SUNRISE ON PROVIDENCE

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed shower caulking in need of touch up in 228. Observed toilet seat/lid not attached in 202. Observed 1st floor bathtique bath in need of cleaning or resurfacing. REPEAT.

.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair. Observed crumbs/debris under cushions of chairs in hallway outside 118 and in Reflection room in memory care. Needs cleaning.

.1311 (b) Ventilation equipment shall be kept clean and in good repair. Observed dust buildup in ceiling vent in room 209 and 214. Keep clean.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed shower floor peeling in room 209. Repair.

.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities. Observed hot water ranging from 99-101F and 117-119F in various rooms/bathrooms throughout facility. Ensure hot water accessible to residents is between 105-116F.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed shower curtain with some staining and pink build up on shower floor in room 210. Observed caulking in need of cleaning/repair in shower of 204. Observed chipping toilet seat in room 23. Needs cleaning/repair. REPEAT.

.1312 (f) Bathing equipment that has contact with a resident's skin and is used by more than one resident shall be kept clean and shall be disinfected between resident uses. Equipment located within a bathing facility that uses a pump to move water shall be kept clean in accordance with the manufacturer's instructions. Observed build up in tubs in bathtique rooms on each floor. Needs cleaning. Staff stated these are not used often.

.1320 (a) All food service equipment and utensils shall be kept clean and in good repair. Observed activity room refrigerator in need of cleaning and refrigerator in room 132 in need of cleaning.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed toilet in need of cleaning in room 217. General comment.

.1313 (d) Institutions shall provide water heating facilities. Hot and cold running water under pressure shall be provided to carry out all operations. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities. Observed hot water reach 83F in room 223 and 119F in room 116.

.1313 (e) The institution shall have a written plan to obtain a backup water supply in the event that the institution's primary water supply is interrupted for more than four consecutive hours. The written plan shall identify a backup water supply or alternate source of water that provides two liters of potable water per day per resident and institution employee for drinking and potable water for food preparation, hand washing, bathing, cleaning, dishwashing, laundry, and disposal of bodily waste. This may include a plan for relocating residents to a facility with a water supply that satisfies Paragraph (a) of this Rule. If an institution's primary water supply or backup water supply becomes unsafe for human consumption, then the water sources within the institution, such as sink faucets, shall be labeled or hooded to prevent their use, and the administrator shall provide potable water for use by the institution's residents and employees. Observed incomplete backup water supply plan. Facility has template that environmental health provides however template is not filled out. EHS advises facility to fill out template according to facilities internal plans in the event of water loss. REPEAT VIOLATION.

.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair. Observed chair seat cushion with red staining near room 119. -General comment.

1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair. Observed minor carpet staining throughout building.

.1313 (e) The institution shall have a written plan to obtain a backup water supply in the event that the institution's primary water supply is interrupted for more than four consecutive hours. The written plan shall identify a backup water supply or alternate source of water that provides two liters of potable water per day per resident and institution employee for drinking and potable water for food preparation, hand washing, bathing, cleaning, dishwashing, laundry, and disposal of bodily waste. This may include a plan for relocating residents to a facility with a water supply that satisfies Paragraph (a) of this Rule. If an institution's primary water supply or backup water supply becomes unsafe for human consumption, then the water sources within the institution, such as sink faucets, shall be labeled or hooded to prevent their use, and the administrator shall provide potable water for use by the institution's residents and employees. Observed incomplete back up water supply plan (facility has template that ENVH provides not filled out). EHS advises facility to fill out template according to the plan they have in place in an event of water loss.

.1316 (a) All solid wastes containing food scraps or other putrescible materials shall be kept in leak-proof, non-absorbent containers which shall be kept covered with tight-fitting lids when not in use. Observed sliding doors opened to dumpster.

.1319 (a) Furnishings in an institution, including furniture, curtains, rugs, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair. Observed handles/knobs missing from dresser against wall in memory care room #23.

.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair. Observed ceiling cracking over room 214. Observed peeling to wall located in bathroom by light switch in memory care unit room 12. Observed peeling to baseboards and doors sporadically on levels 1 and 2 of facility. Observed re-caulking needed to wall behind 2 compartment sink located in memory care serving kitchen.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed cleaning needed to inside basin of toilet in room 12 located in memory care unit.

