Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 07/09/2024
Score: 100
#
Comments
Points
2.
.1310. One room had a small ding in the wall. Walls shall be maintained in good repair. CDI-Work order was entered, and repair will be done immediately per PIC.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 09/26/2023
Score: 98.5
#
Comments
Points
2.
.1310) Some rooms observed with minor wall damage from beds and chairs. Walls in one restroom soiled with residues. The interior walls of the institution, including doors, windows and window trim, and ceilings shall be kept clean and in good repair. Work orders in for some of these areas, and rooms without work orders were placed during inspection for repairs.
0.0
11.
.1312) Zep Apriza 2 (lemongrass fragrance) is being used as disinfectant for bathrooms and spa rooms and being mixed through dispenser. EPA registration #1270-257. In spa rooms Sani-cloth bleach wipes with EPA number 9480-8 has contact time of 2 minutes and 4 minutes. Please use the 4 minute contact time if these wipes are being used. 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 ZEP information online .
1.0
17.
.1313) Backup water supply on-site and facility has contract with US Foods to supply water and food during emergencies, but no where in the plan does it state the health department will be notified when water is interrupted for more than four hours. The administrator shall immediately notify the licensing agency and the local health department that serves the county in which the institution is located if the institution`s primary water supply is interrupted for more than four consecutive hours. Guidance template emailed during inspection.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 10/11/2022
Score: 99
#
Comments
Points
6.
.1311) B. Vents in a few bathrooms of patient rooms with dust accumulation. Ventilation equipment shall be kept clean and in good repair.
0.0
34.
Paperwork from service company that services laundry facilities is provided. Paperwork shows recent visits and laundry sanitizer is marked as OK with checkmark and no ppm is listed. If hot water is used, linen including sheets, pillow cases, absorbent pads, towels and wash cloths provided by the facility shall be washed with a detergent in water at least 71°C (160°F) for 25 minutes.If low temperature (less than 71° C) laundry cycles are used, linens shall be washed in at least 50 parts per million chlorine or an EPA Listed laundry sanitizer shall be used in accordance with the manufacturer's instructions. Please ask company to provide ppm number to ensure laundry is being disinfected at correct concentration.
1.0
General Comments
Bathroom Disinfectant EPA # 1677-202 has contact time of 2 minutes.
Hot water temperatures at 102-115F throughout facility.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 10/05/2021
Score: 99
#
Comments
Points
2.
General Comment - Observed there to be decorative items stored on the floors in a few storage rooms making it difficult to clean | 1309 (a) - Floors shall be free of obstacles to cleaning, and shall be kept clean and in good repair | PIC to reorganize storage to make floors more accessible
0.0
11.
Observed two hand washing sinks to be blocked and inaccessible; one sink used for storage of vases in a laundry room and one storing items in a medical room | .1312 (d) - Hand washing facilities shall be accessible in all areas | PIC to ensure that hand washing stations stay unblocked and accessible
1.0
16.
General Comment - Observed there to be a back up water supply letter that did not meet the specific requirements outlined in .1313 F - The local health department shall be immediately notified if the primary water supply is interrupted for more than four hours. Each institution shall have a plan to obtain a backup water supply in the event that the water supply is lost for more than four hours. The backup water supply plan shall provide for two liters of water per day per person for drinking. The backup water supply plan shall include a plan for either relocating residents or providing an alternative source of water for essential functions such as food preparation, hand washing, bathing, cleaning, dishwashing, laundry and disposal of bodily waste. The amount of water provided for uses other than drinking may be reduced if the plan includes alternatives for water use for services such as laundry and dishwashing. If an assessment determines that tap water is not to be used for drinking, sources shall be prominently labeled or hooded to restrict use and potable water shall be provided. | EHS provided a template for the facility to meet back up water supply requirements
0.0
General Comments
Two hot water handles were missing from the mop sinks in two janitor closets - EHS noticed that back flow on mop sink is not designed to be under constant pressure. Provided education on black flow.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 05/25/2021
Score: 100
#
Comments
Points
General Comments
Due to COVID 19, Please follow CDC guidelines regarding social distancing, quarantine, and disinfecting.
