ECHELON 5

Observed touch up paint needed in room 3. **15A NCAC 18A .1608 (b) Wall and ceiling attachments, such as light fixtures, fans, and vent covers, shall be kept in good repair.

Observed black build up on the wall in the hallway restroom. **15A NCAC 18A .1608 (a) The interior walls and ceilings, including doors, window, and window trim, shall be kept clean.

Observed dust build up on vent cover in hallway bathroom. Observed rusted floor vent cover. **15A NCAC 18A .1609 (b) Ventilation equipment shall be kept clean and in good repair.

Observed no paper towels in the hallway restroom. **15A NCAC 18A .1610 (b) The residential care facility shall provide each resident with soap and individual hand-drying towels. These hand-drying towels will be stored separately after being used.

Observed litter on the ground near the front entrance. **15A NCAC 18A .1615 (a) The external premises of a residential care facility shall be kept clean, and free of litter and pest harborage.

Observed knob missing on the dresser and dresser drawers off track in room 1. **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.

15A NCAC 18A .1607 All floors shall be kept in good repair. Observed carpet staining throughout facility. Observed wooden flooring damaged throughout facility. Repair.

15A NCAC 18A .1608 (b) Wall and ceiling attachments, such as light fixtures, fans, and vent covers, shall be kept in good repair. Observed touch up paint needed to walling, door frames, baseboards, and window trimmings throughout facility. Repair.

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 clenaing needed to shower located in bedroom 3. Clean.

15A NCAC 18A .1610 (b) The residential care facility shall provide each resident with soap and individual hand-drying towels. These hand-drying towels will be stored separately after being used. Observed no paper towels at handsink located in bathroom of bedroom 3.

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 at 84F at hallway bathroom handsink.

15A NCAC 18A .1615 (a) The external premises of a residential care facility shall be kept clean, and free of litter and pest harborage. Observed litter outside main door in bushes. Clean.

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 cabinet missing handle in kitchen. -General comment.

15A NCAC 18A .1620 (c) Cold holding equipment shall be provided with an indicating thermometer that is accurate to +/-3 degrees F. Observd no thermometer in kitchen refrigerator.

15A NCAC 18A .1607 All floors shall be kept clean and in good repair. Observed damage to floors in dining area, TV room, front room, and hallway. Needs repair. REPEAT.

15A NCAC 18A .1608 (b) Wall and ceiling attachments, such as light fixtures, fans, and vent covers, shall be kept clean and in good repair. Observed dust build up on laundry room window. Observed build up on vent cover next to dining room and on fan in dining room. Observed light bulbs missing from light fixture in bedroom 1 and in bathroom of bedroom 3.

15A NCAC 18A .1608 (a) The interior walls and ceilings, including doors, window, and window trim, shall be kept clean and in good repair. Observed window trim missing in bedrooms 1 and 2.. Needs cleaning.

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 build up in shower on shelving and on shower curtain in bathroom. Needs cleaning.

15A NCAC 18A .1611 (d) Residential care facilities 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 bathroom sink reaching 119 F. Needs to be between 105-116. No points deducted. Part of new rule updates.

15A NCAC 18A .1615 (a) The external premises of a residential care facility shall be kept clean, and free of litter and pest harborage. Observed overgrowth of vegetation in the front yard needs trimming to prevent pest harborage.

15A NCAC 18A .1617 (a) Furnishings, including furniture, curtains, draperies, and blinds, shall be kept clean and in good repair. Mattresses shall be kept clean, dry, and in good repair. Observed torn mattress in bedroom 2. Observed torn chair in entrance way. Observed damaged blinds in kitchen. Observed knobs missing from dresser in bedroom 2. Needs repair/replacement.

15A NCAC 18A .1618 (e) Food storage areas shall be kept clean and free of pests. Observed build up in lower kitchen cabinets. Needs cleaning.

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 EHS provided a copy of the Employee Health Policy. No points taken. Part of new rule updates.

15A NCAC 18A .1621 (d) The residential care facility 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 facility 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 provided a copy of procedure. No points taken. Part of new rule updates.

