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

2/12/2018

Final Score @ Grade

General Comments

No points were deducted for the following: 10. Observed one bed pan in Room 808 missing name and date. **Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c). 14. Observed disinfectant for spa tub needed in Spa 79. Spa is not currently being used. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).

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 stained toilet in room 106 and 506. Observed broken toilet tissue holder in room 308. Observed loose toilet seats in Spa 50. Observed backflow prevention leaking in Janitor Closet. **Keep all toilet equipment clean and in good repair. See rule .1312 (b).
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Observed several pieces of equipment stored in Spa 50. **Toilet rooms shall not be used for storage. See rule .1312 (b).
17	1	Water fountains clean, good repair, properly regulated	No	No	No	Observed water fountain with build up near entrance. **Drinking fountains shall be kept clean and properly regulated. See rule .1314 (a)
28	1	Adequate storage, area clean, items properly stored	No	No	No	Observed several items stored on the floor in Supply Storage, Cart Storage 47, Storage 48 and outside storage (huge improvement from previous inspection). Suitable rooms or spaces shall be provided for the storage of all necessary equipment, furniture, and supplies, and kept clean. 15A NCAC 18A .1318 (a). All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed torn pillows in room 601. Observed mattress with debris under sheet. Needs to be cleaned. Observed sofa with stains in common area near 400 Hallway. In the process of being cleaned. 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). Mattresses shall be kept clean, dry, and odor free. 15A NCAC 18A .1319 (a).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed stained linen on bed in room 106 and 601. Linen was changed. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).
35	0.50	Patient contact items in good repair, properly stored, cleaned and disinfected	No	No	No	Observed hair in rollers in Beauty Shop. Needs to be thoroughly cleaned between residents. **Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c).