Premises Information


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Name

BROOKDALE CHARLOTTE EAST

Address

6053 WILORA LAKE RD

City/State/ZIP

CHARLOTTE

28212

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

2/2/2017

Final Score @ Grade

94.50

General Comments

No Points: 3 Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed ceiling leak in the storage room on second floor. 4 All areas shall have sufficient illumination. Maintain 10 foot candles of light at 30 inches above the floor in all areas other than food service areas. 15A NCAC 18A .1311 (a). Observed light out in the janitor closet on first floor and a loose light cover in the bathroom of room 1106. 9 Toilet rooms shall not be used for storage. See rule .1312 (b). Observed wheelchair and mattress stored in second floor bathing facility. 10 Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). Observed unlabelled bedpans in room 1104. 13 Maintain the hot water at all resident accessible hand washing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e) Observed hot water at 119F in room 1106 and at 120F in the activity kitchen upstairs. 32 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). Observed furniture in the lobby area and at entrance to facility stained. **Henry Moore (maintenance) and Tabitha Bridges were present during the inspection.

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	Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed a soiled tub in the second floor bathing facility and soiled shower chairs in rooms 1206 and 1112. Toilet, handwashing, and bathing facilities must be conveniently located and readily accessible to residents and staff. 15A NCAC 18A .1312 (a). Observed an elevated toilet chair in room 1106 and no handsink/sanitizer in the salon. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed dirty toilet and toilet chair in second floor bathing facility.
16	1	Quantitiy and hot water sufficient, backup water supply plan	No	No	No	(REPEAT) Observed backup water supply plan/procedure document was not complete. A checklist for preparing the document was issued and emailed.Observed an **Provide a written plan that meets all parts of 15A NCAC 18A .1313 (f).
17	1	Water fountains clean, good repair, properly regulated	No	No	No	Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a). (REPEAT) Observed a clogged fountain on the second floor hall and calcium buildup in the first floor hall.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	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). (REPEAT) Observed single use cups at first floor water station uncovered. NOTE: Observed an unlabeld spray bottle with an unknow substance. **Alway label generic bottled with name of product when transfered from original container.
34	1	Laundry area and equipment clean, linen disinfected, clean laundry stored and handled separately	No	No	No	All common linen including sheets, pillow cases, absorbent pads, towels, and wash cloths provided by the facility must be sanitized between users with an EPA registered laundry sanitizer or by other methods described in 15A NCAC 18A .1319 (b). Observed no records for calibration of sanitizer dispenser's concentration in laundry area.
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	All kitchenware and food contact surfaces of equipment, exclusive or cooking surfaces of equipment, used in preparation or serving of food or drink, and all food storage utensils, shall be cleaned after each use. 15A NCAC 18A .1320 (c). Observed soiled coffee pots stored in a cabinet above handsink and a soiled microwave in the second floor activity kitchen. Observed refrigerators in rooms 1106, 1112, and 1206 in need of cleaning to remove residue. Also observed a refrigerator in room 1212 with no thermometer present.