EAST TOWNE

.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 touch up paint need to baseboards, door frames, and walling behind beds sporadically throughout facility. Slight improvement from previous inspection.

.1311 (b) Ventilation equipment shall be kept clean and in good repair. Observed dust accumulation to removable vents in rooms B30, B31, and A14.

.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 minor black build up to tub flooring in shared bathing room on “A” hallway. Observed loose toilet seat in room B31. Observed black build up to tub wall and floor in room B30. Observed detailed cleaning needed to tub and toilet in room B43. Observed laminate peeling on handsink in room B43. Observed toilet seat peeling in room A28.

.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident. Observed 2 urinals not labeled in room B43. -General comment.

.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 1 sliding door opened to dumpster. -General comment.

.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 hole in door behind door of room B24. Observed minor touch up paint needed to walling throughout facility particularly behind beds.

.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 loose toilet seat in rooms B29 and A13. Observed cleaning needed to shower curtain in room B29. Observed black build up on floor of tub in room A30.

.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 shared spa room tubs on both “A” and “B” hallways with debris build up inside of tub basins

.1316 (d) An institution's exterior premises, including parking lots, lawns, and walkways, and interior premises within the institution's building or buildings, shall be kept free of garbage, solid waste, yard trash, and pest harborages. Observed minor trash/litter near dumpster area. -General comment.

.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 minor cleaning needed to shelving of dorm sized refrigerator located in room A10. -General comment.

.1319 (c) Linens provided by the institution that are not clean shall be cleaned and sanitized in accordance with this paragraph. When hot water in washing machines is used to sanitize linens provided by the institution, the washing machines shall be operated in accordance with the manufacturer's instructions. When chemicals are used to sanitize linens provided by the institution, linens shall be washed in accordance with the following: (1) using a solution of at least 50 parts per million chlorine; or (2) using laundry sanitizer that is registered in accordance with 40 C.F.R. 152 and that is used in accordance with the manufacturer's instructions. Facility has no documentation for notated rule. EHS advises Executive Director to have their machine company, “Consolidated” to start leaving a service report when they come to service machine so that EHS can verify that notated rule is in compliance during time of inspection. -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 floor tiles damaged in laundry room. Observed floor tiles damaged in supply room on “B” hallway. Observed damage to flooring surrounding toilet in room B31.

.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 damaged in beauty salon and in room B31. Observed wall damaged behind toilet in room B31. Observed wall damage behind toilet in room A13.

.1311 (b) Ventilation equipment shall be kept clean and in good repair. Observed removable AC vent in need of cleaning in multiple rooms within facility.

.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 1 sliding door opened to outside dumpster. -General comment.

.1319 (c) Linens provided by the institution that are not clean shall be cleaned and sanitized in accordance with this paragraph. When hot water in washing machines is used to sanitize linens provided by the institution, the washing machines shall be operated in accordance with the manufacturer's instructions. When chemicals are used to sanitize linens provided by the institution, linens shall be washed in accordance with the following: (1) using a solution of at least 50 parts per million chlorine; or (2) using laundry sanitizer that is registered in accordance with 40 C.F.R. 152 and that is used in accordance with the manufacturer's instructions. Observed no documentation within facility for notated rule. EHS advises facility to start maintaining documentation from servicer. -General comment.

Observed touch up paint needed on the ceiling in the shower in room B35. Observed touch up paint needed in the restroom in room A10. Observed base board in need of repair in room A27. **.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 vent cover in need of repair in the restroom in room B35. GENERAL COMMENT **.1311 (b) Ventilation equipment shall be kept clean and in good repair.

Observed toilet in need of grouting in rooms B35 and A10. **.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 dresser knobs missing in rooms B36 and A10. **.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 laundry room floor in need of repair. **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 touch up paint needed in rooms A36, A35 and B21. Observed wall staining near toilet in room A35. Observed water stained ceiling in bathroom in room A17. **.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 bathroom ceiling vent hanging in room B35. **.1311 (b) Ventilation equipment shall be kept clean and in good repair.

Observed stained toilet in soiled utility room (not being used). **.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 urinal not labeled in room B21. **.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident.

Observed hot water range between 128-130F. **.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 insect crawling in soiled utility closet. **.1317 (a) Pests shall not be present in an institution's building or buildings.

Observed dressers missing handles in rooms A17 and B35. Observed torn pillow in room B35. **.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 laundry room floor in need of repair. Observed floor in the restroom in B30 with strong odor. **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 ceiling near room A23 in need of repair. Observed shower room on A Hall in need of touch up paint. Observed wall damage near the toilet in room A13. **.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 build up on vent cover in the restroom in rooms A13 and B26. **.1311 (b) Ventilation equipment shall be kept clean and in good repair.

