Premises Information


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Name

BROOKDALE SOUTH CHARLOTTE

Address

5515 REA RD

City/State/ZIP

CHARLOTTE

28226

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

12/4/2013

Final Score @ Grade

General Comments

. . #2) Observed on Activity Storage Closet collecting debris and residue on the floor. Keep all closet floors clean. Keep all flooring clean. 15A NCAC 18A .1309 (a).#3) Observed bathroom ceiling unfinished in room 218. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.#5) Observed some return vents collecting dust. Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). #12) Observed soap dispenser in Wellness Center with no soap. Observed two paper towel dispensers not functioning. Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). #14) Disinfectant used for shower is not approved by the EPA for use in Hospitals or Nursing Homes. A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).#26) Observed wood and unused equipment collecting around the storage shed. Observed a spreader collecting water at the shed. There shall be no fly or mosquito breeding places, rodent harborages, or undrained areas on the premises. 15A NCAC 18A .1317 (c). #28) Observed chemicals stored above patient contact items in a 2nd floor storage closet. Observed patient contact items stored under the sink in the Beauty/Barber Shop. 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).Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a).#34) Observed the main clothes washing machine gasket collecting some residue. Observed the main laundry dryer collecting melted residue. Laundry areas and equipment shall be kept clean. 15A NCAC 18A .1319 (b) and .1312 (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 damaged table in custodial portion of laundry area. Observed residue collecting under the shower pad in room 218. Observed 2nd floor spa tub drain collecting residue. Observed damaged fold down bench in the 2nd floor spa shower. Observed shower curtain collecting residue in 204. Observed memory care spa shower chair collecting residue. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
17	1	Water fountains clean, good repair, properly regulated	No	No	No	Observed two hallway water coolers collecting pink residue on the water dispensing spouts. Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a).
30	1	Medication carts clean, sharps containers affixed, food and utensils handled properly	No	No	No	Observed pill crusher on one med cart collecting residue. Repeat Non-Compliance. Observed a damaged water pitcher on one med cart. Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed lobby, hallway, and some residue room chairs collecting dust, residue, and debris. 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).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed soiled linen on the bed in room 106. Observed a stained mattress cover in room 218. Observed an overflowing soiled linen container in the Memory Care area. 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).Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).