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

5/18/2015

Final Score @ Grade

General Comments

1. Observed a throw rug in a few restrooms.**All flooring in shower/toilet rooms shall be non-absorbent.13. -Observed the water in room 253 at 120F.-Observed the water in the 1st floor gym at 98F.**All hot water shall be tempered 100-116F.14. Observed employee without knowledge of how to turn on the spa tub to clean it. Print out the cleaning instructions and post in all spa rooms.The manufacturer's instructions shall be followed for cleaning equipment with pumps. See rule .1312 (f).26. Observed several flies around the dumpster. Clean under where the debris and residue is collecting.The premises shall be kept neat, clean, and free of litter. 15A NCAC 18A .1317 (c).There shall be no fly or mosquito breeding places, rodent harborages, or undrained areas on the premises. 15A NCAC 18A .1317 (c). 34. Observed melted residue on the dryer drum (inside).Laundry areas and equipment shall be kept clean. 15A NCAC 18A .1319 (b) and .1312 (a). Katie (administrator), John (maintenance), and Shacana (Director of Nursing) present. Report emailed to sfleming@actslife.org

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 Non-Compliance: Observed several water stained ceiling tiles throughout facility (nursing area, halls, storage rooms, room 134 closet,). -Observed wallpaper peeling in the Magnolia Hall.-Observed the cove bases missing in the storage room by the elevator on Rose Arbor hall, the Housekeeping Closet on the ground floor,Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
8	1	Facilities conveniently located, clean and in good repair	No	No	No	-Observed pink buildup on the shower heads in rooms 252, and 239-Observed slow draining sink in room 242. -Observed pink buildup in the handsink in the Med room on the ground floor.-Observed soiled toilet seats in rooms 101, 207, 252, and 225.Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).
9	1	Toilet rooms free of storage, hand wash signs posted	No	No	No	Repeat Non-compliance: Observed bedside tables stored in the spa room- 2nd floor.Toilet rooms shall not be used for storage. See rule .1312 (b).
30	1	Medication carts clean, sharps containers affixed, food and utensils handled properly	No	No	No	Observed the mouthpieces of the cups on multiple med carts not protected. Keep covered to prevent contamination.Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	-Observed torn pillows and mattress in the Therapy Gym on the 2nd floor.-Observed Wine stains/residue in the cabinet in the nurse's area on the 2nd floor.-Observed stains on the chair in 207.-Observed sticky residue on the bedside tables in rooms 134 and 113.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).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed linen soiled or in disrepair in rooms 239, 101, 113, 242, 239, 207, and 101.Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	-Observed soiled shelves in the refrigerator in Rose Arbor's Activity Kitchen, and Med room on the ground floor.Non-food contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. See rule .1320 (c).
43	1	Food storage units with thermometers, maintain temperatures	No	No	No	Repeat Non-compliance: Observed no thermometer in the refrigerator in Rose Arbor's Activity Kitchen, and rooms 239, 213, 225.All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).