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

9/13/2019

Final Score @ Grade

General Comments

(continued from page 2) 8. Observed lid on the back of toilet broken. Needs to be repaired. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). REPEAT. No points were taken for the following: 24. Observed what appeared to be roaches in the 100 hall spa. Increase pest management to reduce the occurrence of pest. **Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises. 15A NCAC 18A .1317 (a). 32. Observed handles missing on dresser in room 219 and 213. Needs to be replaced. Observed torn pillow in rooms 219 and 107. Pillows were removed. Observed torn cushion on wheelchair in the 200 spa. Observed mattress torn in room 213. Observed torn blinds in room 107. **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).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
2	1	Floors clean, carpet clean, dry, odor free	No	No	No	Observed floor in need of cleaning in the electrical closet. REPEAT. **Keep all flooring clean. 15A NCAC 18A .1309 (a).
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Observed wall staining in room 219. Needs to be cleaned. Observed wall damage in room 213 and the spa on the 100 wall. Needs to be repaired. REPEAT **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Observed soap dispenser broken in 200 hall utility closet and 200 hall spa. Needs to be repaired. Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b) Observed wall within the shower in 200 hall shower with black build up. Needs to be cleaned. Observed brown staining on the curtain within the spa on the 100 hall. Needs to be cleaned. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). (continued on last page)
9	1	Toilet rooms free of storage, hand wash signs posted	No	No	No	Observed wheel chairs stored within the spas on both 100 and 200 hall. Needs to be removed. REPEAT. **Toilet rooms shall not be used for storage. See rule .1312 (b).
20	2	Wastewater disposed of properly	No	No	No	Observed mop sink near the 100 hallway clogged with standing water. Until drain is unclogged, do not dump water in mop sink. Needs to be repaired as soon as possible. **All wastewater shall be disposed of in accordance with 15A NCAC 18A .1900 or 15A NCAC 02H .0200