Premises Information


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Name

ROYAL PARK REHABILITATION & HEALTH CENTER

Address

2700 ROYAL COMMONS LN

City/State/ZIP

MATTHEWS

28105

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

9/22/2014

Final Score @ Grade

General Comments

John FIckers was present during the inspection.#3 - Observed the walls were damaged in room 117, and the baseboard coming away from wall in the physical therapy kitchen. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.#4 - Observed lights were not functioning in housekeeping closet (500), and the men's restroom in physical therapy. **All areas shall have sufficient illumination. Maintain 10 foot candles of light at 30 inches above the floor in all areas other than food service areas. 15A NCAC 18A .1311 (a). #9 - Observed a food service cart was stored in the shower in room 218, and a box of equipment used for a resident's bed was stored in the Spa room. **Toilet rooms shall not be used for storage. See rule .1312 (b). #15 - Observed no backflow prevention device on the detachable shower head at the bathtub in the ADL shower. **Provide backflow prevention devices on each detachable shower head. **Cross-connections with sewage lines, non-potable water supplies, or other potential sources of contamination are prohibited. 15A NCAC 18A .1313 (d).#21 - Observed litter collecting on the ground at the dumpster area. **Solid waste containers, rooms, or designated areas shall be kept clean. 15A NCAC 18A .1316 (c).#24 - Observed 2 live roaches in the 300 hall nourishment room, and several dead on the floor. Also observed several drain flies in the service kitchen in the staff service hallway. **Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises. 15A NCAC 18A .1317 (a).#34 - Advised by staff that facility will begin to launder linens on site. **Provide documentation for chlorine concentration at each washing machine. **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).#36 - Observed some residnet's personal refrigerators needed cleaning (rooms 117, 615). **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).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
2	1	Floors clean, carpet clean, dry, odor free	No	No	No	Observed several storeage closet floors with dust and debris, the floor in the 600 hall nourishment room was dirty and had dead insects, and the carpet was stained in the 500 and **Keep all flooring clean. 15A NCAC 18A .1309 (a).
8	1	Facilities conveniently located, clean and in good repair	No	No	No	Observed the shower chair and shower head in room 117 was not clean. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).Observed an elevated toilet seat with rust, and an elevated toilet basin was not clean. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).Observed the backsplash in the service kitchen was water damaged. **Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)
14	1	Disinfectant accessible, properly used	No	No	No	(REPEAT NON-COMPLIANCE) Observed no disinfectant solution available in any of the spa rooms. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Observed toothbrushes and dentures were stored within the splashzone of the bathroom hand washing sinks (rooms 117, 514). 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).NOTE: Observed the exterior stoage area (maintenance shop) was unorganized and cluttered. Organitize/arrange items so that there is a walkway.
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed some soiled utility closets with soilet linen no in bags, the soiled linen container in physical therapy was not labeled, a bedspread was soiled in room 514 and a fitted sheet on a resident bed has holes/tears in room 406. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).
40	0.50	Food brought by employees or visitors handled properly	No	No	No	(REPEAT NON-COMPLIANCE) Observed unlabeled food in the service kitchen. **Food brought from home by employees or visitors of patients or residents shall be stored separately from the institution's food supply and shall be labeled with the name of the person to receive the food and the date the food was brought into the facility. 15A NCAC 18A .1321 (b).