Premises Information


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Name

CAROLINAS MEDICAL CENTER

Address

1000 BLYTHE BV

City/State/ZIP

CHARLOTTE

28203

Premise Type

41 - Hospitals

County

Mecklenburg

Inspection Date

9/12/2019

Final Score @ Grade

96.50

General Comments

#2) Observed badly stained carpet in waiting area on wing 8E and residual glue around wall tile on wing 8L. Clean trash debris under shelving in storage room on 7 Tower wing & 8E clean utility. Keep all flooring clean. 15A NCAC 18A .1309 (a). #3) 3M at Children’s ED: soiled utility room with walls damaged and shelving damaged. Emergency’s Women’s restroom with pink, bulging ceiling tile. ED Major Room 3 with scuffed walls. Hole in wall of OR Storage. Observed walls damaged in patient rooms (4 tower) #4908, (6B) #6225, (6 C/D) #6713, (Cath Lab) #6115. Observed walls damaged in storage / nourishment/ utility rooms (6 tower) Equipment room, (6 C/D) Nourishment room, (6 C/D) Soiled Utility. Observed hole in the wall around toilet on wing 8A. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. #5) Clean ceiling ventilation in resident room and resident bathroom. Check with team 6 scribe. Observed dusty vents in room 124 on 10th floor, Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). #12) Observed no paper towels and no soap at hand washing sink in 9C room 124. Observed hand washing sink blocked in 9c room and soiled utility 10A. Observed no paper towels in 9E 104. Move soap and paper towels from eye wash sink in 9E 104 to hand washing sink that is no longer used as a processing sink (now hand washing sink) near Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). #17) Drinking fountain on wing 7B is inoperable (Has work order on file). Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a). #18) Observed unlabeled water pitcher in 9T 9905. 10th floor room124.Label all disposable water pitchers with the resident’s/patient’s first name and last name. 15A NCAC 18A .1314 (a). #30. Observed tape residue on emergency cart in emergency triage. Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). #32. Clean/dust high fixture in 11113. Observed torn chair in family lounge on 8th floor. Observed gasket on refrigeration unit in ED major room 3 with pink and black build up on gasket. 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). #34. Observed linens stored with other items in carts in 10T, 9A and 9122. Replace damaged linen cart cover observed in 9DE. Clean linen shall be stored and handled in a separate room or area, or in another manner that will prevent contamination of clean linen. 15A NCAC 18A .1319 (b). #43. Provide thermometer in refrigeration unit in 4011. All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).

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	Repair leak on under counter toilet in 11621 and 10601. Observed hand washing sink not draining in LCH women’s restroom. Observed slow draining handwashing sink in 10T nourishment. Recaulk around sink in 9115. Re caulk /reseal around toilet on wing 8A. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Observed pink and black build up in ice dispensing part of the ice machine. on 8A, 8E, & 8L wing. Observed ice machine/dispenser soiled on 8th floor family room and nourishment kitchen. Observed ice dispenser soiled on 10T, 10A, 10DE, 9E, 9T and 9B. 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).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Observed storage near hand washing sink and under hand washing sink in 11T supply room. Observed storage near hand washing sink in Med air supply room. Keep an 18 inch clearance around/near hand washing sink. Cover top of single service article cup holder in nourishment room in 11T. Observed storage on the floor in 11B storage. Do not store or place items on the floor. Store items on shelving. Observed boxes of charts stored on the floor in the physical therapy storage room. Observed storage on the floor under shelves throughout 9th and 10th floor.
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Observed interior of the microwave with debris in 3B. Clean counter tops underneath microwaves in nourishment area (5 tower). Clean spills in refrigeration units on 9th and 10th floor. Replace damaged shelving in 9A nourishment Non-food contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. See rule .1320 (c).