Observed urinal not labeled in rooms A28 and B50. **.1312 (c) When disposable bedpans, emesis basins, and urinals are reused, they shall be labeled so that they are associated with an individual resident.

Observed tub faucet cover missing in room A38. Observed tub faucet missing and toilet in need of cleaning in room A28. Observed shower curtain staining in room A13. Observed tub staining in room B30. **.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 hot water range between 118-119F. **.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 no back-up water supply plan. **.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 dresser handle missing/in need of repair in rooms A38, A28, A13, B26 and B50. **.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.

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 dirty looking and sticky when walking on it though out the facility. Deep floor cleaning needed and maintain clean.

REPEAT .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 holes on wall in bathroom A10, evidence of wall patching here and there. Scraping doors/door frames throughout the facility. Need repair, touch up, repaint, and keep all in good condition. Observed damaged wall behind toilet in room B29. Repair needed and keep in good repair. Observed dusty window trim and all around near air conditioner in most rooms. Need general cleaning and maintain clean. Observed peeling ceiling in bathroom A39, need repair and keep in good repair.

REPEAT .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 loose toilet seats, need repair or replace. As well as dirty toilets, need cleaning and maintain clean throughout the facility. Some toilets throughout the facility need replace or caulking and maintain in good repair and keep clean. Damaged shower faucet, need repair or replace in room A39, A36, B30. Observed shower chair in room B45 has a cut on the seat, and the leg was not standing up properly. Need to take a look, repair or replace as necessary for safety. Observed stain tub in room B30, need repair. Observed cleaning needed underneath a shower chair in A hall, and maintain clean.

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices. Observed no paper towel available at the hand sinks in A hall bath, and general storage room next to staff launch in B hall. Paper towel was provided at the time of inspection. ENSURE TO PROVIDE ALL HAND WASHING SUPPLIES AT ALL HAND SINKS AT ALL TIME.

REPEAT .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 facility without Back-up water supply plan available and complete. The facility did not have it at the last inspection as well. The example of plan emailed to administrator at the time of inspection.

.1314 (a) Drinking fountains shall be kept clean and in good repair. Observed soiled water fountain in B hall, need cleaning. The facility cut water supply off, however the fountain need to kept clean.

REPEAT .1317 (a) Pests shall not be present in an institution's building or buildings. Observed drain flies in women restroom in A hall, in the kitchen near the dishwasher machine, outside the building on the way to the dumpsters. A lot of drain flies in room B45, observed them on bedsheets, throughout the room and bathroom. Room B45 smells like urine. Observed dead cockroaches in Salon room and room 26. Remove dead bugs and keep facility free of pests.

.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 many chairs in common rooms have soiled spots on them. Deep cleaning needed and keep clean. Observed damaged mattress in room B30. Need replacement.

.1319 (b) A resident's bed linens shall be changed when no longer clean. Observed soiled and smelly bed linens in room B45 causing drain flies to be everywhere in the room. ENSURE TO PROVIDE CLEAN LINENS AND CHANGE THEM WHEN NEEDED FOR ALL RESIDENTS.

.1324 (c) Institution employees shall comply with the requirements for exclusion from work and restriction due to communicable disease or illness required for food employees as set forth in Parts 2-201.12 and 2-201.13 of the Food Code incorporated by reference at 15A NCAC 18A .2650 as amended by 15A NCAC 18A .2652. NEW RULE. No point deduction. Employee Health Policy poster provided and discussed with staff and administrators at the time of inspection.

.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. NEW RULE. No point deduction. Vomiting and diarrhea procedure poster provided at the time of inspection. EHS inform the facility to obtain a vomiting and diarrhea kit.

REPEAT- Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed dirty wall in the restroom room B15. Observed old leak stained celling in room B27, stained celling throughout the facility. Observed peeling celling in both the central baths, and some of resident restrooms throughout. Observed brown/black buildup along the shower wall and floor in central bath, need cleaning.

REPEAT- Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed cracked seating surface on shower bench in room 43. Observed dirty shower chair in room in B15. Observed stain bathtubs in some of the resident rooms throughout the facility. Observed non functioning therapy bathtub in the of the central baths. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed loose toilet seats, and missing caps at the base, need caulking around the base, damage/misplaced toilet thoughout the facility. Observed dirty toilets, need cleaning throughout the facility. Keep all handwashing facilities clean and in good repair. 15A NCAC 18A .1312 (b). Observed leaking/ broken hand sink in the storage room in TV room. Observed broken faucet at the hand sink in room 28.

