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

6/24/2016

Final Score @ Grade

General Comments

NO POINTS DEDUCTED TODAY: 8. Observed no hand sanitizer in the dispenser in the salon. Replace. Facilities in operation prior to March 1, 2003 that do not have handwashing lavatories in all areas required shall have an approved hand hygiene program established. 15A NCAC 18A .1312 (d). 32. Observed the shelf in the cabinet under the ice machine with water damage- 3rd floor family room. 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). 43. Observed no thermometer in the refrigerator in room 213. Provide. All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Nelson Santos & Richard Lyon present during the inspection.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
13	1	Lavatory and bathing hot water between 100 and 116 F	No	No	No	Observed all the water temped at 119F, 120F, 122F, and 123F. Per Mr. Santos, new water heater was placed inthe faciilty. Ensure the rule below is followed. Maintain the hot water at all resident accessible handwashing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e).
15	2	Approved water supply, no cross-connections	No	No	No	Observed no back flow preventer on the shower wands in room 318, 322, and 233. Provide on these and any other shower wands that do not have one. Cross-connections with sewage lines, non-potable water supplies, or other potential sources of contamination are prohibited. 15A NCAC 18A .1313 (d).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Repeat: Observed stained sheet and mattress pad in room 223, and stains on the comforter in room 101. Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).