Premises Information


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Name

EASTOVER NURSING CENTER

Address

2616 E 5TH ST

City/State/ZIP

CHARLOTTE

28204

Premise Type

40 - Rest/Nursing Homes

County

Mecklenburg

Inspection Date

5/13/2021

Final Score @ Grade

General Comments

NO POINTS FOR THE FOLLOWING VIOLATIONS: #5. Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b). Observed dust accumulation to ceiling vent located outside of pantry in room west wing. Clean, Observed AC wall vent with heavy dust accumulation in room 223. #9. Toilet rooms shall not be used for storage. See rule .1312 (b). Observed wheelchairs stored in west 2 shared spa room. #24. Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises. 15A NCAC 18A .1317 (a). Observed dead cockroach in room 205 and cockroach eggs. *NOTE: Naly Lor was present during time of inspection with EHS Alexis Welch. Maintenance Director Rico Fourney was present during time of inspection.

Violations

CDI=Corrected During Inspection

R=Repeat Violation

VR=Verification Required

Violation Item	Demerits	Violation Description	CDI	R	VR	Comments
1	1	Floors easy to clean, no obstacles, drains where needed	No	No	No	Keep all flooring in good repair. 15A NCAC 18A .1309 (a) and (b). Observed floor tile damaged in room 228. Observed floor tile under refrigerator in pantry located on east wing with heavy black build up and in need of repair.
3	2	Walls and ceilings cleanable, clean, good repair	No	No	No	Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed touch up paint needed to walls, door frames, and doors throughout facility. Observed wall tile missing in west shared spa 1. REPEAT VIOLATION
8	2	Facilities conveniently located, clean and in good repair	No	No	No	Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed black build up inside the chalking of shower in all shared spas throughout facility. Observed build up on shower table in west shared spa 2.Observed build up on the under side of shower mat located in west shared spa 1. REPEAT VIOLATION.
13	1	Lavatory and bathing hot water between 100 and 116 F	No	No	No	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 at 120F in west shared spa 1. Observed hot water at 85F in west shared spa 2. Observed hot water at 80F in room 223. Observed hot water at 84 in room 213. Observed hot water at 77F in room 205.
14	2	Disinfectant accessible, properly used	No	No	No	Observed EPA disinfectant not readily available to bathing areas, disinfectant is housed in supply closet located near laundry room. A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). REPEAT VIOLATION
19	1	Ice protected, dispensed, equipment clean in good repair	No	No	No	Ice shall be handled, transported, stored, and dispensed in such a manner as to be protected against contamination. 15A NCAC 18A .1314 (b). Observed ice chest on East and West wing stored unprotected, unattended, and unlocked in main hallways.
26	1	Premises clean, no breeding places or rodent harborage	No	No	No	The premises shall be kept neat, clean, and free of litter. 15A NCAC 18A .1317 (c). Observed dilapidated furniture stored outside of dumpster area. Observed several bags of trash stored outside of dumpster area.
32	1	Furniture clean and in good repair. Mattresses clean, dry, odor free	No	No	No	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). Observed dressers and furniture throughout chipping. Observed drapes stained in rooms 102, 110, and 228. Observed rolling bedside tables in several rooms chipping (205, 223 Mattresses shall be kept clean, dry, and odor free. 15A NCAC 18A .1319 (a). Observed mattress torn in rooms 205.
36	1	Approved utensils and equipment, cleaned and sanitized	No	No	No	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). Observed build up on the shelving of refrigerators and freezer in both East and West wing pantries.