A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f). Observed very little to empty bottle of disinfectant solution in one of the hall bath. To refill the bottle, staff has to walk a little to the other wing of the hall, and still same hall.

REPEAT- 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 drain flies throughout the facility, especially in room B15 restroom. Observed several live brown insects in the restroom room 53.

REPEAT- 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 brown stained furniture pillows and seating pad in the outdoor non-smoking patio. Observed some dust on window blinds in resident rooms. Observed stained and damaged pillows throughout the facility.

REPEAT- Soiled laundry shall be handled and stored separately from clean laundry using separate cleanable carts or bags. 15A NCAC 18A .1319 (b). Observed soiled linen stored on top of the clean linen cart, please keep them separate. Observed stained linen and stained pillow cases throughout the facility.

Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed debris on flooring throughout. Observed debris on floors under resident's bed throughout.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed crack in wall from ceiling to door jam and crack at door jam in room B36. Room A10 missing knob on door to toilet and debris on wall, food and other debris under bed. Loose railing on hall near toilet on A hall. Door need wider plate to completely cover hole from door knob. Laundry room has minor hole damage to wall. Touch up paint needed on wall throughout. Affix cover tightly on ceiling in room B36 toilet. Observed hole in the door in room B22. Replace face plate on cable outlet in room B43. PIC replaced face plate during inspection. Observed popcorn peeling and black residue from exhaust vent in beauty salon.

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). Observed in room B36, dirty shower curtain and tub, trashcan propped under tank and between toilet catching and holding water and debris around the base of the toilet. In room B30, black residue (appear to be from mildew) in tub and debris around the base of the toilet. In B22 broken sink stop under sink. B43, dried urine under toilet seat and dirty shower. Loose toilet in women's toilet. Observed broken vaccum beaker on sink in maintenance room. REHS recommended to PIC to add a backflow prevention device to faucet. Observed full bucket of water propped under sink in beauty salon.

Except for the stipulations stated in rule .1312 (d), handwashing sinks shall only be used for handwashing. 15A NCAC 18A .1312 (d). Residents clothing in hand sink in laundry room. PIC removed laundry out of sink.

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 roach coming out of box of diapers near the therapy room.

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 and debris under sofa and chair cushions in common area. Observed ripped pillows in rooms B36, B30, B22, and B43. Observed (maybe insect) droppings in drawers in empty room B47. Repeat

Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed food debris, dried drool on bed linen in room B30.

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). Clean linen stored in hall near laundry room. Door block with dirty laundry at exit.

Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). Observed ripped blanket on bed 2 in room A36 and food debris and stains on sheets on bed 1. Observed food debris and dried drool on bed 1 and soiled/dirty bedding on bed 2 in room B30. Observed dirty linen in drawer of empty room B47, blood stained pillow case and dirty linen and blanket in room B43. Observed bags of resident's clothing on floor in storage room. Observed diapers stored on the closet floor in room B43. Observed soiled pillow stuffed between bed and wall in room B30. Observed hair in chair and sink in beauty salon. Observed arms on wheel chair in common area ripped.

All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed no thermometer in refrigerator in room B43 and broken thermometer in refrigerator in therapy room.

Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed peeling ceiling paint above shower in room A16. Observed cobwebs in room A25. Observed base cove separating from wall in restroom for room A25. REPEAT VIOLATION.

Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed soiled shower seats in room A16, B23, and B49. Observed soiled shower curtain in room A39. Observed shower head with buildup in room B23 and B25. Observed two shower seats and shower walls soiled with buildup in shower room(B hall). Observed heavy black buildup on shower in rooms B25 and B30- shower tub "bubbling up" around base, faucets leaking, and poor ventilation. Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed toilet seat soiled in room B49, B25 and B23. Observed base of toilet soiled in room B25. REPEAT VIOLATION.

Except for the stipulations stated in rule .1312 (d), handwashing sinks shall only be used for handwashing. 15A NCAC 18A .1312 (d). Observed soiled pillow in hand sink in laundry room. CDI: PIC removed pillow.

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 water temperature of 97F in room A39.

Observed no backup water supply plan. Provide a written plan that meets all parts of 15A NCAC 18A .1313 (f). Observed no backup water supply plan at time of inspection. EHS provided template for facility to utilize.

Minimize accumulation of feces and other allergens generated by insects and other vermin by cleaning the facility. 15A NCAC 18A .1317 (d) Observed several areas throughout facility(occupied rooms, vacant rooms, resident closets, storage rooms, and hallway corners) with spiders nests and dead insects.

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 missing hardware on dresser in room A25. Observed debris under cushions on couch in common room(B hall). Observed cushions on furniture in sunrooms in poor repair/cigarette burns/stained. REPEAT VIOLATION.

