MIRACLE HOUSES-MONTEITH

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

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 plaster peeling on tub flooring. -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 torn blinds in the living room. Observed one dresser with missing drawers in Rooms 2 and 4. Observed a broken dresser knob in Room 2. Observed one missing dresser knob in Room 3. Repair/replace.

15A NCAC 18A .1621 (d) The residential care facility shall have personal protective equipment 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 should be taken to minimize the exposure to vomitus or fecal matter. Facility did not have copy of required procedure plan, EHS emailed facility copy of required plan. -General comment.

Observed knobs missing on dresser in bedroom 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.

Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed sink cabinet in the hallway restroom in need of repair. Observed shower grout with build up in the hallway shower.

All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). - Observed dresser knobs missing in rooms 1, 2 and 3. 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 case in room 2 and stained linen in room 3.

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. - Observed minor touch up paint needed to wall thsroughout facility.

Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a). Observed toilet lid in restroom 1 chipped. Observed plaster peeling on flooring of tub. Observed minor black build up within caulking of tub. (Improvement has been made from previous inspection report).

All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed blinds in living room in need of repair/replacement. Observed handles missing to dresser drawers throughout facility. Observed laminate counters chipping on bottom in kitchen.

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed minor touch up paint needed to walling throughout facility. Major improvement from previous inspection report.

The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a). Observed several trash bags stored near rear fencing to residence.

Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).Observed minor build up inside of toilet located in main hallway. Clean. Observed black build up inside of the shower tiles and surrounding the tub. Observed plaster on flooring of shower peeling. Observed handsink in main hallway restroom detaching from wall. Repair.

All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed staining on mattress in room 1 and room 3. Observed staining on pillows in rooms throughout facility. Observed dresser in need of repair and with markings in 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 minor staining on pillow case in room 3 and staining on linen in room 2. (No demerits taken for violation).

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

The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608. Observed touch up paint needed to baseboards, walls joints, and walls throughout facility. Observed debris build up on wall behind door in room 1. Clean.

Observed handles missing on the dressers in rooms 1 and 4. Observed dresser face missing 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 black build up on the wall near the shower in the bathroom. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed paint peeling around the drain in the tub. **Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Observed dressers missing handles on rooms 1, 2 and 4. Needs replacing. Observed dresser drawer missing in room 2. Observed drawer face missing in room 3. Observed torn mattress cover in room 1. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed wall damage in rooms 2 and 4. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed mouse droppings in the kitchen cabinet underneath the sink. Needs to be cleaned and increase pest management if droppings are continuing to be found. **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 dresser missing handles in 1st, 2nd and 3rd bedroom. Needs to be repaired. Observed torn mattress cover in 1st, 3rd and 4th bedroom. Needs to be repaired. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a). Observed mattress cover stained in 2nd bedroom. Needs to be replaced/cleaned. **Clean bed linen in good repair shall be provided for each resident and shall be changed when soiled. 15A NCAC 18A .1617 (b).

Observed washer and dryer stored outside at the back of the house. Needs to be removed. **The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a).

Observed plastic plates and cup stored in the kitchen cabinets with worn/microwave damaged surface, a cup rim was broken and damaged. Observed several plastic cups were wet and tightly stacked (REPEAT). Completely dry all eating utensils before stacking. **All multi-use eating and drinking utensils shall be thoroughly cleaned after each usage, and the facilities needed for the operations of washing and rinsing shall be provided. 15A NCAC 18A .1618 (b). CONTINUED ON PAGE 4

Observed the door hindge was brokn in bedroom1. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed a dilapidated exterior shed with debris. If not in use, remove from property. Keep the premisesclean and free of dilapidated items. **The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a). NOTE: Observed mouse dropping in the oven drawer. The current quarterly preventive pest control/maintenance may need to increase. **Clean up all rodent droppings to ensure pest control is effective. If droppings continue, provide more effective pest control methods.

Observed a bowl and a cup stored as clean in the kitchen cabinets with food residue. Observed plastic bowls were wet and tightly stacked. Completely dry all eating utensils before stacking. **All multi-use eating and drinking utensils shall be thoroughly cleaned after each usage, and the facilities needed for the operations of washing and rinsing shall be provided. 15A NCAC 18A .1618 (b). Observed interior of cabinets were dust and had debris. Keep all equipment 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 the bed frame was not secure / properly fastened in bedroom 3, the mattress cover was torn / damaged in room 4. Bed spreads and pillows were damaged and stained, dresser drawer fronts were broken damaged, a child's backpack was moldy, the couch and love seat with damaged vinyl, a desk chair with damaged surface, and some pillows were misshapen and in need of replacing, **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 laundry detergent was stored unlocked in the laundry area, the storage closet inside bedroom 1 containing hand sanitizer and spray paint was left unlocked. **Household cleaning agents such as bleaches, detergents and polishes shall be stored out of the reach of young children unless otherwise required in the rules of the licensing agency. 15A NCAC 18A .1616 (c ). Observed items stored on the floor in some bedroom closets, storage closets were unorganized and needed cleaning, and toilet paper was stored beneath the sink in the hallway restroom. If items are stored beneath the sink drain; store clean supplies and paper stock in a tightly sealed container or sealed bag. **Rooms or spaces which are provided and used for the storage of clothing, personal effects, luggage, necessary equipment and supplies and for items not in routine use, shall be kept clean. 15A NCAC 18A .1616 (a).

