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

4/28/2016

Final Score @ Grade

General Comments

5. Repeat non-complaince: Observed vent in activity room in 1000 hall collecting dust. Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). Improvement from previous inspection. 15. Repeat non-complaince: Observed removable eyewash stations throughout facility with no backflow preventers. Cross-connections with sewage lines, non-potable water supplies, or other potential sources of contamination are prohibited. 15A NCAC 18A .1313 (d). Improvement from previous inspection. 14. Caregiver stated that disinfectant is left on toilets for less than 10 minutes. A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). 28. Observed patient contact items stored in box on floor in treatment nurse room. Observed storage of clothing in clean linen room, clothing co-mingled. Observed storage in restrooms in back hall unused rooms. All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). 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). 32. Observed one damaged mattress and two damaged pillows in room 905. 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. Observed refrigerator light damaged in Spark Unit nourishment room. 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).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
1	2	Floors easy to clean, no obstacles, drains where needed	No	No	No	Repeat non-complaince: Observed separation in floor tiles in nourishment room in arboretum. 105 bathroom floor damaged at threshold. Keep all flooring in good repair. 15A NCAC 18A .1309 (a) and (b).
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Repeat non-compliance: Observed walls damaged in hallways and resident rooms throughout 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	Observed sink backsplashes throughout facility damaged, caulk damaged, cabinets damaged, cabinets missing backsplash, and hand sink basins collecting residue throughout facility. Observed showher bed collecting residue in 900 spa. Observed shoer curtains collecting residue in Spark Unit and 900 spa. Observed soiled hand towel in 900 spa. Toilet, handwashing, and bathing facilities must be conveniently located and readily accessible to residents and staff. 15A NCAC 18A .1312 (a).
10	0.50	Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected	No	No	No	Repeat non-complaince: Observed bed pan in spark unit not labeled. Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). Improvement from previous inspection.
12	1.50	Lavatories have mixing faucet or tempered water, soap hand towel and hand drying device	No	No	No	Repeat non-complaince: Observed several hand wash lavatories with no towles, one nourshment room one resdient room. Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d).
18	1	Drinking utensils properly handled	No	No	No	Repeat non-complaince: Observed one water pitcher with room number only. Label all disposable water pitchers with the resident's/patient's first name and last name. 15A NCAC 18A .1314 (a). Improvement from previous inspection.
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed ice makers collecting residue throughout. Observed ice bucket in arboretum collecting pink residue on cart. Ice shall be handled, transported, stored, and dispensed in such a manner as to be protected against contamination. 15A NCAC 18A .1314 (b).