.1313 (e) The institution shall have a written plan to obtain a backup water supply in the event that the institution's primary water supply is interrupted for more than four consecutive hours. The written plan shall identify a backup water supply or alternate source of water that provides two liters of potable water per day per resident and institution employee for drinking and potable water for food preparation, hand washing, bathing, cleaning, dishwashing, laundry, and disposal of bodily waste. This may include a plan for relocating residents to a facility with a water supply that satisfies Paragraph (a) of this Rule. If an institution's primary water supply or backup water supply becomes unsafe for human consumption, then the water sources within the institution, such as sink faucets, shall be labeled or hooded to prevent their use, and the administrator shall provide potable water for use by the institution's residents and employees. Observed incomplete backup water supply plan. EHS emailed director a template for constructing a detailed plan to be in compliance with notated rule.

1309 (a) and (b) The floors in an institution shall be made of smooth, non-absorbent materials and shall be kept clean and in good repair. When carpet is present, it must be kept clean, odor free, and in good repair. Observed minor carpet staining throughout facility.

.1310 (a) The interior walls of the institution, including doors, windows and window trim, and ceilings, shall be kept clean and in good repair. Observed minor touch up paint needed throughout facility to baseboards, door frames, and walling.

.1311 (a) The areas interior to an institution's building or buildings shall be equipped with at least 10 foot candles of light at 30 inches above the floor. Observed light not operating in memory care unit room “09” bathroom.

.1312 (a) All institutions shall provide toilet, handwashing, and bathing facilities that are available for use by residents and staff. These facilities shall be kept clean and in good repair. Observed build up under removable toilet seat in room 206.

.1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed bathique in memory care unit being used for storage of furniture (wheels chairs, picture frames, etc). Although bathique is not used, it should not be used for storage according to notated rule. .1312 (b) A sign shall be posted in each toilet room for institution employees, directing them to wash their hands after each visit to the toilet room and before returning to work. Observed several general public restrooms that employees use without handwashing signs posted at handsinks throughout building.

.1324 (d) The institution shall have gloves, personal protective equipment, disinfectant, individual disposable towels, and a coagulating agent on-site for employees to use and a written procedure for employees to follow when responding to vomitus or fecal matter on institution surfaces. The procedure shall specify the actions that employees shall take to minimize the exposure of employees, residents, guests, food, and additional surfaces to vomitus or fecal matter. EHS emailed facility template for required notated rule.

Observed wall paper peeling in the bathtique on the 2nd floor. Observed wall paper peeling above the toilet in room 23. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed handles missing on dresser in rooms 202 and 23. Observed cabinet door removed from handwashing sink in the bathroom in room 224. Observed cabinet door hinge in need of repair at the kitchen sink in room 224. **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 toilet seat in disrepair in rooms 107, 131, 215, and 217. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed wheel chairs, area rugs, and other items in 2nd floor bathique and Memory Care bathique. Toilet rooms shall not be used for storage. See rule .1312 (b).

Observed hot water 75F in room 23, 88F in room 13, 93F in room 131, and 94F in room 215. Hot water must be 100-116F. 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).

Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed spots/stains on carpet throughout facility in common areas/hallways. REPEAT VIOLATION.

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed black buildup on shower seat in room 214. Obsereved black buildup in shower of room 12. Observed brown stains in "bathique" shower on main level of building. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed toilet seat with loose screws and soiled in room 214. Observed rusted toilet seat in room 12.

Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). Observed no paper towels in room 12, 108, and 214. Observed no hand soap in room 108. REPEAT VIOLATION.

Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c). Observed employee food stored in top drawer of medication cart in common area. Observed employee coffee cup stored on top medication cart. Observed unused medication cups stored is disorganized manner with rims of cups exposed/not inverted. REPEAT VIOLATION.

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 couch in common area stained. Observed couch in room 16 soiled with food waste and old gloves. Observed trash under several cushions in common areas throughout building. REPEAT VIOLATION.

Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed flooring that needs cleaning/repair in laundry areas.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed loose wallpaper throughout facility.

Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). Observed no soap or paper towels available in 2 of 3 laundry areas. One hand sink blocked by garbage can. Keep sink accessible.

A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Observed bathtiques were missing cleaning detergent/disinfectant.

All solid wastes shall be disposed of with sufficient frequency and in such a manner as to prevent insect breeding or public health nuisances. 15A NCAC 18A .1316 (d). Observed dumpster lid and door open. Trash on ground around dumpster.

Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c). Observed cups and med cups not inverted on med cart Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). Observed med cart drawer and pill crusher need cleaning.

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 trash below cushions, under pad in baby doll area. Chair with torn upholstery in hall 2nd floor. Mirror damaged in hall bathroom.

Laundry areas and equipment shall be kept clean. 15A NCAC 18A .1319 (b) and .1312 (a). Observed laundry areas need cleaning and organizing. Trash and clothing behind dryers. bucket full of water behind one washer, repair leak.

