Premises Information


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Name

CLEAR CREEK NURSING AND REHABILITATION CENTER

Address

10506 CLEAR CREEK COMMERCE DR

City/State/ZIP

MINT HILL

28227

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

10/30/2015

Final Score @ Grade

General Comments

#4 Observed light flickering in bathroom of room 704. Repair/replace lighting. #19 Observed slight residue build up at hallway water fountain nozzle in front of therapy room. #30 Observed build up in corners of container trays located on 200 hall med cart. Observed drinking cups slightly overstocked stored on of med cart on 200 hall. Observed cracked pitcher top located on med cart on 300 hall. **Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).**Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c).#36 Observed food debris/residue present in therapy fridge and microwave. Per operator fridge is used by staff. Observer soiled utensil (chocolate spatula) stored in cabinet of activity area 500 hall. Spatula was removed. All food and non food contact surfaces shall be kept clean and or sent to be wash, rinsed, sanitized when visible soiled. #44 Observed food (vital care) stored on floor in med room 28. Store all food above floor.Documents were observed for back up water supply, but not formally in written plan (per operator plan was sent to previous inspector) send written plan via email (Alex Torres) to keep on file. Ms. Coleen Anderson (Administrator) was present during inspection.

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 residue on floor tile in resident shower room in 505. Observed slightly loose toilet seat in room 309. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).
12	1.50	Lavatories have mixing faucet or tempered water, soap hand towel and hand drying device	No	No	No	Observed paper towels missing from hand sink in activity area 500 hall, and in soiled utility room 57. Provide paper towels at all hand sinks. **Provide liquid soap and disposable towels at all hand washing sinks. 15A NCAC 18A .1312 (d).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Repeat Non Compliance: Observed briefs stored on floor in storage room 19, therapy ADL bathroom, clean clothes in black bag in laundry room stored on floor. **All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).