, debris on window curtain in room S6, tears in pillows in rooms W22 and E26, and soiled window curtain in parlor of East unit.
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed minor staining of bed sheets in rooms S26 and S23. Also observed no pillow case on pillow in room W29.