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

5/11/2022

Final Score @ Grade

General Comments

NO POINTS FOR THE FOLLOWING VIOLATION: #9. Toilet rooms shall not be used for storage. See rule .1312 (b). Observed large gray bins on wheels stored in both shared spa rooms that are used for trash and soiled linen. #35. Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). Observed hair accumulation inside of brushes and razor guard in beauty salon. Per conversation with staff, the person who does hair for the residents was not finished doing hair for the day and had not had an opportunity to properly clean patient items. #43. All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed no thermometer in refrigeration labeled “residents only” in medication room. *NOTE: Staci Clark was present during time of inspection along with Assistant Administrator Mindy:

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
1	1	Floors easy to clean, no obstacles, drains where needed	No	No	No	Keep all flooring in good repair. 15A NCAC 18A .1309 (a) and (b). Observed flooring in laundry room with brown staining and in need of detailed cleaning.
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed touch up paint needed to walls, wall joints, and baseboards throughout facility. Observed chipping paint on walls and door paint in room 109. Observed laminate flooring in restroom located in room 107 peeling up under toilet chair and in need or repair. Observed wall tile missing under handsink in shared spa room on 200 hallway.
8	2	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 detailed cleaning needed tubs stored in shower spa located on 100 and 200 hallways. Observed black build up inside the shower grout in both 100 and 200 hallways. Observed bathroom near room 206 with a sign stating “do not use due to active leak” per conversation with staff, they are aware of issue and are working to have it repaired. Observed shower chair in 100 shared spa with heavy rusting and in need or replacing. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed 1 loose toilet seat in 200 spa room. Observed detailed cleaning needed to the outside and corners of toilet bowl’s throughout facility.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	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 chair cushions in activity rooms with staining and railings on chair in need of resurfacing/replacing. Observed bed frame chipping in room 109. Observed refrigerator in mediation room in need of detailed cleaning to shelving and flooring of inside of unit.