Premises Information


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Name

WILLOW RIDGE ASSISTED LIVING

Address

2040 MILTON RD.

City/State/ZIP

CHARLOTTE

28215

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

8/21/2013

Final Score @ Grade

General Comments

3. Observed popcorn ceiling peeling in room 113.**Keep all walls and ceilings clean and in good repair. See rule .1310.18. Observed a few disposable water pitchers and cups unlabeled.**Label all disposable water pitchers with the resident’s/patient’s first name and last name. See rule .1314 (a).32. Observed wet towel under refrigerator in room 207. Residue and black build up is collecting on the towel and dresser.Observed knob hanging off of dresser in room 202.**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. See rule .1319 (a).Pate Wilkerson & Morgan White present.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
5	1	Ambient air temperature 65 to 85 F, equipment clean	No	No	No	Observed AC filters dusty throughout bedrooms, common rooms, etc.**Keep all ventilation equipment clean and in good repair. See rule .1311 (b).
8	1	Facilities conveniently located, clean and in good repair	No	No	No	-Observed pink build up on the shower chairs.Keep all bathing equipment clean and in good repair. See rule .1312 (a) and (f).-Observed loose toilet seats in multiple areas on the 100 and 200 halls. -Observed urine on the toilet seat in room 207.Keep all toilet equipment clean and in good repair. See rule .1312 (b). -Observed loose handsink faucet in 100 hall spa.**Keep all handwashing facilities clean and in good repair. See rule .1312 (b)
14	2	Disinfectant accessible, properly used	No	No	No	Repeat Non-Compliance: Observed shower rooms/spas missing disinfectant/cleaner. A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. See rule .1312 (f).Spoke with employee who stated that the showers/spas are cleaned by spraying the disinfectant on the surface, let stand for about 5 minutes, then wiped off. Instructions on the disinfectant/cleaner stated there is a 10 minute contact time.Skin contact surfaces of all shared bathing equipment shall be cleaned with a detergent solution and then disinfected with an EPA registered hospital disinfectant between patient uses. See rule .1312 (f).
30	1	Medication carts clean, sharps containers affixed, food and utensils handled properly	No	No	No	Observed med carts with residue in the bottom of the areas holding the cups and spoons. **Medication carts shall be cleaned when visibly soiled. See rule .1318 (c).