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

12/22/2017

Final Score @ Grade

85.50

General Comments

Escorted by Cleveland Williams and Frank Taylor. Report received by Howard Staple (administrator) NO POINTS WERE ISSUED FOR THE FOLLOWING: 4. Observed lights were not working in 400 hall lift storage and physical therapy restroom , and the light shield in the soiled linen room was not secure. **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). 12. Observed no soap at the hand washing sink in 300 hall service kitchen and 300 soiled utility room. **Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). 10. Observed bedpans were not labeled in rooms 615, 503. **Where bedpans are cleaned in patient/resident rooms, bedpan cleaning facilities shall consist of a water closet with bedpan lugs or spray arms. 15A NCAC 18A .1312 (c). 14. Observed no disinfectant supplied in the 500 hall spa room. Post procedure for cleaning the spa tub in each spa room. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). 21. Observed litter and fallen debris/trash in the ground surrounding the dumpster. **The rooms, enclosures, designated areas, and containers shall be adequate for the storage of all solid wastes accumulating on the premises. 15A NCAC 18A .1316 (c). 34. Observed a disposable brief were stored with clean linen in physical therapy. **Clean linen shall be stored and handled in a separate room or area, or in another manner that will prevent contamination of clean linen. 15A NCAC 18A .1319 (b). 40. Observed a container of personal food was not labeled in the 600 nurishment room. **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). 43. Observed no refrigerator thermometer in the 600 hall nourishment room. **All refrigerators shall maintain a temperature of 45°F or below. 15A NCAC 18A .1323 (b).

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
2	2	Floors clean, carpet clean, dry, odor free	No	No	No	Observed floors were soiled and/or had an accumulation of debris in lift storage rooms, soiled linen rooms, clean utility rooms, nourishment rooms, resident rooms, and supply/equipment storage areas throughout the facility. Observed the hallway carpet with several stains/spills needed cleaning throughout the facility. Observed the bathroom floor grout with black residue in room 503. **Keep all flooring clean. 15A NCAC 18A .1309 (a).
3	1	Walls and ceilings cleanable, clean, good repair	No	No	No	(REPEAT) Observed the walls throughout the facility needed cleaning, the walls were splattered with dried food in the 200 hall service kitchen. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Observed soiled shower chair, grout with pink and brown residue, shower curtain with black/brown residue, and the shower head with pink residue in rooms 503; soiled shower chair in room 615; soiled shower curtains in room211 and 414; Observed a soiled portable toilet in the clean utility room (300 hall). Observed sinks were not clean throughout the facility. Observed bags fallen from the soiled linen storage container in the soiled linen storage room. Provide hand sanitizer in all soiled linen storage areas where their is potential for hand contamination. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b) **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
9	0.50	Toilet rooms free of storage, hand wash signs posted	No	No	No	Observed the dentist's chair, table, chair, and ether items were stored in the spa restroom on the 500 hall. An alternate room must be provided for dental procedures. **Toilet rooms shall not be used for storage. See rule .1312 (b).
18	1	Drinking utensils properly handled	No	No	No	(REPEATED) Observed water pitchers were not labeled throughout the facility (rooms 306, 615, 414, 211) Observed the ice machine with pink/brown residue accumulated near cube forms in the 300 nourishment room. **Label all disposable water pitchers with the resident's/patient's first name and last name. 15A NCAC 18A .1314 (a).
28	1	Adequate storage, area clean, items properly stored	No	No	No	Observed broken and soiled equipment stored in clean supply/equipment rooms. Observed boxes of single service cups and bowls. Observed a staff members belonging were stored in the resident's shower in room on the 100 hall. 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	2	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	Observed the mattress with a strong urine odor in room 211, the divider curtains needed cleaning or replacing in 211, the room chair needed cleaning in room 414, the buttons on the bed remote with debris accumulation in several rooms, telephone receivers with residue, the patio table in the ext. smoking area was broken and mended with duct tape, and facility issued pillow were torn/damaged. 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	2	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed soiled linen on the floor in the 500 spa room, soiled linen on the floor in the lift storage 600 hall, and soiled rags in the floor in the clean laundry area. **Soiled laundry shall be handled and stored separately from clean laundry using separate cleanable carts or bags. 15A NCAC 18A .1319 (b).
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Observed the microwaves were not clean in 300, 600, 200; the microwave in the 300 hall nourishment room with damaged interior surface needs replacement. Observed the refrigerators in the nourishment rooms throughout the facility with spilled liquid, and debris. **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).
39	2	Food supply complies with 15A NCAC 18A .2600	No	No	No	Observed opened high protein milk-based drinks were stored on medication carts on ice baths was 57F (300 hall); observed food server's cell phone on the counter in the service kitchen; an individual salad was not date marked in the service kitchen; a refrigerator was at 50F and milk at 53F in room 414. **All food and food supplies provided by an institution shall be from sources that comply with 15A NCAC 18A. 2600.