Facility has Peroxide Multi Surface cleaner and disinfectant with EPA number 1677-238 and contact time of 30 seconds and facility also has Heavy Duty Alkaline Bathroom cleaner and disinfectant with EPA number 1677-202 with contact time of 2 minutes.
Hot water measured in restroom sinks and laundry room sinks between 110-115F.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 12/17/2020
Score: 99
#
Comments
Points
8.
Dust buildup along fan blades in laundry room. Facilities shall be clean and in good repair. Clean the dust from this fan.
1.0
General Comments
Due to COVID 19, Please follow CDC guidelines regarding social distancing, quarantine, and disinfecting. Facility using ozone for laundry and peroxide disinfectant with contact time of 5 minutes. Floors walls and ceilings throughout facility looks good!
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 08/01/2019
Score: 98
#
Comments
Points
13.
All rooms inspected had hot water between 100-115F,but the laundry room handsink had low pressure water and the water was not hot. Increase the pressure and ensure the hot water is between 100F-116F.
2.0
14.
Please keep test strips for disinfectant in the room where the disinfected is dispensed. Test strips must be used to ensure the disinfectant is at the correct concentration. Where disinfectants are mixed on site, the concentration of the mix shall be assured by use of a metering pump, measuring device or chemical test kit.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 11/05/2018
Score: 98
#
Comments
Points
3.
Walls are in good condition overall, however a couple places are still damaged, including walls in 5106, 5118, 5112. Minor dust accumulated in 5364 storage room. Walls and ceilings shall be clean and in good repair.
0.0
13.
Most lavatories and showers have water between 100-116F; however, handsink in 5380 soiled laundry room is only 95F and handsink in 5172 laundry room is 123F . Lavatory and bathing hot water shall be between 110-116F. Adjust hot water at these sinks to be within this range. Full credit may be taken on next inspection if repeat.
1.0
32.
Bed linens in room 5318 are stained. Chair ripped in room 5327. Couch stained in South common area. Furniture shall be clean and in good repair.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 10/19/2017
Score: 97
#
Comments
Points
3.
Walls in several rooms are in poor repair due to reclining chairs/beds scratching them. Wall in hallway near room 5401 is a bit dirty. Walls shall be in clean and in good repair. Clean and repair the walls in the rooms/hallways.
1.0
4.
Light blown out in bathroom in room 5102. Replace this light.
0.0
8.
Toilet seat in room 5430 is loose and shifts around. Toilet facilities shall be clean and in good repair. Repair this toilet seat so it is no longer loose.
0.0
13.
Laundry rooms used by residents in the central and east houses have water in excess of 116F. Hot water shall be between 100-116F. Adjust the hot water at these sinks to be less than 116F in order to prevent a scalding hazard.
1.0
32.
Medication refrigerator in med prep room in south house does not stay closed. Pillow cases stained in rooms 5329 and 5421. Furniture shall be clean and in good repair. Repair the med prep refrigerator to remain close. Pillow cases replaced during inspection.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 09/22/2016
Score: 95
#
Comments
Points
2.
Continue to replace carpeting as needed throughout facility (torn and stained carpeting).
1.0
3.
Repair walls as needed in rooms where beds have caused damage.
0.0
8.
Handwash sink is required in laundry rooms. East Hall laundry room does not have a handwash sink.
1.0
10.
Repair toilet seat in room 5101. Bedside toilets may not be cleaned in patient rooms unless the rooms have a water closet with bedpan lugs or spray arms.
0.5
13.
Hot water was less than 100F. CDI-water temperature was adjusted.
1.0
28.
All storage must be at least 8 inches above the floor.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 08/25/2015
Score: 97
#
Comments
Points
2.
The building is undergoing extensive renovations. The remaining stained or damaged carpet and flooring will be replaced.
1.0
3.
The walls will be repaired and painted as part of the renovations.
0.0
8.
Tile damage in the shared bathrooms will be repaired as part of the renovations.
1.0
14.
The disinfectant cleaner is registered as a pesticide. Use a disinfectant that is an EPA registered hospital disinfectant as a final step in cleaning shared bathing equipment that has contact with the patient`s skin ( a product in a spray can will work for this purpose ).
1.0
30.
One sharps container on a med cart was left unlocked.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 12/08/2014
Score: 94
#
Comments
Points
2.