Containers and clean utensils shall be covered, inverted, stored in tight, clean cabinets, or otherwise stored in such a manner as to prevent contamination. 15A NCAC 18A .1618 (f). Observed utensils stored in cabinets with build up. Needs cleaning. All pots, pans and other utensils used in the preparation or serving of food or drink, and all food storage utensils, shall be thoroughly cleaned after each use. 15A NCAC 18A .1618 (c ). Observed tupperware containers with residue on them stored in the cabinets. Needs cleaning.

Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed staff bathroom tub needed cleaning. Toilet seat was loose.

All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed water damaged cabinetry near sink in kitchen. Observed kitchen cabinets with loose fittings, cracks or other damage. Kitchen cabinets are in need of repair. Observed dishwasher is taped together at the bottom. Observed closet door missing in one bedroom. Observed dust build up on ceiling fan in dining area.

All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607. Observed staining and debris on carpets and flooring. Observed damaged tiles in dining area. Observe rust on all floor ventilation covers. Needs cleaning/repair.

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed cob webs in corners of walls and ceilings in entryway. Observed loose outlet fittings in bathroom and bedroom of two person room. Observed cracks in doors. Needs cleaning and repair.

REPEAT All lavatories and baths shall be supplied with hot and cold running water through mixing devices. 15A NCAC 18A .1610 (b). Hand washing sink inside bathroom located inside bedroom has broken hand sink pending repair. Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed both bathroom toilet seats having loose hardware in need of repair.

REPEAT All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607. Observed carpet throughout home worn / damaged / stained in need of repair / replacing.

REPEAT The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed walls throughout home having scuffs / holes / damage in need of repair / touch up painting.. (Walls inside bathrooms accumulating mildew near ceiling; recommend placing dehumidifier in bathrooms during showers to prevent moist environment).

REPEAT Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observe toilet seat very loose in back bathroom near laundry room in need of repair.

REPEAT Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b). Observed comforter on bed of back bedroom far back right of main entrance having rips and tears in need of replacing.

All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607. Observed carpet worn / stained throughout.

REPEAT The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed scuffed walls throughout in need of touch-up painting.

REPEAT Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed toilet seats very loose in need of tightening in both restrooms.

All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed stained / worn mattresses in need of covers or replacing in several bedrooms. Observed misc debris under cushions on couch in need of general cleaning.

REPEAT The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed touch-up painting needed on door frames going from room to room; Observed wall scuffed in need of touch-up painting in restroom in back bedroom.

Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed toilet seat very loose (damaged) in back bathroom and in bathroom near washing machines, in need of repair.

REPEAT All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607. Observed floor and carpet damage throughout in need of repair.

REPEAT The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed wall damage throughout home in need of repair.

Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). Observed damaged light fixture in back bedroom closet in need of repair.

Repair shelving under two compartment sink in kitchen. 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 damage to floor in dining area. All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed ceiling peeling in hallway restroom. Observed wall damage in tub in hall restroom. Observed paint peeling on walls in restrooms. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Repair shelving under two compartment sink in kitchen. Repair drawer door under stove. Paint, apply wood sealant or stain bare wood cabinet and drawer doors in kitchen where laminate was removed. Replace damaged kick plate on base of kitchen cabinet. Repair damaged kitchen drawer. Observed utensil/equipment storage areas soiled. Thoroughly clean utensil/equipment storage 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). Utensils shall be handled in such a manner as to prevent contamination. 15A NCAC 18A .1618 (f).

Repair damaged shower/wall liner in both bathroom shower/tub area. Thoroughly clean shower curtain in hallway area. PROVIDE SOAP AND PAPER TOWELS AT ALL HAND WASHING SINKS AT ALL TIMES. Today soap and paper towels missing from hand washing sinks in bathrooms. Toilet, hand washing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b).

Replace broken/damaged window blinds. Replace stained pillows in resident room. Replace damaged bed spread in resident room. Repair damaged drawer on bedroom dresser stand or replace dresser in room. Monitor and repair arm rest on couch in common area or replace couch. 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).

