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

9/13/2016

Final Score @ Grade

95.50

General Comments

(NO POINTS DEDUCTED) 3. Obsered slight wall damaged behind bed in room 907. Touch up wall. 10. Observed urinal soiled with resiude in room 803. Urinals shall be disinfected after each use. 14. Observed bottle of disinfectant empty located in 600, 700 hall. 16. Observed back up water supply plan provided from supplier with calculation of water per resident. Calculation was short (2 liters per person per day). Contact supplier and provided 2 liters per resident per day. 18. Observed multiple staff at med carts describe cleaning of drinking pitcher at 600 hall nourishment room. Pitchers shall be taken to kitchen to be washed, rinsed, and sanitized between uses. 19. Observed ice chest unattended to 800 hall way. Keep ice protected and or supervised at all times to prevent contamination. Mr. Paul and Mr. Drew was present during inspection.

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 blue spa mat with slight build up between at holes in 800/700 spa. Ensure full mat is being properly cleaned. Observed back of shower chairs starting to breakdown in 600/700 spa. Observed 1 underside of shower chair collecting residue in 700/600 spa. Improvement seen from previous inspection. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Observed boxed items stored on floor in following areas: Med prep right wing of facility, 400 storage closet, outside storage area. Observed bag of clean linen stored on floor in clean linen 600 hall. All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). 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).
30	1	Medication carts clean, sharps containers affixed, food and utensils handled properly	No	No	No	Observed pill debris, debris, and sticky residue present on 900, Observed drinking cups on med cart overstocked with mouth contact portion not protected 400 and 500 hall. Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c). Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).
33	2	Linen changed when soiled. Soiled linen handled properly	No	No	No	Repeat Non Compliance: Observed debris in linen, stains on linen, comforter and or pillow case in room 803, 403, 604. Repeat Non Compliance: Observed lids not closed at soiled linen container in soiled utility closet (500/400 hall) Observed carts in soiled laundry room not labeled "soiled linen" just labeled linen (500 hundred hall) Observed linen stored in shower tub 700/600 spa. Observed rip in linen room 403 and 902. 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). Carts used for soiled laundry shall be labeled for soiled laundry use only. 15A NCAC 18A .1319 (b).