Clean the soiled flooring in mop sink/can wash areas, mechanical rooms, storage rooms, oxygen tank storage room, etc...Seal (caulk) the peeling floor linoleum around mop sink/can wash basin in #5341. Also replace the missing cove base behind door in this room.
1.0
3.
Repair the damaged wall surfaces in storage and med rooms. Seal the small holes in mop sink/can wash rooms... Replace the stained/damaged ceiling tiles in east nurses' station bathroom...Remove the spider webs and dust from walls/ceiling in east oxygen tank storage room...Clean (and properly disinfect) the soiled sides and edges of bathroom doors and handles in resident rooms and common bathrooms.
1.0
4.
Observed that lighting in various locations through facility was quite dim (dining room areas, hallways, bathrooms, etc.) Lighting in all areas throughout establishment must be at least 10 foot-candles (fc) at 30 inches above the floor. NOTE: Lighting in food preparation areas shall be at least 50 fc on prep surfaces.
1.0
5.
Clean the dusty ceiling vent grates/covers in bathrooms, storage rooms, mop sink/can wash rooms, laundry room, etc. throughout the facility.
1.0
8.
Replace/repair the rusty toilet over lays and toilet seat hinges in a few resident rooms and common bathrooms.
0.0
15.
Observed a few shower spray arms in bathrooms without proper backflow prevention since these arms can easily touch the shower floors when freely hanging. Either shorten the spray arms so that they do not reach the floor when freely hanging or provide approved backflow prevention devices on these shower arms.
0.0
16.
No hot water knobs were present at a few mop sink/can wash faucets. Also, no cold water was available at the laundry room mop sink faucet. Replace the hot water faucet knobs. Hot and cold running water under pressure must be maintained at all areas where water is required in sufficient quantities to carry out all operations...No hot water available at south dirty linen room handsink. Maintain hot running water at all times at this sink. Unplug the plugged drain in this sink.
1.0
17.
Observed one water fountain in hallway near main nursing home kitchen that did not have proper water pressure (water only dribbled out of fountain nozzle). Increase the water pressure at this fountain so that there is a tall arc of water when fountain is turned on.
0.0
21.
Observed a few uncovered trash cans in dumpster area that had some trash in them. Keep these cans of trash covered.
0.0
26.
During the phases of construction taking place in health care facility, frequently remove construction waste and old equipment from the establishment grounds to prevent insect or vermin breeding. Today observed old equipment, toilets, fixtures, etc. on outside establishment grounds. Establishment administrator stated these items are removed several times during the week.
0.0
28.
In dining room food service area, observed old cardboard boxes and old torn foil used to store food service items. Only use hard, durable, non-absorbent and easily cleanable containers/surfaces for storing food service items.
0.0
30.
Remove the spills, dust and old pills from interiors of a few medication carts. Clean the soiled exterior of a few med carts...Clean the soiled shelves where disposable medication and drinking water cups are being stored. Observed some water cups stored too high on med carts. Do not store these cups too high to prevent them from falling over. Consider keeping them in their original plastic sleeves until ready to use...In dining rooms, observed some plastic ware (plastic knives, spoons) stored with food contact sides up. Store them with handles up and presented to user.
1.0
32.
Repair the damaged doors/hinges on some cabinets in med rooms.
0.0
36.
Replace the cracked plastic shelf in east dining room domestic refrigerator.
0.0
42.
Observed mashed potatoes at 136F at north dining room steam table. Hot potentially hazardous foods shall be kept at 140F or above.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 12/17/2013
Score: 94
#
Comments
Points
2.
Remove the dust, debris and cob web accumulation from flooring in a few storage rooms.
0.0
3.
In common bathrooms, repair the damaged wall tiles. Replace the missing grout between tiles where needed...Repair the damaged wall surfaces in some storage rooms.
0.0
4.
Observed that lighting in various locations through facility was less than 10 foot-candles (fc)at 30 inches above floor (common areas, nursing stations, bathrooms, etc.). Lighting in all areas throughout establishment must be at least 10 fc at 30 inches above the floor.
0.0
5.
Clean the dusty ceiling vent grates and covers throughout the facility.
0.0
8.
