DALMOOR DRIVE GROUP HOME

15A NCAC 18A .1607 All floors shall be kept in good repair. Observed laminate plaster peeling to flooring in room 2.

15A NCAC 18A .1610 (a) Residential care facilities shall provide toilet, handwashing, and bathing facilities that are available for use by residents and employees that are kept clean and in good repair. Observed minor build up on bottom of shower curtain liner in bathroom 1. Observed toilet seat peeling in bathroom 2.

15A NCAC 18A .1617 (b) Clean bed linen in good repair shall be provided for each resident. Observed minor staining to pillow case in room 3. -General comment.

Observed touch up paint needed in room 1. Observed water stained ceiling in the hallway. **15A NCAC 18A .1608 (b) Wall and ceiling attachments, such as light fixtures, fans, and vent covers, shall be kept in good repair.

Observed toilet base cover missing in bathroom #1. Observed base of toilet in bathroom #2 in need of cleaning. **15A NCAC 18A .1610 (a) Residential care facilities shall provide toilet, handwashing, and bathing facilities that are available for use by residents and employees that are kept clean and in good repair.

Observed living room furniture in need of repair. **15A NCAC 18A .1617 (a) Furnishings, including furniture, curtains, draperies, and blinds, shall be kept in good repair. Mattresses shall be kept in good repair.

Observed bed linen torn in room 1. **15A NCAC 18A .1617 (b) Clean bed linen in good repair shall be provided for each resident

Observed stained sheet in room 2. **15A NCAC 18A .1617 (b) Clean bed linen shall be changed when no longer clean.

Observed linen stored on the floor in linen closet. Observed linen on the floor in room 3. **15A NCAC 18A .1617 (c) Clean linen shall be stored and handled in a manner to protect from contamination and separate from linen that is not clean.

Observed dresser knob missing in bedroom 1. Observed dresser drawer off track in rooms 4 and 6. Observed cracked cushions on the sofas in the living room. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed wall damage behind the door in room 3. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). Observed stained pillow cover, stained pillows, faded, and torn comforter at resident rooms. Linens shall be clean and in good repair. EHS advised PIC to remove torn linens and replace soiled linens with clean linens. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed damaged dresser drawer at resident room. Need repaired.

Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). Observed rusted ceiling vents at 2 resident rooms. Need repaired/replaced.

Observed dresser drawers off track in bedroom 3. Observed knob missing on the dresser in bedroom 4. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed handles missing on furniture in bedrooms 1 and 3. Needs to be replaced. Observed chair peeling in bedroom 1. Needs to be repaired/replaced. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed vent covers with build up in both bathrooms. Needs to be cleaned. Observed window blinds torn in bedroom 2. Needs to be replaced. **Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b).

-Observed a large stain on the box spring in room 1. Provide a fully enclosed mattress cover or replace. -Observed a chair in the den in disrepair. Ripped leather. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). -Observed debris in the made up bed in room 2. Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).

-Observed buildup on the walls in bedroom 1. Clean. -Observed a hole in the wall behind the door in bedroom 4. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed a shelf and a drawer broken in the refrigerator. Mr. Clarence the refrigerator will be replaced. Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean and sanitary condition. 15A NCAC 18A .1618 (c ).

-Observed pink buildup on the shower heads in both restrooms. -Observed pink buildup in the soap dish in the restroom by the living room. -Observed the toilet seat very loose in the restroom by the dining room. Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

-Observed a tear in the mattress in room 1. -Observed a stain on the comforter in room 3. -Observed on of the dresser drawers in disrepair (comes off when you pull it) in room 5. -Observed the mattress pad torn in several areas in room 6. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).

Observed the floor in bedroom 2 very sticky. Mop to try to remove the strong urine smell. All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed stains on the wall in the bedroom with vinyl floor. Clean. *This room has a very strong urine smell. Deep Clean this room. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Report emailed to dalmoordrive@carolina.rr.com

Observed turkey on sandwich was 50F, broccoli slaw was 47.8F. Observed very hot chicken and chicken broth were tightly covered in the kitchen refrigerator. Internal temperatures of the refrigerator was 50F. Ensure proper cooling procedure is used to cool hot food to prevent warming of entire refrigerator. Corrected during the inspection - Hot food was moved to the freezer to quickly cool; internal temp of the refrigerator dropped to 48F. Cooling procedure handout was provided to staff. **A RETURN VISIT WILL BE MADE TO VERIFY REPAIR OF THE REFRIGERATOR.**

Observed black residue on the grout, tiles, and around the hand rails in the bathrooms, the toilet bases in both bathroom needed cleaning. Also observed a resident's personal elevated toilet seat (room #2) was not clean and stored in the closet and was very rusty. **Replace elevated toilets seat with one in good condition. **Toilet, hand washing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed a pillow case was not clean in a resident room, and one comforter was not clean on a resident's bed. **Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). Observed several pillows were flat and/or lumpy. Replace worn pillows. Also observed the vinyl surface was cracked/damage on a living room chair. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed the carpet was stained and burned in the hallway; the carpet was water damaged outside the bathroom doorways in the hallway and the living room. **Repair all ongoing leaks from showers. **All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed ceiling water/moisture damaged in a resident's room, the wall was damaged in the living room, the closet door casing was very rusty in resident room#2, and the walls were water damaged in the water heater closet. **Repair all water leaks from the roof and the bathrooms. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed the light was not working in the exterior storage closet, and the hallway supply closet light was not functioning properly. **All rooms shall be well lighted by natural or artificial means. 15A NCAC 18A .1609 (a).

Observed bottoms of shower curtains collecting residue. Observed tile grout in both restrooms in need of cleaning. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed knobs to dressers off and or loose in rooms #5 & 6. All knobs or furniture shall be in good repair. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed an elevated toilet seat was rusty and was not clean and was stored in the resident closet, the shower heads with pink residue, and sections of shower grout was missing/mildew.**Toilet, hand washing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed sheets were discolored on a resident's bed, some window blinds were dusty, and a lamp was in disrepair.Observed some furniture with missing handles and knobs.**All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed the walls and ceilings with mold in both bathrooms, and the closet door frame was rusty in one resident bedroom.**The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.GENERAL COMMENTS: Clarence Stowers was present during the inspection#4 - Observed a cutting board was stored beneath the kitchen sink. Keep all equipment and utensils stored in a clean area.Observed a refrigerator drawer handle was broken.

Observed pink residue on the shower head and the shower curtain liner, and and the sink drain with rust. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed some handles and knobs were missing on some dressers, and one resident bedframe with strong urine odor. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed the refrigerator thermometer was not working. **An indicating thermometer shall be located in each refrigerator. 15A NCAC 18A .1620 (a).

Observed several plastic serving bowls with surface damage. **All equipment and utensils shall be so constructed as to be easily cleaned and shall be kept in good repair. 15A NCAC 18A .1618 (a).

. Observed black residue build-up around bathtub handrails, and some grout with mildew. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed some drawers with missing/broken handles/knobs, two couches in the living room were broken, and the mattress in bedroom3 was stained. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed the carpet was stained in the hallway and some bedrooms. **All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed the wall behind the bed was damage in bedroom3, the ceiling was water damged and had mold in bedroom 2, the door was unfinished(raw wood) in bedroom 1, and the bathroom door had moisture damage and mold. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed the light were not functioning in the pantry, kitchen and the hall closet. **All rooms shall be well lighted by natural or artificial means. 15A NCAC 18A .1609 (a).**Clarence Stowers was present during the inspection.