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

5/11/2022

Final Score @ Grade

General Comments

NO POINTS FOR THE FOLLOWING VIOLATIONS: #3. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed ceiling damage on mid 100 hallway and outside of room 605. EHS advises facility to ensure no active leak is occurring and to have ceiling resurfaced. Observed minor touch up paint needed to walls and wall joints throughout. Per conversation with staff, facility is in the process of renovating 100 hall and touching up paint throughout facility. #16. Observed an incomplete backup water supply plan. Provide a written plan that meets all parts of 15A NCAC 18A .1313 (f). EHS emailed Administrator a guidance document detailing all that needs to be outlined in backup water supply plan. #26. The premises shall be kept neat, clean, and free of litter. 15A NCAC 18A .1317 (c). Observed dilapidated furniture stored outside of dumpster area (doors, refrigerator). EHS advises facility to have items removed from dumpster area. #34. All common linen including sheets, pillow cases, absorbent pads, towels, and wash cloths provided by the facility must be sanitized between users with an EPA registered laundry sanitizer or by other methods described in 15A NCAC 18A .1319 (b). Observed no documents detailing the concentration of chlorine or EPA laundry sanitizer being pumped into system. The requirement outlined in 15A NCAC 18A .1319 is 50 ppm chlorine. *NOTE: EHS Staci Clark was present during time of inspection along with Maintenance Romanell Report emailed to ED, Michelle Flowers, at 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	2	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 loose toilet seats in rooms 303, 504, 603, and 709. Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b). Observed several handsink with slow drainage in residents rooms. EHS advises facility to ensure no clogging/blockage is manifesting in slow draining handsinks.
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 chairs in common areas with minor staining on cushions and railings on chairs in need of resurfacing. Observed green rolling chairs therapist use in therapy room beginning to fray around outer cushion.
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed minor staining on fitted sheet in room 309 and 802. Observed staining on pillow in room 709.