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Mecklenburg County Health Dept
Public Health Inspections
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Premises Information

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NameSHADY HARBOUR ADULT LIVING
Address908 TOM HUNTER RD
 
City/State/ZIP
CHARLOTTE NC 28213
Premise Type43 - Residential Care
CountyMecklenburg
Inspection Date 7/16/2015
Final Score @ Grade
9
General Comments

Violations

 
CDI=Corrected During Inspection  R=Repeat Violation  VR=Verification Required 
Violation Item Demerits Violation Description CDIRVRComments
4 4 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 Repeat Non Compliance: Observed torn gasket at fridge, paint chipping on inside surfaces of cabinets and cabinet drawers. Observed broken handle at fridge as well as broken drawer at door of fridge. **Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. 15A NCAC 18A .1618 (c ).**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).General Comment: Observed backflow prevention device not present at back outside spigot. This is a 6 point item (PROVISIONAL). Provide back flow prevention device at all spigots. Observed A/C PVC pipe leading to back outside floor drain. Provide air gap by sticking something under the pipe to prevent back syphionage. Ms. Carrie was present during inspection.
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 Repeat Non Compliance: Observe calcium build up at back shower head, and pink residue collecting at bottom of shower curtain in same restroom. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).
9 2 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 debris present in linen in far back right room. Change linen when required. **Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).
12 1 WALLS AND CEILINGS: In good repair 1; kept clean 2 (.1608) No No No Repeat Non Compliance: Observed slight chips in walls and window sills throughout facility. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.