Observed black stains on carpet near restroom and urine on floor in restroom in room 214. Keep all flooring clean. 15A NCAC 18A .1309 (a).

Observed leaking faucet(hot) in restroom in 234, toilet chair stained in 111, toilet stained in 119, toilet stains in MC 09, and stained toilet chair in MC 16. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed stained sheets or pillow cases in rooms 223, MC 09, and MC 16. Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed flooring needs cleaning in closets, behind equipment, around storage, etc. Observed swollen 1/4 round in common bathroom where soap dispenser leaks on it.

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed showers in rooms with build-up on shower heads, stall floors, under non-slip mats. Shower chairs with build-up on undersides. Bathtique tubs with jets have build-up in and around jets. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed one toilet chair rusted and seat in disrepair. Handwashing sinks shall be accessible to all areas where personnel may be exposed to bodily excretions or secretions. 15A NCAC 18A .1312 (d). Observed blocked hand sink and hopper with housekeeping cart. Only soiled utility room seen. Keep sinks and hopper accessible.

Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d). Observed no paper towels at bathroom sinks in guest rooms throughout.

Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c). Observed pill crushers, med drawers need more frequent cleaning of build-up.

Laundry areas and equipment shall be kept clean. 15A NCAC 18A .1319 (b) and .1312 (a). Observed laundry rooms need thorough cleaning including cabinets and sinks.

Cooking surfaces of equipment shall be cleaned at least once each day. 15A NCAC 18A .1320 (c). Observed oven in memory care area needs cleaning of burnt on food spills 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). Cabinets and drawers in memory care dining area needs wiping out of spills and debris.

All food and food supplies shall be clean, free from spoilage, free from adulteration and misbranding, and safe for human consumption. 15A NCAC 18A .1321 (a). Observed uncut unwashed berries in refrigerator in memory care. All food is to be prepped in kitchen.

All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed room refrigerator broken/turned off and another with a broken thermometer.

Observed bathtique on second floor with brown staining on the side door. Needs to be cleaned. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed hoppers in janitor's closet in need of cleaning. Hoppers have heavy accumulation on the inner bowls. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed linen with staining in room 233 and mattress cover with staining in room 123. Linen needs to be changed routinely when stains appear. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Observed stained toilet in rooms 233 and room 12. Ensure toilets are being thoroughly cleaned routinely. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed disposable under garments stored underneath handwashing sink in rooms 214a and 12. **Patient care or consumable items shall not be stored below exposed sewage lines. 15A NCAC 18A .1318 (a).

Observed stains on toilet in room 202. Observed stained shower curtain in room 214. Observed stained tub with patient's soap and shaving cream in bathtique. Observed black build-up in shower head in room 229. Observed build-up on shower curtain in room 113. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).

Observed stains on pink chair in room 214. Observed food and trash debris under chair cushion in reminisince suite. Observed debris in couch in common area rear room 218. Observed torn cushion on couch in main common area. 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 stained mattress and mattress pad in room 202. Observed stained sheets in room 214. Observed pillow stains and stain on padding in room 113. Observed stain on mattress pad and pillow case in room 229. Observed stained mattress and sheet in room 133. Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Observed no thermometer if refrigerators in rooms 214, 113, 217. All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).

Observed ceiling paint peeling in second floor laundry room and first floor bathique. Observed wall peeling around vent in shower in room 13. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed stained toilet, toilet seats, and/or cushions on toilet stained/soiled in rooms 209, 220. Observed toilet seats rusting in rooms 107 and 115. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed eaten apple rinds in cabinets and drawers in room 214. 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 stained sheets, pillows, and /or comforter in rooms 202, 214, 220, and 115. Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Repeat Non Compliance: Observed ceiling peeling in 1s floor lounge room. Observed fixtures missing in same area. (holes in ceiling) Observed stained ceiling in janitor closet 2nd floor right side. Observed stained ceiling in club room (reminiscence) Observed wall worn in room 210. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Repeat Non Compliance: Observed rusting shower chair located in room 232. Observed loose toilet seat in room 210, 23. Observed debris on underside on of toilet assistance chair in room 221. Observed debris build up present on top side of soap of dispenser in A.L activities room. Observed sinks/hoppers blocked by carts in janitors closets. Sinks shall be accessible at all times. **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) **Toilet, hand washing, and bathing facilities must be conveniently located and readily accessible to residents and staff. 15A NCAC 18A .1312 (a).

Repeat Non Compliance: Observed briefs stored on closet floor in room 118, and 1st floor storage closet. **All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).

