Premises Information


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Name

AUTUMN CARE OF CORNELIUS

Address

19530 MT ZION PY

City/State/ZIP

CORNELIUS

28031

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

1/26/2017

Final Score @ Grade

96.50

General Comments

NO POINTS: Remove soap and paper towels from sinks that are not hand sinks (ones labeled hand utensil sinks). ie. OT 2 bowl sink and in the Med Room 2 bowl sinks. #3: Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed minor damage to many walls and wall corners. Recommend installing corner guards and other means to protect walls and doorways in storage areas. #4: 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). Observed light fixture loose from its base in room 707. #16: Observed an incomplete backup water supply plan. Provide a written plan that meets all parts of 15A NCAC 18A .1313 (f). Observed that some of the procedures were a little vague. Elaborate better on protecting ice, coffee machines, drink machines, how human waste is going to be disposed of, etc. #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 documentation that laundry is being properly sanitized at a minimum of 50 ppm chlorine OR a 25 minute wash cycle at 160F. #13: Maintain the hot water at all resident accessible handwashing sinks and bathing facilities within the temperature range of 100°F to 116°F. 15A NCAC 18A .1312 (e). Observed hot water range up to 121F on the 100-400 side of the building, PT and beauty salon. Facility provided water temperature logs where water temps are taken weekly with last one being yesterday. Water temperatures were in proper range until boiler inspector arrived. Corrective action will be readjusting boiler and calling recirc pump repairperson.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
11	1	Hand sinks used only for intended purpose	No	No	No	Except for the stipulations stated in rule .1312 (d), handwashing sinks shall only be used for handwashing. 15A NCAC 18A .1312 (d). Per discussion with med nurses water from pitcher to fill water cups is from the hand wash sinks. Water for drinking needs to come from a sink that is not a hand sink.
14	1	Disinfectant accessible, properly used	No	No	No	A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Repeat Non-Compliance: Observed no disinfectant (besides in the tub) in the spas.
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 storage on floor and in splash zone of hand sinks. Extra pillows stored on floor in room 707. Items/boxes on floor in outbuilding. Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a). Observed storage below hand sinks without the slanted board to protect storage from drips.
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 soiled linens on several beds, the sheets and pillow cases need to be checked and changed if needed when bed is made.