Premises Information


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Name

OAKBRIDGE TERRACE AT MATTHEWS GLEN

Address

701 PAVILION VIEW DR

City/State/ZIP

MATTHEWS

28105

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

8/26/2013

Final Score @ Grade

General Comments

Mr. Ron Kloosterman and Scott Talaski present during inspection. **Medications unlocked in med room, medicare unit. **Maintain record of ppm amount of chlorine is being dispensed by each washing machine.**Keep plastic around single service ware in pantry storage.**Water fountain with too high of water pressure, splattering onto carpet, 2nd floor.**No thermometer in refrigertor, 1st floor nourishment room.**Do not use cup to dispense sugar, also label sugar, pantry.**No paper towels in soiled utility room, 1st floor.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Observed storage in shower room, 2nd floor.9. Toilet rooms shall not be used for storage. See rule .1312 (b).
11	1	Hand sinks used only for intended purpose	No	No	No	Observed dirty dishes in hand sink, memory care nourishment room.11. Except for the stipulations stated in rule .1312 (d), handwashing sinks shall only be used for handwashing. 15A NCAC 18A .1312 (d).
14	1	Disinfectant accessible, properly used	No	No	No	Observed disinfectant not accessible in shower room, 1st floor.14. A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed brown build up on ice chute, memory care nourishment room.19. Ice machines, buckets, other containers, and scoops shall be cleaned on a regular schedule such that they are kept free of scum, rust, mold or other contamination. 15A NCAC 18A .1314 (b).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed bed with frayed edges, PT 1st floor. Torn mattress cover, room 117. Blinds dusty in central supply.32. 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).
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Observed cabinets need cleaning in nourishment rooms, med rooms and activity rooms. Oven, stove-top and microwave need cleaning in activity kitchen.36. All kitchenware and food contact surfaces of equipment, exclusive or cooking surfaces of equipment, used in preparation or serving of food or drink, and all food storage utensils, shall be cleaned after each use. 15A NCAC 18A .1320 (c).
46	0.50	Clothing clean, no tobacco used while handling food	No	No	No	Observed laundry attendant remove soiled linens from soiled laundry cart and carry them against her uniform.46. While on duty, employees shall wear visibly clean outer clothing and shall be clean as to their persons. 15A NCAC 18A .1324 (a).