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

7/21/2017

Final Score @ Grade

96.50

General Comments

Elisa Matheney was present during the inspection. 15A NCAC 18A .1306 PUBLIC DISPLAY OF GRADE CARD (a) Whenever an inspection of an institution is made, the Environmental Health Specialist shall remove the existing grade card, issue a new grade card, and post the new grade card where it may be readily observed by the public upon entering the facility. The administrator shall be responsible for keeping the grade card posted at the location designated by the Environmental Health Specialist at all times. If the administrator objects to the location designated by the Environmental Health Specialist, then the administrator may suggest an alternative location which meets the criteria of this Rule. NO PINTS WERE ISSUED FOR THE FOLLOWING: #2 - Observed the treatment closet floor with debris. **Keep all floors clean. #12 - Observed no paper towels were supplied at the hand washing sink in the med prep room. **Each hand washing areas must be supplied with soap and paper towels. #18 - Observed disposable drinking cups throughout the facility were not labeled with the patient's name and date. ****Label all disposable water utensils with the resident's/patient's first name and last name. 15A NCAC 18A .1314 (a). #26 - Observed wasp nests, birds nests, and dirt dauber nests on exterior porches. **Remove all nests from the premises. #28 - Observed clean items were stored with-in 1 inch of hand washing sink. **Keep all clean supplies out side of spa-zone of the hand washing sinks to prevent contamination. Recommend 12 inches on both sides.

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 a shower chair with damaged / worn mesh backing and was not clean. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed sinks were very slow to drain in rooms 505 and in the spa room. Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b) Observed a soiled elevated toilet chair was stored in the clean utility room with other clean chairs, and the hopper was not clean in the soiled utility room. Observed a significant improvement. **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	(REPEAT) Observed bed pans were not labeled with the resident's name and date in rooms 505 and 409. **Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed the ice machine shoot with pink and black residue in the nourishment room. **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).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed soiled transport cart was stored in a storage closet, the chair upholstery was not clean in room 505, the divider curtain was not clean in room 604, and plastic lined pillows were worn/torn in room 804