Repeat. Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed wall tile missing behind handwashing sink in laundry room Observed peeling ceiling in shower room on hall A and in room A36.

Repeat Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed soiled bathing chair in both shower rooms (hall A and hall B). Observed residue build up on shower head in room A10. Observed stained shower curtain in room B42.

Repeat 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 storage rooms (A11 and housekeeping closet) with facility boxes stored on the floor. Maintain all supplies at least 8 inches off the floor and/or in easily moveable bins. EHS discussed storage options with Director and staff.

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 a stained bed spring in room A36 and a torn bed spring in room A37. Observed several stained chairs in activity room.

Observed ceiling peeling in the shower room on A wing. Observed wall tile missing behind the handwashing sink in the laundry room. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed vent cover in need of cleaning. **Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b).

Observed toilet in room A34 in need of cleaning. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed tub in room A34 in need of cleaning. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).

Observed boxes stored on the floor in room A39. **All patient care or consumable items shall be stored at least 8 inches above the floor. 15A NCAC 18A .1318 (a).

Observed mattress cover torn in room A34. Needs to be replaced. **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 no thermometer in the refrigerator in room A34. **All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b).

Observed debris underneath the bed in room A33. Needs to be cleaned. **Keep all flooring clean. 15A NCAC 18A .1309 (a).

Observed the ceiling peeling in the bathroom within room A14. Observed wall near the toilet with paint chipping and staining in the bathroom within room A12. Observed the baseboard missing and wall damage in the laundry room. REPEAT. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed paint chipping on the floor of the shower in room B44. Observed shower curtain with build up in room B44. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f). Observed toilet with build up on base in room B44. Observed loose toilet seat in room B16. Observed build up on bedside toilet in room A12. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed disposable urinal with blue substance inside in room A28, also labeled C50. **All bedpans/urinals/emesis basins shall be cleaned after each use. 15A NCAC 18A .1312 (c). **Label all disposable bed pans with the residents/patients name and date. 15A NCAC 18A .1312 (c).

Observed closet in need of cleaning in room A33. **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 torn pillows in rooms A38, A33 and A12. Observed mattresses torn in rooms A14 and A12. Observed box spring cover torn in room A28. **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 sheets with black splotches which is a sign of bed bugs in room A38. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Observed floors in need of cleaning in rooms A-30, A-10, B-33 and B-14. Ensure that floors are being cleaned at a high enough frequency to prevent build-up. Strong urine odor is some rooms. REPEAT. **Keep all flooring clean. 15A NCAC 18A .1309 (a).

Observed staining on the wall behind the toilet in room A-30. Observed wall damage in rooms A-32, A-30, A-10, B-33, B-14 and the Laundry room. Needs to be repaired and touch-up paint needed. REPEAT. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed HVAC filters in need of cleaning in rooms A-30, A-10 and B-33. Observed vent cover with dust build-up in the bathroom in room A-32. **Keep all ventilation equipment clean and in good repair. 15A NCAC 18A .1311 (b).

Observed toilet chair rusting in room A-32. Observed toilet in need of cleaning in rooms A-30 and B-33. REPEAT. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed shower chair stained underneath in the shower room. Needs to be cleaned. **Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).

Observed resident items on the floor within the closet in room A-32. Closet needs to be arranged to help facilitate cleaning. REPEAT. **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 missing dresser drawer handles in rooms during the inspection. Needs to be repaired. Observed damaged pillows in rooms A-30 and B-14. Observed soiled box spring in room A-10. Observed cracked surface of mattress in room B-27. Needs to be replaced. REPEAT. **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 soiled sheets in rooms A-30, B-33 and B-14. Linen was removed. REPEAT. Observed torn blanket in room B-33. Needs to be replaced. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).

Observed wall stained behind the toilet in room B-32. Observed wall damage in the laundry room. Needs to be repaired. **Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310.

Observed soiled toilets in A-36, shower room on A hall, B-47, soiled linen room and room B-32. Needs to be cleaned. **Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b).

Observed no disinfectant in the shower room on either A or B hallway. **A cleaning detergent and an EPA registered hospital disinfectant shall be accessible to all bathing areas. 15A NCAC 18A .1312 (f).

Observed bed bugs in rooms A-31 and A-29. Pest management was called and residents will be moving to other rooms. **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 storage room near laundry room in disarray. Storage needs to be more organized to help facilitate cleaning. **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 soiled linen on the bed in room B-32 and soiled blankets in the shower room on B Hall. Ensure that linen is removed when soiled and placed in appropriate locations. **Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b).