RANSON RIDGE ASSISTED LIVING & MEMORY CARE

REPEAT 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 dusts/ debris on flooring/carpet in room and or underneath the bed in room 200, 310, 307, 505, 512, 515. Cleaning needed, keep clean.

General comment: .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 soiled toilet needs cleaning and keep clean in room 515, 106. Observed slow draining at the sink in room 403 need repair. Keep clean and in good repair.

General Comment: .1320 (a) All food service equipment and utensils shall be kept clean and in good repair.- Observed soiled microwave and refrigerator in nourishment room in memory care need cleaning. Observed disrepair of drawer and shelf inside the refrigerator in nourishment room in memory care, need repair. Keep equipment clean and in good repair.

REPEAT 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 food debris on floor in room 307. Cleaning needed, keep clean.

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 at hand sink measure 118F at SPA in AL, 117F in room 403. Ensure to provide tempered water range from 105F-116F.

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 scuffed floors in Memory care dining area. Needs repair.

.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 grout in need of repair in 414. Observed build up on hopper in soiled utility. Observed hair sprayer in salon in need of cleaning. Observed soap scum on floor in shower of spa room. Needs cleaning. REPEAT.

.1320 (a) All food service equipment and utensils shall be kept clean and in good repair. Observed build up in microwave and some cabinets in Memory care norishment room. Needs cleaning.

.1321 (b) Food brought from home by employees or visitors of patients or residents shall be stored separately from the institution's food supply as described in rule .1321 (a). Such food shall be labeled with the name of the resident or employee that the food belongs to and the date the food was brought into the institution. Labeling as required by this Rule shall not be required for food items stored in employee-designated or individual residents' refrigerators or rooms. Observed watermelon, beverages and other items stored in Memory care Norishment room refrigerator with no name labels for the resident or employee the food belongs to. Needs name and date labels.

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 slow drain at hand sink in 210, and hallway restroom to the right upon entry. Observed black buildup in hand sink drain in common areas need detail cleaning and Keep clean. Half points due to improvement.

REPEAT .1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.- Observed no soap available in the dispenser at hand sink in 306, soiled room 400 hall, No paper towel available in the dispenser at hand sink in 307, memory care 501, 508, 515. Ensure to provide all hand sink with soap and paper towels at all times.

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 the facility without/incomplete water back up supply plan. EHS emailed a checklist of the plan again this time to an administration and head of maintenance at the time of inspection. The facility will working on getting a complete plan.

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 detail cleaning needed on flooring (underneath the beds throughout the facility- which include room 508, 500, 114, nourishment room in memory care). Keep flooring clean.

.1311 (b) Ventilation equipment shall be kept clean and in good repair.- Observed AC filter throughout the facility need detail cleaning and keep clean.

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 toilet/toilet chair seat need detail cleaning in spa 400 hall, Rehab restroom, 301, 500, 218 and 316. Keep clean. Observed rusted toilet chair in 316, 301, repair/replace needed.

REPEAT .1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed wheelchair, maintenance carts, walkers, stored in spa room in 400 hall. Remove items and only store bath related/permitted items.

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.- Observed no paper towels and soap in the dispenser in med room hand washing sink. Ensure to provide all handwashing supplies at all hand sinks at all time.

.1312 (e) EPA registered disinfectants shall be used in accordance with the manufacturer's instructions. When EPA registered disinfectants are mixed and prepared by institution employees, a measuring device, chemical testing device, or the methods and devices prescribed by the chemical manufacturer shall be used to prepare the concentration of chemicals in accordance with the disinfectant's label and the manufacturer's instructions.- According to a housekeeper, the facility does not have clear knowledge of the contact time for chemical use for cleaning. Ensure to contact the company who supply the products, know and educate all cleaning staff about the contact time for effective and proper cleaning of the facility.

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 the facility without/incomplete water back up supply plan. EHS emailed a checklist of the plan to an administrator and head of maintenance at the time of inspection. The facility will working on getting a complete plan.

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 toilet/toilet chair needed cleaning in room 220, 311. Loose toilet seat in room 210. Shower bench needs cleaning on the bottom in room 307. Keep clean and good repair.

REPEAT .1312 (b) Bathrooms shall not be used for storage of items not currently in use. Observed wheelchair, medicine carts, walkers, stored in spa room in 400 hall. Remove items and only store bath related/permitted items.

REPEAT .1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices. Observed no paper towel in soiled utility room in 400 hall, need refill. Ensure to provide hand washing supplies at all hand sink at all time.

.1312 (e) EPA registered disinfectants shall be used in accordance with the manufacturer's instructions. When EPA registered disinfectants are mixed and prepared by institution employees, a measuring device, chemical testing device, or the methods and devices prescribed by the chemical manufacturer shall be used to prepare the concentration of chemicals in accordance with the disinfectant's label and the manufacturer's instructions. Observed cleaning bottles with labeled, and other bottle with faded labels. Ensure to label all chemical bottles and ensure all labeled are legible.

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 the facility without incomplete back up water supply plan. EHS emailed a sample plan to an administrator at the time of inspection. The facility will working on getting a complete plan.

.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 dumpster door left open when not in used. Keep all lids/doors close to prevent pest harborage.

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 dusts/residues under sofa chairs in Huntersville room and Yatch club in memory care. Need cleaning and keep clean.

.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 walls in room 214 splattered. Baseboard detaching from wall, room 504.

.1310 (b) Light fixtures, fans, conduits, and heating, ventilation, and air conditioning vents shall be kept clean and in good repair. Observed dusty vent main laundry

.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. Repeat- Observed toilets/toilet seat with build-up in rooms 504, 214. Heavy soiling in all areas under shower seat in room 307. Mildewed shower curtains in rooms 307 and 401.

.1312 (b) Bathrooms shall not be used for storage of items not currently in use. Repeat-Observed spa room with toilet covered and storage inside

.1312 (d) Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices. Repeat -Observed many hand sinks missing soap and/or paper towels-

.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. Repeat-Observed an incomplete back-up water supply plan.

.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. Repeat- Observed no drain plug in 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. Repeat-Observed trash, food, used tissues, pens under couch and chair cushions throughout facility. Zipper broken on chair in Cornelius room, foam exposed

.1319 (e) Laundry areas and equipment shall be kept clean. Repeat-Observed all vents on back of dryers not attached to dryer. Dryers creating moisture and lint inside building. Resident laundry with lint build up behind dryer.

.1323 (a) All TCS food shall be maintained at temperatures required by Part 3-501.19 of the Food Code incorporated by reference at 15A NCAC 18A .2650 as amended by 15A NCAC 18A .2653 during storage, preparation, transportation, display, and service of the TCS food. Observed milk at 47F in kitchenette. CDI- milk discarded. Do not use fridge unless can hold TCS foods <41F

.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. Observed no employee health policy for non-kitchen staff.