Repeat Non Compliance: Observed disinfectant not present in bathtique 1st floor. Provide disinfectant. Observed articles of clean linen on floor in 2nd floor clean linen closet and reminiscence housekeeping. **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). **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).

Observed bathroom smelled very strongly of urine in room 211. Dirty mop water on housekeeping cart. Change out mop water more frequently to cut down on transferring odors.All carpet/flooring shall be kept odor free. 15A NCAC 18A .1309 (a).GC #21: Observed dumpster doors open. Keep doors closed.

Observed stained ceiling reception area. Damaged ceiling in memory care common area.**Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed loose toilet seat in common bathroom on 1st floor. Non-slip bath mats with mold/debris (slip hazard) in rooms 211 and 233. Soil ring in sink and toilet of room 119. Moldy grout in showers of several rooms. Rusted toilet chair in room 107. Soiled toilet seat below toilet chair in room 219. Stain/ring in shower in room 219.**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).**Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)

Observed ants swarming in memory care kitchen/dining area. Bedbugs found in room 212, resident still residing in room and still several days until exterminator coming.**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).

Repeat: Observed storage on floor in most closets. Stick deodorant, razors, and used bar soap in common bathroom on 1st floor.**All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).**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).

Repeat: Observed pill crushers on med carts need some cleaning. Debris in containers holding pill cups.**Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).

Repeat: Observed garbage below couch cushions and in drawers in common areas. Broken drawer and broken drawer pull of common furniture on 2nd floor. Torn mattress protector in room 233. Refrigerator needs cleaning in room 211.**All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutionsshall be kept clean and in good repair. 15A NCAC 18A .1319 (a).

Observed no thermometer in refrigerator of room 119.**All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).

Observed broken shower wand in bathtique. Slow drain at hand sink and loose toilet seat in room 229.**Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).**Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)**Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed storage on floor in most closets and in room 25. Combs and toothbrush in common bathroom in memory care.**All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).**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).

Observed pill crushers on med carts need some cleaning.**Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).

Observed garbage below couch cushions and in drawers in common areas. Refrigerator cracked and very dirty in room 111. Closet door handle broken in room 111.**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).Ms. Diane McClarney present during inspection.**Great improvement throughout facility

Observed no disinfectant in commercial washer. Washing machines need wiping out of soap build-up.**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).**Laundry areas and equipment shall be kept clean. 15A NCAC 18A .1319 (b) and .1312 (a).

Observed several sinks in common areas and patient rooms without soap or paper towels.**Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d).

Observed hot water reached 123F in room 119, several other areas reached above 116F.**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 pet vaccination records not available.**Maintain adequate vet records for all animals. 15A NCAC 18A .1317 (f).

Repeat Non-Compliance: Observed crumbs and build-up in drawers of Bistro and memory care kitchenette. Refrigerator with spills in Bistro.**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).

Repeat Non-Compliance: Observed med carts with excessive residue build-up on pill crushers, Single service cups unprotected on visibly soiled surfaces.**Medication carts shall be cleaned when visibly soiled. 15A NCAC 18A .1318 (c).**Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c).

Repeat Non-Compliance: Observed crumbs and garbage below seat cushions and in drawers of common furniture throughout building.**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).

Repeat Non-Compliance: Observed undated and unlabeled food in refrigerator in Bistro.**Label food with name and date.

Observed stained/damaged ceiling in several areas throughout building. Wall damage where soap dispenser removed, room 213.**Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed sink not working, kitchen near lobby. Loose toilet seat room 124. Shower with build-up and toilet seat with tape residue, room 117.**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). **Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b)

Observed no paper towels in several bathrooms, private and common. All handsinks must be supplied with soap and paper towels. No soap in room 213.**Provide liquid soap and disposable towels at all handwashing sinks. 15A NCAC 18A .1312 (d).

Observed crumbs/spills in cabinets in kitchen near lobby. Spills in refrigerators in rooms 117 and 206.**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).

Repeat Non-Compliance: Observed single service cups sitting on sharps container. Single service cups no sleeved on med cart. Med cups and single service cups stacked too high (lip exposed).**Unused medication cups shall be kept covered or inverted. 15A NCAC 18A .1318 (c).**Food and utensils used on medication carts shall be handled in a sanitary manner. 15A NCAC 18A .1318 (c).

Observed lots of trash and spilled items under seat cushions of common area furniture.**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 employee folding laundry in common sitting area and clean sheet touching floor (as being folded).**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).

Observed shower chair and bath mat with residue build-up, room 223. Single service cup dispenser not covered, kitchen by lobby.**Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c).

Observed plates of food not labeled or dated in refrigerator in kitchen near lobby.**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).

Observed no thermometer in refrigerators in room 223 and 206.All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).