Premises Information


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Name

UNIVERSITY PLACE NURSING AND REHABILITATION CENTER

Address

9200 GLENWATER DR

City/State/ZIP

CHARLOTTE

28262

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

4/22/2015

Final Score @ Grade

General Comments

#1 Observed floor cracked in Carnation Dinning room and 800 hall. Keep all flooring in good repair for easy cleaning.#4 Observed 1 light that in need of replacement in resident room #703. Repair light. #23 Observed trash can labeled "Biohazard trash" without red bag. Ensure medical waste is properly disposed of in correct container. #24 Observed several ants found in clean utility room cabinet in Sparks wing. Ensure facility is free of pests.#32 Observed residue on mattress in room 1001. Keep mats in good repair. #35 Observed corner table in rehab room with rip present in corner surface. Observed bookshlelf in 900 hall activity room in need of repair. Shelf is pulling away and potentially about to fall. Furniture shall be kept in good repair. #36 Observed microwaves containing residue in need of cleaning in the following areas: Both Rehab gyms, 600 hall nourishment. Food service equipment shall be kept clean.#40 Observed 2 containers of ice cream stored in resident fridge. All other employee food was separate from resident food. -Observed back up water supply present with numbers supplied. Observed telephone number missing for back up water supply "source" water utlility. PET agreement to provide 10 gallons of water per patient a day was observed, but signed back in 2006. Ensure agreement is up to date. Ms. Vanessa Poindexter and Mr. Kevin Scruggs was present during inspeciton.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Repeat Non Compliance: Observed damaged walls and wall paper in resident rooms, activity rooms, laundry room, sparks unit, resident bathrooms and hall ways throughout facility. Observed pop corn ceiling peeling around vent in activity room at front of facility. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Repeat Non Compliance: Observed shower bed mat in disrepair located on 900 Hall and in rehab unit. Observed debris located under shower pad in rehab bathing facilityRepeat Non Compliance: Observed pink residue present on bathing facility shower curtains and on underside of shower chair in rehab bathing facility.**Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Repeat Non Compliance: Observed soiled utility carts stored in resident bathrooms and in bathing facility's. Areas included, but not limited to: Rehab bathing facility, Sparks bathing facility, and in 911. Observed garland stored in a soiled utility closet, and work tools and other storage in sparks soiled utility closet.**Toilet rooms shall not be used for storage. See rule .1312 (b).
10	0.50	Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected	No	No	No	Repeat Non Compliance: Observed bed pans not labeled in following areas: 808 1001, 604, with residue still in container. Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).All bedpans/urinals/emesis basins shall be cleaned after each use. 15A NCAC 18A .1312 (c).
14	2	Disinfectant accessible, properly used	No	No	No	Repeat Non Compliance: Observed disinfectant looked in storage cabinet in resident bathing facility on 900 hall, with disinfectant present in Spark bathroom but not being used. Cap was still present. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).
28	1	Adequate storage, area clean, items properly stored	No	No	No	Repeat Non Compliance: Observed multiple storage areas throughout facility with overloaded resident items stacked together enabling proper cleaning. Organize items to facilitate easy cleaning. Repeat Non Compliance: Observed patient contact items stored on floor of central supply closet. Items included diapers, food bags, tissue paper. Observed boxes stored on floor at end of hall near kitchen. Shipment was received yesterday per Ms. Vanessa.Observed used hair brush stored with clean linen on 800 hall and resident nebulizer tube on floor in room 910. Suitable rooms or spaces shall be provided for the storage of all necessary equipment, furniture, and supplies, and kept clean. 15A NCAC 18A .1318 (a).All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).
33	2	Linen changed when soiled. Soiled linen handled properly	No	No	No	Repeat Non Compliance: Observed stained comforter, linen, pillow case and or mattress pads in the following rooms: 808, 911, 910, 604, 403, 703.Observed soiled hand rags stored underneath cabinet found in Carnation Dinning room. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).