Premises Information


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Name

PAVILION HEALTH CENTER AT BRIGHTMORE

Address

10011 PROVIDENCE RD W

City/State/ZIP

CHARLOTTE

28277

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

10/6/2014

Final Score @ Grade

96.50

General Comments

2. Observed restroom floor in 212 collecting urine with a strong urine smell.Keep all flooring clean. 15A NCAC 18A .1309 (a).19. Observed coolers of ice stored unattended in an unlocked and/or opened nourishment room.Ice shall be handled, transported, stored, and dispensed in such a manner as to be protected against contamination. 15A NCAC 18A .1314 (b).All ice machines and storage chests which are accessible to the residents and the public shall be automatic ice dispensing machines. 15A NCAC 18A .1313 (b).36. Per multiple nurses, the water pitchers on the med carts are washed in the nourishment rooms. They all have been informed to send them to the kitchen to be washed, rinsed, and sanitized. They have also been informed to receive to drinking water from the kitchen (not the handsink in the nourishment rooms).All multi-service utensils shall be washed, rinsed and sanitized between each user using a method listed in 15A NCAC 18A .2619.Ms. Myrna & Mr. John present during the inspection.Inspection emailed to: mgibson@liberty-ltc.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	-Repeat Non-Compliance: Observed no hand sanitizer in the salon. Facilities in operation prior to March 1, 2003 that do not have handwashing lavatories in all areas required shall have an approved hand hygiene program established. 15A NCAC 18A .1312 (d). -Observed soiled toilet seats and/or 3 in 1 toilet seat in rooms 408, 413, 212, soiled shower chair in room 309, shower stretcher pad ripped exposing the inside cushion with hair and brown matter under the pad.Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
10	0.50	Bedpans, urinals, bedside commodes and emises basins properly cleaned and disinfected	No	No	No	Repeat Non-compliance: Observed unlabeled bed pans.Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).
18	1	Drinking utensils properly handled	No	No	No	Repeat Non-Compliance: Observed unlabeled disposable water pitchers in several rooms.Label all disposable water pitchers with the resident's/patient's first name and last name. 15A NCAC 18A .1314 (a).
33	1	Linen changed when soiled. Soiled linen handled properly	No	No	No	Observed soiled pillow cases and/or sheets and comforters in 408, 413, and 212.Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).