Repair flooring in kitchen, dining room and bathrooms. Clean carpet in living room area and resident rooms. All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Clean walls throughout facility! Repaint throughout facility. Tighten loose handles on doors. Patch holes in walls and repaint. Patch holes in bed room and closet doors and repaint doors or just replace closet and bedroom doors. Repair wall paper in bathroom within bedroom or remove wall paper and paint walls. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Replace blown light bulbs in light fixtures throughout in bathrooms. Replace broken floor vent cover/register in dining room area. Tightly secure ventilation in bathroom in hallway area. Repair ventilation in bathroom. All rooms shall be well lighted by natural or artificial means. 15A NCAC 18A .1609 (a). Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). General Comment: #14. Fill in low area beside drive way where water is standing. Replace missing crawlspace vent cover on back side of house.

Observed laminate cover missing from several cabinet doors. Replace missing laminate or continue to paint exposed wood on cabinet doors. Replace damaged(burnt) oven mitten. Monitor and repair kick plate on side base of kitchen counter. 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 ). Store opened packages of dry food products in sealable container, labeled and kept clean.(flour, grits, etc.). The (1) damaged plate removed from service at time of inspection.

Thoroughly clean shower curtain or replace soiled and and damaged shower curtain in residents bathroom. Provide soap and paper towels at all hand washing sinks at all times. Observed soap and paper towels missing from hand washing sinks in bathrooms and kitchen area. Thoroughly clean shower/bathtub wall liner in hallway bathroom. Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Provide soap and paper towels at hand washing sink/kitchen sink at all times.

Replace damaged couch in living room area. Replace stained resident pillows. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Repair or repalce damaged carpet in living room area. Repair or replace damaged flooring in kitchen area. All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Replace damaged closet door in residents room. Continue to paint throughout residents. Repair or remove damaged wall paper in bathroom within resident room. Wipe/clean and closet doors throughout where needed. The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Replace damaged floor register in dining area. Clean return air ventilation in hallway area. Ventilation equipment shall be kept clean and in good repair. 15A NCAC 18A .1609 (b). Replace missing railing on hand railing on back deck. Mr. James Brice present at time of inspection.

Repeat non-compliance: Observed no thermometer in kitchen refrigerator. Observed raw eggs stored above ready to eat foods.An indicating thermometer shall be located in each refrigerator. 15A NCAC 18A .1620 (a).All foods, while being stored, prepared, served, and during transportation, shall be protected from contamination. 15A NCAC 18A .1620 (a).

Repeat non-compliance: Observed utensil trays insert in kitchen drawer collecting food residue. Observed cabinet finish and drawer finish damaged thoughout kitchen. Observed coffee mug stored in kitchen cabnet with handle broken off, ceramic mug, break area not cleanable.All containers and clean utensils shall be stored in a clean place. 15A NCAC 18A .1618 (f).All pots, pans and other utensils used in the preparation or serving of food or drink, and all food storage utensils, shall be thoroughly cleaned after each use. 15A NCAC 18A .1618 (c ).

Repeat non-compliance: Observed toilet tank loose in master bathroom. Observed hand sinks with pitting finish in hall restroom. Observed no papertowels at all bathroom hand sinks.Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b).Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Repeat non-compliance: Observed damged mattress in care room at left end of hall, springs bent holes in cover.All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Repeat non-compliance: Observed kitchen and dining area floor damaged, holes in vinyl.All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Repeat non-compliance: Observed holes in doors and closet doors.The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed no thermometer in refrigerator.An indicating thermometer shall be located in each refrigerator. 15A NCAC 18A .1620 (a).

Observed gasket refrigerator collecting debris. Observed drawers and cabinets with finish damaged, loose hanging on hinges and damaged. Observed kitchen sink damaged and rusting. Observed backsplash caulk damaged on kitchen counter.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 no soap at hand sinks for residents. Observed no paper towels at hand sink for staff restroom. Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b). Observed bath tub with damaged around wood for window, water entering wall, water damage present on wall and floor behind toilet in hall restroom. Observed hand sink damaged in restroom connected to bedroom, hanging away from wall. Toilet, hand washing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed bed damaged in bedroom across from hall restroom.All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed floor damaged in kitchen.All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

Observed walls damaged throughout facility, wall repairs not complete.The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.