Premises Information


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Name

SUMMIT PLACE OF SOUTHPARK

Address

2101 RUNNYMEDE LN

City/State/ZIP

CHARLOTTE

28209

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

4/9/2014

Final Score @ Grade

97.50

General Comments

Observed damaged chair(torn) in television lounge on second floor. Replace damaged chair. Observed hair present on shelving within cabinet area of beauty parlor. Clean shelving within cabinet area. **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 damaged window screen in television room on second floor and window was open. Replace damaged window screen if facility is going to open windows.**All openings to the outer air shall be protected against the entrance of flies and other flying insects by self closing doors, closed windows, 16-mesh or finer screening, controlled air currents, or other effective means. 15A NCAC 18A .1317 (a).Mr. Nelson Santos present at time of inspection.

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	Observed loose flooring near base of shower in room 329, 335 and 317. Observed missing floor tile near nurse station on third floor. Observed missing base board in dining room area of dementia unit. Tightly secure and seal loose flooring near shower in residents bathroom. Replace missing floor tile near entrance to nurse station. Replace missing base board in dining room of dementia unit.**Keep all flooring in good repair. 15A NCAC 18A .1309 (a) and (b). Floors shall be free of obstacles to cleaning. 15A NCAC 18A .1309 (a).
3	1	Walls and ceilings cleanable, clean, good repair	No	No	No	Observed damaged wall near top of can wash in 3rd floor janitor closet. Observed hole in wall in clean linen room/ storage room and laundry room on 1st floor. Repair wall in janitor closet. Patch holes and repaint wall in clean linen/storage room and laundry room. Tightly secure loose rubber cove base moulding in storage room/laundry room.**Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Observed case of gloves stored on the floor in nurse station on third floor. Observed case of isolation gown and adult wipes stored on the floor in closet area of activity room. No storage on the floor; store items on shelving!**All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).