Premises Information


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Name

PEAK RESOURCES-CHARLOTTE

Address

3223 CENTRAL AV

City/State/ZIP

CHARLOTTE

28205

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

7/10/2014

Final Score @ Grade

91.50

General Comments

GC #9: Observed storage in bathroom of room 603.**Toilet rooms shall not be used for storage. See rule .1312 (b). GC #34: Observed no data for amount of chlorine residual going into each washine machine.**All common linen including sheets, pillow cases, absorbent pads, towels, and wash cloths provided by the facility must be sanitized between users with an EPA registered laundry sanitizer or by other methods described in 15A NCAC 18A .1319 (b).Note: Observed chemicals in spray bottles that were mislabeled. Properly label all chemicals. Buckets of cleaners with rags in them, cleaning cart, and used rags on another cleaning cart. Dispose of chemicals and used rags at end of shift.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Observed shower beds with torn mattresses, hall 500 hall and 600 hall. Many toilet chairs with residue on undersides throughout facility. Loose toilet seat in 900 hall spa. Clean hoppers even if not used-getting ring around basin. Bottom sides of toilet chairs with residue in clean utility room, 800 hall.Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)**Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
10	0.50	Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected	No	No	No	Observed unlabeled bed pans in rooms 405 and 307.**Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).
14	1	Disinfectant accessible, properly used	No	No	No	Observed no disinfectant available in spa, 500 hall. No cleaning instruction for spa's posted in any bathroom.A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).The manufacturer's instructions shall be followed for cleaning equipment with pumps. See rule .1312 (f).
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed ice scoop holder's with slime build-up. Send through dish machine daily.**Ice machines, buckets, other containers, and scoops shall be cleaned on a regular schedule such that they are kept free of scum, rust, mold or other contamination. 15A NCAC 18A .1314 (b).
30	1	Medication carts clean, sharps containers affixed, food and utensils handled properly	No	No	No	Observed several pill crushers with pill/powder build-up. Spill in med cart drawer, 500 hall.**Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed frayed fall mats in room 405. Brown chairs in rooms with discolored cushions, arms, and backs rooms 909 and .**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	2	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed many pillows with tears throughout facility. Soiled linens on beds in rooms 503, 602, 405, 307, and 204.**Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).