Observed soiled interior bottoms of bathing tubs in a few common bathrooms. Also observed hair and debris accumulation on wheels/castors of some chair lifts in these rooms. Properly clean and disinfect tubs and wheels on bathroom fixtures and equipment...Replace/repair the rusty toilet over lays and toilet seat hinges in resident rooms.
1.0
12.
No soap was available at handsink in north/central hall utility room. Maintain soap at all handwashing sinks.
0.0
13.
Observed hot water in central common bathroom at 117F and 118F in north wing common bathroom. Hot water at all sink and bathing areas accessible to residents shall not exceed 116F.
0.0
21.
Remove the accumulation of leaves and small amounts of trash from ground around outside dumpsters/compactor...Observed that one cardboard dumpster has rusted through. Replace this dumpster.
0.0
28.
In storage rooms, found boxes and other items stored directly on floor. Elevate these items above the floor at least 8 inches to adequately clean under and around these items.
0.0
29.
No cold water available at mop sink/can wash off of central laundry room. Provide cold running water under pressure at this sink (along with hot water already available).
0.0
30.
Clean the soiled exteriors of medication carts...Observed disposable medication and drinking water cups being stacked high on medication carts. Do not store these cups too high to prevent them from falling over. Consider keeping them in their original plastic sleeves until ready to use.
1.0
32.
Clean the soiled furniture in resident rooms, common areas, etc. (seat cushions, under cushions, in sleeper sofa side areas under cushions, etc)...Repair the loose or damaged handles on a few cabinet doors in wing kitchenette areas...Clean (and disinfect) the soiled wall railings throughout facility. Remove dust and debris build-up from inside of railings.
1.0
34.
Observed soiled linens stored in a laundry cart that was labeled "clean linen". Do not store soiled linen in carts that are labeled for clean linen. Also, properly label soiled linen carts. Replace the damaged or torn linen carts.
1.0
35.
Observed patient care or consumable items stored on floor in a few storage rooms. Store these items at least 8 inches above floor to prevent contamination.
0.0
42.
Observed food delivered (from main kitchen) to one wing kitchenette at incorrect temperatures: okra at 110F, lima beans at 131F, and jumbalaya at 126F. These foods must be maintained at 140F or above during transport.
2.0
General Comments
NOTES about emergency water supply: The facility has a plan for obtaining water from US Foods in case of an interruption in the facility's water supply, if this company has the capacity to do so during an emergency...In 15A NCAC 18A .1313, the local health department shall be immediately notified if the primary water supply is interrupted for more than four hours. A plan must be available to obtain a backup water supply in the event that the water supplyis lost for more than four hours. The backup water supply plan shall provide for two liters of water per day per person for drinking. The backup water supply plan shall include a plan for either relocating residents or providing an alternative source of water for essential functions such as food preparation, hand washing, bathing, cleaning, dishwashing, laundry and disposal of bodily waste. The amount of water provided for uses other than drinking may be reduced if the plan includes alternatives for water use for services such as laundry and dishwashing. If an assessment determines that tap water is not to be used for drinking, sources shall be prominently labeled or hooded to restrict use and potable water shall be provided.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 12/14/2012
Score: 98
#
Comments
Points
42.
Opened and used single service milk cartons should not be replaced in service kitchen refrigerators for reuse at a later date. Opened single service milk cartons should be discarded after initial use. Ex: North Wing service kitchen.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 06/29/2010
Score: 97.5
#
Comments
Points
9.
Do not store patient contact/therapy items in bathroom for physical therapy room. Do not store clean linen cart in shower/bathroom for East wing.
0.5
24.
Ants are present in north servery kitchen. Have an approved professional pest control specialist treat this area.
1.5
43.
Thermometer was not present or in a visible location in east wing servery kitchen cooler.
0.5
General Comments
Use only water proof chairs in shower rooms. Ex: North wing shower room. Clean toilets and therapy tubs in shower rooms. Keep items like portable toilet inserts for shower chairs stored above the floor in shower rooms. Repair nonfunctional light in shower room for South wing. Regrout shower floor tile in same area. Keep patient contact items stored away from the splash of handwash sinks in medical supply rooms. Verify that all food product that has been removed from original packaging for latter service is properly labeled and dated in servery kitchen coolers. Ex: Fruits or ice cream. Staff food and drinks should always be labeled and be stored away from food product for clients in servery kitchens.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 04/13/2009
Score: 97
#
Comments
Points
3.
