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

9/13/2019

Final Score @ Grade

95.50

General Comments

GENERAL COMMENTS NO POINTS DEDUCTED FOR THE FOLLOWING VIOLATIONS: #9. Toilet rooms shall not be used for storage. See rule .1312 (b). Observed all shared spa rooms checked during time of inspection with chairs, wheelchair's, and other furniture stored within spa facility. #16. Observed no backup water supply plan. Provide a written plan that meets all parts of 15A NCAC 18A .1313 (f). Observed no back up water supply plan within facility. EHS emailed back up water supply plan guidelines to facility. #17. Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a). Observed black and pink build up inside of water fountains located in front of therapy room. Clean. #30. Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c). Observed all unused medication cups on medication stored uncovered and exposed to contaminates of the air. **Inspection report signed by Ken Zielinski and emailed to ccn56-admin@clearcreeknursing.com

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	Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed soiled shower chairs in rooms 308 and 207. Observed loose toilet seats in rooms 609 and 806. Clean/Repair. Points de-escalated due to improvement from previous inspection.
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a). Observed single service patient cups in storage closets throughout facility stored on the floor.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	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). Observed furniture chairs stored in common areas throughout facility with staining. Observed two stained pillow cases in room 609.
36	2	Approved utensils and equipment, cleaned and sanitized	No	No	No	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). Observed interior of cabinets with brown and black build up in satellite kitchens throughout facility. REPEAT. Observed build up in microwaves in satellite kitchens throughout facility. Clean. REPEAT VIOLATION.