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

11/10/2022

Final Score @ Grade

97.50

General Comments

No points deduction the following: 8. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed shower bed cracked/ripped in central bath room on the west hall. Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b). Observed clogged sink in the soil work room, staff unclogged during inspection. 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 stained on pillow case and ripped bed linen in resident rooms.

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	REPEAT. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.9 Observed damaged walls along bath area in central bath rooms. Observed paint on ceiling peeling near the heater in central bath 2 (south). Observed ceiling peeling near the janitor’s closet (west). Observed touch up paint needed in room W26.
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Toilet rooms shall not be used for storage. See rule .1312 (b). Observed wheelchair and lamp in the central bath rooms. Items removed during inspection.
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 dirty surface undersink in need of cleaning in soil work room, and loose cabinet used to store disinfectant solution in central bath on east hall. Damaged cabinet surface need repair/replace in clean work room on west hall.