Premises Information


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Name

ATRIUM HEALTH PINEVILLE

Address

10628 PARK RD

City/State/ZIP

CHARLOTTE

28210

Premise Type

41 - Hospitals

County

Mecklenburg

Inspection Date

4/8/2019

Final Score @ Grade

95.50

General Comments

NO POINTS WERE TAKEN FOR THE FOLLOWING: #3 - Observed water stained ceiling tiles in hallway by room 4326 of 4th floor and in clean utility room 2113. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. #13 - Observed hot water reach temperatures above 116F in patient rooms 5333, 3303, and 3332. **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). #17 - Observed water fountains with too high of pressure where water is splashing onto the floor in rehab, 4th floor, and ICU. **Drinking fountains shall be kept clean and properly regulated. 15A NCAC 18A .1314 (a). #32 - Observed tears on pillows in several areas of first floor. Observed rusted bed frame in 212. **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). #33 - Observed soiled linen signage missing from small bins in several patient rooms, in endo, and radiology. **Carts used for soiled laundry shall be labeled for soiled laundry use only. 15A NCAC 18A .1319 (b). #34 - Observed chemicals and other care items being stored on same cart with clean linen in hallway of med-surge 2 west. Observed boxes of tissues being stored on covered clean linen cart in clean utility of med-surge 2 west. **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). #38 - Observed boxed meals from main kitchen being stored in refrigerator of storage room 1236 where a hand sink is not present. Only pre-packaged individually portioned items may be stored in this area. **Any area where food is portioned, served or handled (does not include activity kitchens serving food to 12 people or less) shall be equipped with a separate hand wash lavatory with hot and cold mixing faucet, soap and individual towels or hand drying device. 15A NCAC 18A .1320 (b). #40 - Observed employee creamer brought from outside facility in nourishment of 1236 without labeling. **Food brought from home by employees or visitors of patients or residents shall be kept only as long as it is clean, and free from spoilage. 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
8	1	Facilities conveniently located, clean and in good repair	No	No	No	Repeat Observed cleaning needed on the toilets in visitor restrooms of 3rd floor. Observed re-caulking needed behind the toilet in 2124. Observed slow draining sink in day surgery hallway patient restroom. Observed hand sink in radiology soiled utility room where sensor had dead batteries. Observed cleaning needed in the hopper of PACU. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all hand washing facilities clean and in good repair. 15A NCAC 18A .1312 (b)
18	1	Drinking utensils properly handled	No	No	No	Repeat Observed water pitchers without labeling in room 4328, 203, and 212. **Label all disposable water pitchers with the resident’s/patient’s first name and last name. 15A NCAC 18A .1314 (a).
28	0.50	Adequate storage, area clean, items properly stored	No	No	No	Repeat Observed cleaning needed in clean supply bins in clean utility rooms throughout. **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).
36	2	Approved utensils and equipment, cleaned and sanitized	No	No	No	Repeat Observed crumb debris build-up in nourishment room cabinets throughout. Observed cleaning needed in nourishment refrigerators of 3rd floor, ED, freezer of med-surge 2 east & west, and in pump room of OR. Observed cleaning needed in nourishment room microwave of med-surge 2 west. Observed coffee pot being stored in the hand sink of nourishment room on CVICU. Employee stated this is where coffee pot is dumped and cleaned. EHS advised that coffee pot be cleaned in the kitchen or that water be used from coffee maker to rinse coffee pot out. No storage in hand washing sinks. Activity kitchens or nutrition stations that are not approved to clean food service utensils and equipment shall return all food service utensils, equipment, and utensils not continuously subjected to high temperatures to the kitchen after each use to be washed, rinsed, and sanitized. 15A NCAC 18A .1320 (b). **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).