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

6/29/2017

Final Score @ Grade

General Comments

Nelson Santos was present during the inspection. Susan Protsko accepted the report. NO POINTS WERE DEDUCTED FOR THE FOLLOWING: 28. Observed cabinets were water damaged beneath the ice machine in 3rd floor activity room. **Repair machine and repair water damaged cabinets. 34. Observed wet / damp aroma therapy hand cloths were stored in a warmer that was turned off. Ensure the cloths are maintained at an adequate temperature (warmer turned on) to prevent the growth of bacteria. Ensure aroma therapy cloths(blue) are sanitized between uses. Current sanitizer used for linen in chlorine bleach. Hot water sanitizing may be an option if hot water temp 160F or high for 25minute at the commercial washing machine. Provide adequate documentation for all sanitizing of common linen. 36. Observed the drink dispenser stand (3rd floor) needed cleaning. **Keep all non-food contact surfaces in a sanitary condition.

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 the sink with residue / debris and needed cleaning in room 229. Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b) Observed the shower curtain with pink / brown residue in room 101, and the shower head with pink residue in room 244. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed the toilet and toilet seat were soiled in room 244. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed the washing machine was not draining in the 2nd floor laundry room. Repair washing machine and keep in good repair.
13	2	Lavatory and bathing hot water between 100 and 116 F	No	No	No	REPEAT Observed the hot water in some resident rooms 118F - 123F; 119F in rooms 316, 325, 326, 219, and 123F in room 229. **Maintain the hot water at all resident accessible hand washing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed couches with debris and crumbs under cushion, and upholstery needed cleaning in the 2nd floor TV room, and 3rd floor activity 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).