Premises Information


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Name

SUNRISE ON PROVIDENCE

Address

5114 PROVIDENCE RD

City/State/ZIP

CHARLOTTE

28226

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

4/20/2018

Final Score @ Grade

97.50

General Comments

No points were deducted for the following: 14. Observed no disinfectant stored in the bathtique on the first floor. Ensure that disinfectants is accessible for adequate cleaning. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). 33. Observed stained mattress cover and sheet in room 214a. Observed stained linen on bed in room 117. Ensure that all bedding are being changed when stained and have linen with set in stains removed. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). NOTE: Observed disposable under garments stored on the floor during inspection. Ensure that items are being stored off of the floor. Have staff check for disposables (in or out of boxes) on the floor during routine checks and relocate them to appropriate places. **All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Observed stained toilet in rooms 233 and room 12. Ensure toilets are being thoroughly cleaned routinely. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Observed disposable under garments stored underneath handwashing sink in rooms 214a and 12. **Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a).