LAKEVIEW

15A NCAC 18A .1608 (b) Wall (doors, windows and window trim) and ceilings and ceiling attachments (light fixtures, fans, and vent covers) shall be kept in good repair. Observed touch up paint needed to walling, door frames, baseboards, and window frames/sills throughout facility. Observed popcorn ceiling was peeling in small bathroom. Needs repair. REPEAT.

15A NCAC 18A .1609 (b) Ventilation equipment shall be kept clean and in good repair. Observed dust build up on vent in bathroom 3. Needs cleaning. REPEAT.

15A NCAC 18A .1618 (a) All food service equipment and utensils shall be kept in good repair. Observed a couple of plates in kitchen worn and peeling. Needs removal.

General Comment: 15A NCAC 18A .1621 (c) Residential care facility 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 facility does not have Employee Health Policy. EHS emailed a copy.

15A NCAC 18A .1621(d) the residential facility shall have gloves, personal protective equipment, disinfectant, individual disposable towels, and a coagulating agent onsite for employees to use and a written procedure for employees to follow when responding to a vomitus or fecal matter on facility surfaces. The procedure shall specify the actions that employees shall take to minimize the exposure of employees, residents, guest, food, and additional surfaces to vomitus or fecal matter. EHS emailed facility a copy of the plan. REPEAT.

15A NCAC 18A .1608 (b) Wall (doors, windows and window trim) and ceilings and ceiling attachments (light fixtures, fans, and vent covers) shall be kept in good repair. Observed touch up paint needed to walling, door frames, baseboards, and window frames/sills throughout facility.

15A NCAC 18A .1609 (b) Ventilation equipment shall be kept clean and in good repair. Observed dust accumulation to ceiling vent near main entrance door.

15A NCAC 18A .1610 (a) All residential care facilities shall provide toilet, handwashing, and bathing facilities that are available for use by residents and employees. These facilities shall be kept clean and in good repair. Observed loose toilet seat in shower room 1. Observed minor build up around outline of shower tiles in shower room 2.

15A NCAC 18A .1611 (d) Residential care facilities shall provide water heating facilities. Hot water shall be provided at temperatures between 105F and 116F at handwashing and bathing facilities. Observed hot water ranging between 96F-98F at hand sinks in residents bathrooms. New rule, general comment.

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 1 dresser drawer off track in room 3. Observed vinyl bed cover peeling on bed 1 in room 2. Observed 1 handle missing to cabinet in kitchen.

15A NCAC 18A .1621(d) the residential facility shall have gloves, personal protective equipment, disinfectant, individual disposable towels, and a coagulating agent onsite for employees to use and a written procedure for employees to follow when responding to a vomitus or fecal matter on facility surfaces. The procedure shall specify the actions that employees shall take to minimize the exposure of employees, residents, guest, food, and additional surfaces to vomitus or fecal matter. EHS emailed facility new required plan, copy of updated rules, and employee health policy. -General comment.

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 handle to microwave broken.

Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). Observed dust accumulation to ceiling vent in main hallway.

Observed stains on box springs in bedroom closest to laundry room. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed touch up paint needed in various rooms and areas.

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 cabinet door with broken hinge and one drawer off track. Repair track if broken After cleaning and until use, food-contact surfaces of equipment shall be protected from contamination. 15A NCAC 18A .1618 (f). Observed dish drainer under soap dispenser in kitchen with clean utensils in it. Do not store under soap dispenser or any other item that can contaminate clean dishes.

Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). Observed soiled sheet, torn sheet, torn bedbug covers, soiled bedspread, and threadbare bath towels. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed stained box spring, dresser with broken track for drawer

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed chipped paint on window areas in kitchen and back bedroom

Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). Observed dusty ceiling ventilation and floor fan. Rusted wall and ceiling vent covers.

The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a). Observed rotted board near front stairs. Broken board on walkway towards wheelchair ramp.

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 buildup in the kitchen cabinets on the lazy susan shelves. Clean.

Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b). Observed jammed paper towel dispenser in residents bathroom. Repair or replace.

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed scarring on the wall in the common area as a result of friction from the furniture. Spot paint.

-Observed large handle spoon with a burn mark. Replace. 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 buildup in the kitchen cabinets and shelves. Clean. 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 yellow stains on the mattress cover in bedroom 2. Replace. Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). -Observed a strong urine smell from the mattress in bedroom 3. This bed also is collecting debris in the folds of the vinyl mattresses. Clean. -Observed dresser drawers off track in bedroom 3. Repair. -Observed a stained pillow in bedroom 4 (back bedroom). All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed gaps in between the floor tiles in living areas and bedrooms. Close gaps to prevent collection of dirt and dust and to make the floors easily cleanable. All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

-Observed the paint on the window sill peeling in bedroom 3. Repaint. -Observed paint chipping off of the doors and door frames. Repaint. -Observed the popcorn ceiling peeling in the back double bedroom over the shower. Repair. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed shower head with build up in bathroom on the far right side of the house. Needs to be cleaned. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed small dresser in far right bedroom near the kitchen missing handles and a hole in the sheet. 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 wall damage near trash can in the kitchen. Needs to be repaired. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed urine on toilet and discoloration in tiles of shower in bedroom near laundry room. Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed stains on blue separation curtain in bedroom. Observed plastic mattress cover on bed in room with separation curtain.

Observed wall damage at front living room area and on door in first bedroom closet door. Observed popcorn ceiling peeling in bathroom in bedroom near laundry room. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Clean toilet in hall bathroom. Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Vinyl mattress cover torn in room 1. Replace. Observed small tears on couches in rear living room(near backdoor). All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Repaint walls in room 1. Observed writing on wall. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed raw chicken and shell eggs stored above ready to eat foods. Chicken dripped onto shelf and pitcher sitting in it.**All foods, while being stored, prepared, served, and during transportation, shall be protected from contamination. 15A NCAC 18A .1620 (a).

Observed kitchen cabinets and drawers need wiping out of crumbs/food debris.**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 ).General Comment: Keep all boxes stored off floor.

Observed loose toilet seat in far right bathroom.**Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed soiled pillow cases in one room and a small tear on a comforter in another room.**Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).

Observed tear in vinyl flooring in bulk dry storage and lifted floor tiles in kitchen.**All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed dusty vent in hall and rusted vent cover in right side far bathroom.**Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b).

Observed rice, coconut not in sealed baggies. Container of frosting in pantry, must be refrigerator once opened-CDI disposed of.**All foods, while being stored, prepared, served, and during transportation, shall be protected from contamination. 15A NCAC 18A .1620 (a).

Observed no paper towels in bedroom closest to kitchen.**Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b).**General Comment #1: Observed outside faucets without backflow preventers. (critical violation)**No backflow connections or cross connections with unapproved supplies shall exist. 15A NCAC 18A .1611 (c ).

Observed couches with damaged finish. 2 torn mattress covers. 1 torn pillow. Torn comforter. Damaged dresser drawer.**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: Opened dry goods not sealed in lidded container or baggie. Raw meats and shell eggs stored above ready to eat foods.All foods, while being stored, prepared, served, and during transportation, shall be protected from contamination. 15A NCAC 18A .1620 (a).Observed broken thermometer i refrigerator (food temped to 42F).An indicating thermometer shall be located in each refrigerator. 15A NCAC 18A .1620 (a).

Observed torn comforter, torn pillow, and torn pillow protector. Worn chair in living room.Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).

Observed dusty vent in hall. A couple of blinds dusty.Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b).