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

8/3/2018

Final Score @ Grade

General Comments

No points were issued for the following: 3. Observed what appeared to be brown splatters and water marks on the ceiling of the third floor. Needs to be repainted/cleaned. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. NOTE: 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	1	Facilities conveniently located, clean and in good repair	No	No	No	Observed bathtique on second floor with brown staining on the side door. Needs to be cleaned. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed hoppers in janitor's closet in need of cleaning. Hoppers have heavy accumulation on the inner bowls. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed linen with staining in room 233 and mattress cover with staining in room 123. Linen needs to be changed routinely when stains appear. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).