|
3
|
1
|
Walls and ceilings cleanable, clean, good repair |
No |
No
|
No |
Observed lower section of wall throughout facility in rooms and bathrooms in need of painting. Continue to touch-up paint/repaint throughout facility where needed. Wipe/clean walls throughout where needed. Repair lower section of wall in room 204 bathroom, tightly secure rubber cove base moulding and repaint. Observed water stain on ceiling in nourishment room on 200 hall. Monitor spot on ceiling and repair any roof leaks and repair/repaint ceiling. Monitor ceiling around crown moulding and expansions joint and seal any gaps if needed. Observed some small gaps around crown moulding and expansion joint due to building settling. Observed some nail poppers on ceiling in hallway and resident rooms. Hammer in nails and touch-up paint ceiling where needed. Replace missing rubber cove base moulding near counter top in room 111. Repair wall in lower section of can wash in janitor closet and monitor and repair wall behind drain trough in laundry room. 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 |
Observed minor dust on heating and cooling unit covers in rooms. Observed debris present behind heating and cooling unit covers throughout in several rooms. Remove covers/face plate on heating and cooling unit and clean top of units. Clean ceiling ventilation near hand washing sink in common bath/shower. Observed some accumulation of dust on fixture. Replace cracked cover on heating and cooling unit in room 119.Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). |
|
8
|
1
|
Facilities conveniently located, clean and in good repair |
No |
No
|
No |
Observed underside of potty chair in room 211 soiled. Thoroughly clean underside of potty chair. Observed pitted faucet fixture on hand washing sink in room 225. Replace pitted faucet fixture on hand washing sink in 225 and anywhere else needed. Tightly secure and seal hand washing sink to wall in room 111 bathroom. Observed some leakage around hand washing sink handle valve stem in supply room/ soiled item room. Repair leaking valve stem on hand washing sink handles. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b) |
|
28
|
0.50
|
Adequate storage, area clean, items properly stored |
No |
No
|
No |
Observed storage on the floor in employee training room and storage room. Remove storage off the floor.All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). |
|
30
|
2
|
Medication carts clean, sharps containers affixed, food and utensils handled properly |
No |
No
|
No |
Observed single service articles(water cup and med cups) not properly stored on medication carts. Keep med cups and water cups covered/protected from contamination. Clean shelving area on med carts where cups are stored. Thoroughly clean pill crushers on medication carts. Wipe/clean base of drawers on medication carts. Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). 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 loose and damaged laminate on edge of cabinet, drawer doors and kick plate on base of cabinets. Tightly secure loose laminate on cabinet and drawer doors. Where laminate is missing; I recommend painting bare wood area. Repair hinge on cabinet door in room 204. Observed some spots/stains on privacy curtains in rooms. Thoroughly clean privacy curtains or replace. Observed soiled fall mat in room 119. Observed some fall mats showing wear where mats is folded. Monitor area where fall mats are folded and replace if needed. Recommend not folding fall mats to prevent damaged at area where mats are folded. Observed some areas on furniture where sealant is worn/damaged. Recommend restaining/revarnishing areas on night stands and foot and head boards where sealant/varnish is worn off.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). |
|
40
|
0.50
|
Food brought by employees or visitors handled properly |
No |
No
|
No |
Observed food products stored in nurishment room refrigeration unit on 100 and 200 hall not properly labeled. Labeled resident food, employee food, activity food with a name and date food was brought into facility. Activity program food/drink label; facility activity and date when food was brought into center. Food brought from home by employees or visitors of patients or residents shall be stored separately from the institution's food supply and shall be labeled with the name of the person to receive the food and the date the food was brought into the facility. 15A NCAC 18A .1321 (b). |