| Violation Item
| Demerits
| Violation Description
| CDI | R | VR |
|
|---|
|
4
|
2
|
FOOD SERVICE UTENSILS/EQUIPMENT: Utensils/Equipment in good repair, clean 4; eating and drinking utensils clean, cleaned after each use; approved facilities 4; clean utensils properly stored 2; substances containing poisonous material not used 6; disposable properly stored/handled, used once 2 (.1618) |
No |
No
|
No |
Observed base of utensil shelving, drawer under oven and cabinet area soiled in kitchen. Thoroughly clean utensil/equipment storage area/shelving in kitchen area. Observed bare wood shelving in pantry cabinet. Recommend sealing bare wood shelving with a varnish/sealant. All equipment and utensils shall be so constructed as to be easily cleaned and shall be kept in good repair. 15A NCAC 18A .1618 (a).Utensils shall be handled in such a manner as to prevent contamination. 15A NCAC 18A .1618 (f). |
|
8
|
2
|
TOILET: HANDWASHING: LAUNDRY AND BATHING FACILITIES: Toilet, lavatory and bathing facilities adequate 4; fixtures in good repair and kept clean 2; soap and towels provided 2 (.1610) |
No |
No
|
No |
Observed shower chair soiled with microbial growth on underside of chair and damaged head rest on chair. Observed faucet fixture pitting on hand washing sink in bathroom. Thoroughly clean shower chair and replace damaged head rest on chair and replace pitted faucet fixture on hand sink. Toilet, hand washing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). |
|
9
|
4
|
BEDS: LINEN: FURNITURE: All furniture, mattresses, linen, drapes, blinds and similar items in good repair and clean 2; bed linen changed as required 2; clean and soiled linens properly stored and handled 2 (.1617) |
No |
No
|
No |
Observed damaged chair in resident room. Discard and replace damaged chair. Observed broken window blinds on back door. Replace broken window blinds. Observed linen soiled on resident bed and bedding missing flat sheet. Change linen on residents bed when linen is visibly soiled and provide fitted sheet and flat sheet for residents. Observed soiled pillow in resident room. Discard and replace soiled/stained pillow.All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). |
|
11
|
1
|
FLOORS: In good repair 1; kept clean 2 (.1607) |
No |
No
|
No |
Observed flooring damaged in office area and between living room and dining room. Repair flooring in office and between dining room and living room. Monitor floor in kitchen near refrigeration unit and repair if needed.All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607. |
|
12
|
3
|
WALLS AND CEILINGS: In good repair 1; kept clean 2 (.1608) |
No |
No
|
No |
Patch holes in walls, tightly secure wall laminate in can wash, replace missing door stopper and repaint throughout where needed. Thoroughly clean walls in residents rooms. Thoroughly clean ceiling in kitchen and bathroom. Replace damaged electrical outlet covers. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. |
|
13
|
2
|
LIGHTING AND VENTILATION: Windows and fixtures in good repair 1; kept clean 2 (.1609) |
No |
No
|
No |
Observed ceiling ventilation, register and return air ventilation soiled throughout facility. Thoroughly clean ceiling ventilation, register and return air ventilation.Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). |
|
14
|
2
|
VERMIN CONTROL: PREMISES: Outside openings effectively screened or otherwise protected against entrance of flying insects, and flying insects absent 4; effective control of rodents and other vermin 4; approved pesticides properly used 4; premises neat, clean, drained and free of litter and vermin harborages and breeding areas 2 (.1615) |
No |
No
|
No |
Observed damaged railing on back porch area, damaged and rotten fencing and containers holding water in back yard area. Repair railing on back porch, repair or remove fencing and store containers in back yard so they do not hold or collect water.The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a).General Comment: Did not observe back flow prevention device on shower wands in both bathrooms. Mr. Jones stated that maintenance man informed him that shower wands had back flow prevention devices built in. Please provide documentation on next inspection stating and showing shower wands have back flow prevention devices built in or install back flow prevention devices on shower wands. Mr. Jones present at time of inspection. |