Premises Information


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Name

TERRABELLA LITTLE AVENUE

Address

7745 LITTLE AV

City/State/ZIP

CHARLOTTE

28226

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

4/25/2019

Final Score @ Grade

94.50

General Comments

2) REPEAT VIOLATION Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed stained carpets in stair wells and in therapy room. Observed vacuuming needed in file storage room. Previous violation corrected. 9) Toilet rooms shall not be used for storage. See rule .1312 (b). Observed mattresses stored in therapy room bathroom. 33) Soiled linen shall be placed in a covered container or bag at the point of use and stored and handled so as to contain and minimize aerosolization of and exposure to any waste products. 15A NCAC 18A .1319 (b). Observed soiled linen placed in open hamper in 132. Clean linen in good repair shall be provided for each individual and changed when soiled. 15A NCAC 18A .1319(b) Observed stained cover in room 132. REPEAT VIOLATION Improvement from previous inspection. 35) Patient contact items that become contaminated during use shall be cleaned and disinfected after each use. 15A NCAC 18A .1319 (c). Through discussion with beautician, hair clips are only rinsed in hot water for cleaning. Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). Observed comingled patient contact items (brushes) in room 132. 43) All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed broken thermometer in 101 refrigerator. Observed no thermometer in room 104. All refrigerators shall maintain a temperature of 45°F or below. 15A NCAC 18A .1323 (b). Observed air temperature in refrigerator at 58F in room 104. Only gatorade drinks were in the refrigerator. NOTE: Building grade card was covered by "activities for the week" display. Ensure grade cards remain visible at all times as required by law.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
3	1	Walls and ceilings cleanable, clean, good repair	No	No	No	REPEAT VIOLATION Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.Observed wall damage in 2nd floor storage room, bathroom by nursing storage, 226 bathroom, and 101 closet door. Observed touch up paint needed in housekeeping on 2nd floor, biohazard room, therapy room baseboards, laundry room walls, community mens bathroom, and memory care med supply storage.
8	1	Facilities conveniently located, clean and in good repair	No	No	No	REPEAT VIOLATION Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed pink build up on shower heads in room 211, 226, 229, and 115. Observed stained shower curtain and build up on shower seat in 101. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed peeling/chipping on inside of toilet in 101, 226 and 229. Observed broken/missing toilet paper holder in 115. Observed toilet riser loose in 206 and 104. Observed flush handle broken in 104. Observed strong odors in 1st floor womens community bathroom and 229 bathroom.
26	1	Premises clean, no breeding places or rodent harborage	No	No	No	There shall be no fly or mosquito breeding places, rodent harborages, or undrained areas on the premises. 15A NCAC 18A .1317 (c). Observed standing water in buckets in main courtyard. Observed gnats in 226 and therapy room. Observed door to outside left propped open in memory care area with no fly fan or barrier to keep pests from entering building.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	REPEAT VIOLATION All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). Observed briefs stored on floor throughout resident rooms including 211, 206, 132, and med supply storage in memory care. Observed boxes of plastic cups on floor in nursing storage. Observed catheter kit stored under medication disposal chemical in nursing storage. Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a). Observed briefs stored under sink in room 101.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	REPEAT VIOLATION 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 stained chairs in memory care day room and 132. Observed stained pillows throughout resident rooms in facility including in 206, 229, and 132. Observed debris under couch and chair cushions throughout living rooms and in main hallway on first floor. Observed minor wear on arms and backs of chairs in activity room. Observed debris and dust build up on window sill in 101. Observed jam spilled in drawer in 101. Observed heavily rusted washing machines.
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	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). Observed build up on inside of therapy room refrigerator and memory care refrigerator.