Repair loose base tile along shower and bathroom wall in north wing bathing room.
1.0
10.
Verify that all portable commodes and room urinal bottles are drained and cleaned immediately after use. Ex: Portable commode in north wing shower room and urinal bottle in private room in dementia wing.
0.5
19.
Clean dispensing chute for ice machine in dementia ward. Some residue present.
1.0
43.
Thermometer was not present or in a visible location in east wing servery kitchen cooler.
0.5
General Comments
Do not leave opened personal drinks in servey coolers. Opened drink bottles or cans could spill on and contaminate general food product for residents in cooler. Do not store can drinks in cabinets beneath sink drains in servery kitchens. Keep dry foods like chips in sealed containers after opening product packages in servery kitchens. Keep plastic spoons, knives, and forks in sealed platic wrap, bags, or containers in servery kitchen cabinets. Handles for plastic utensils must point out of containers. Mouth parts of these utensils should not be touched. Keep items like bed pans and commode inserts stored above the floor in main shower rooms. Clean floors beneath beds in resident rooms. Ex: East wing. Keep facility pets out of nursing station medicene and nutritional storage rooms. Repair whirlpool tub that has leaks. Ex: East wing shower room. Clean beneath shower/bathroom chairs in East Wing bathing room. Some mold growth was present.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 01/14/2008
Score: 97
#
Comments
Points
8.
Clean beneath rims of shower chairs in resident bathrooms Ex: Assisted living wing. Clean beneath pad on tub chair/platform. Ex: North wing shower room.
1.0
10.
Clean urinal bottles thoroughly in resident rooms. Keep bedpans stored above the floor in community bathrooms.
0.5
32.
Repair damaged bed frame in room 5611.
1.0
40.
Product like opened/used employee drink bottles should be stored away from food product for residents in servery kichen coolers. Ex: Assisted living wing. Recommend seperate storage in staff refrigerators. All foods brought by residents like milkshakes should be covered, labeled, and dated in servery refrigerators. Ex: Central wing. Do not replace opened containers of single service milk cartons back into servery kitchen coolers.Ex: Cental wing. Opened containers of product like thickened liquids should be kept covered, labeled, and dated in areas like med. room coolers. Ex: North wing.
0.5
General Comments
Foods like individual portions of chicken salad prepared in central kitchen and stored servery coolers should be properly labeled and dated. Opened product like pudding or apple sauce on nurses carts should be discarded immediately after shift/round is completed. Keep individual dry food snacks like cookies or cereal stored in sealed and labeled containers after product package is opened. Ex: Servery kitchen areas. Replace garbage dumpster with damaged lid. Keep lid on cardboard dumpster closed.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 01/18/2007
Score: 96
#
Comments
Points
8.
Clean tubs in main bathing rooms on hallways. Clean beneath shower chair in north hall bathing room. Some mold growth present. Repair leak at base of shower head in south hall bathing room. Clean cloth shower curtains in bathing rooms. Some curtains had mold growth at base.
1.0
19.
Clean top of ice machine in north hall dining room. Some dust present.
1.0
28.
Clean cabinet for food supplements by nurses station on north wing. Some residue was present in cabinet. Do not store boxes of single service utensils like plastic spoons in cabinets beneath sinks. Spoons should also be kept covered.
0.5
30.
Clean interior drawers on med. carts. Some residue was present around liquid medicene containers in drawers. Clean bins for utensils on top of carts.
1.0
43.
Thermometer was missing in refrigerator in dining room on north hall. Verify that all dining area refrigerators have functional thermometers
0.5
General Comments
Clean bathroom vent fans Ex: Individual private bathrooms on Assisted Living Wing.
Location: 200 W CORNWALL RD CARY, NC 27511-3802 Facility Type: Nursing Homes Inspection Date: 12/15/2005
Score: 98.5
#
Comments
Points
36.
Clean inside activity kitchen drawers and oven. Clean the containers before placing in drawers. Do not store food containers/pots under sink plumbing (RAL).
