Premises Information


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Name

MERRYWOOD ON PARK

Address

3600 PARK RD

City/State/ZIP

CHARLOTTE

28209

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

2/18/2019

Final Score @ Grade

General Comments

NO POINTS WERE TAKEN FOR THE FOLLOWING: #15 - Observed no backflow prevention device present on shower wand of B104. **Cross-connections with sewage lines, non-potable water supplies, or other potential sources of contamination are prohibited. 15A NCAC 18A .1313 (d). #32 - Observed cleaning needed under couch cushions in living area near nourishment kitchen. **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). #40 - Observed 2 gallons of almond milk brought from outside of facility in nourishment refrigerator with names but no date. Observed ice cream in nourishment freezer brought from outside of facility with name but no date. **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).

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	Repeat Observed cleaning needed on the floor of the trash room. Observed stains on carpet in closet of B112. Observed heavy urine odor in room B112. EHS did not notice any urine stains on sheets. **Keep all flooring clean. 15A NCAC 18A .1309 (a).
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Repeat Observed heavy pink and black build-up on underside of shower chair in room B104. Observed dried urine all around on toilet seat of spa. Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	Repeat Observed splatter in microwave of B112 and cleaning needed in refrigerator of B112. 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).