Observed a broken / damaged baseboard in the kitchen, walls in the bedroom needed cleaning, the exterior crawlspace door was damaged and had chipping paint, chipping paint / wall damage throughout the home. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed a dilapidated exterior shed with debris, and missing door. If not in use, remove from property. Observed mattresses, and broken furniture was stored on the backside of the home. Was advised bulk pick-up was scheduled for 10/24/17. Keep the premises clean and free of dilapidated items. **The premises shall be kept neat, clean, adequately drained, and free of litter and vermin harborage. 15A NCAC 18A .1615(a).

Observed eggs stored on top shelf in fridge over ready to eat food items. **All foods, while being stored, prepared, served, and during transportation, shall be protected from contamination. 15A NCAC 18A .1620 (a).

Repeat Non Compliance: Observed interior finish of cabinets in disrepair, with debris present. **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).

Repeat Non Compliance: Observed knobs, drawers at dressers missing. Observed back room bed frame bending. Observed couch arm rests and kitchen cushions peeling. Keep all furniture clean and in good repar. **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 walls throughout with scrapes and scratches. Keep all walls in good repair. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Observed light out in 1st front room on left. Repair light. **All rooms shall be well lighted by natural or artificial means. 15A NCAC 18A .1609 (a).

Repeat Non Compliance: Observed interior finish of cabinets in disrepair, with debris present.**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 both toilet seats in far back right and front right restrooms with loose toilet seats. Seats in need of tightening. Observed bottom of cabinet finish wet indicating there is a leak coming from the pipe at hand wash sink in front right restroom. Repair sink.**Toilet, handwashing, bathing, and laundry facilities shall be kept clean and in good repair. 15A NCAC 18A .1610 (a).

Repeat Non Compliance: Observed linen stained and or in disrepair in rooms both on right and left side of hall way. Keep all linen clean and in good repair. Observed knobs to drawer missing in back left bedroom. **All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed door cracked right at knob in front right bedroom. Observed back left bedroom door in disrepair with paint peeling. Observed wall chips in front left bedroom from the dresser rubbing up against the wall. **The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.

Repeat Non Compliance: Observed handle missing off stove.Repeat Non Compliance: Observed the interior of the kitchen cabinets finish damaged** 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).Repeat Non Compliance: Observed old food debris and residue collecting in the interior of the microwave; debris collecting on shelves. **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 bathroom in far back side of house with out soap or paper towels.**Each resident will be provided soap and individual towels. These towels will be stored separately after being used. 15A NCAC 18A .1610 (b).

Repeat Non Compliance: Observed closet door in front room damagedObserved chest of drawers shelving missing in back left room.Repeat Non Compliance: Observed multiple discolored pillows throughoutRepeat Non Compliance: Observed damaged comforters/linen with stains.**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 hole in floor near floor vent in back right room. Ground is exposed when peeling back paper covering hole. Repeat Non Compliance: Observed hall/wall damaged throughout facility. **All floors shall be easily cleanable and shall be kept clean and in good repair. 15A NCAC 18A .1607.

-Repeat Non-Compliance: Observed handle missing off of the stove.-Repeat Non-Compliance: Observed the interior of the kitchen cabinets finish damaged.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 old food debris and residue collecting in the interior of the microwave.Non-food-contact surfaces of equipment shall be cleaned at such intervals as to keep them in a clean andsanitary condition. 15A NCAC 18A .1618 (c ).

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

-Repeat Non-Compliance: Observed hall restroom cabinet damaged by the toilet paper dispenser.-Repeat Non-Compliance: Observed closet door in the rear left bedroom damaged. Also closet door damage in the front bedroom.-Observed missing dresser knobs in 2 of the bedrooms.-Observed multiple discolored pillows.-Observed torn/freyed comforter in the rear bedroom to the right. All furniture, mattresses, curtains, draperies, and other furnishings shall be kept clean and in good repair. 15A NCAC 18A .1617 (a).

Observed an aerosol can of Raid, and an aerosol can of air freshener stored unlocked sitting on the desks in the living room. Residents in the facility are 18 years old or less.Pesticides, herbicides and other substances which may be hazardous if ingested, inhaled, or handled, shall be stored in a closet, cabinet or box not accessible to young children unless otherwise required in the rules of the licensing agency. 15A NCAC 18A .1616 (b).

Observed wood paneling in disrepair in the front bedroom.Observed wall damage in the hall restroom (baseboard areas and by the tub).The walls and ceilings of all rooms and areas shall be kept clean and in good repair. 15A NCAC 18A .1608.Ms. Shay present.