Clara's Cottage # 2

Facility Information

License Number: FCL-012-043
Site Address: 5824 Holland Street
Morganton, NC 28655
County:Burke
Capacity: 6 Beds

Statement of Deficiencies

Statements of Deficiencies (form used by the state to document inspections) are posted for adult care facilities with survey dates beginning November 1, 2014 and deficiencies or violations were identified.

Inspection TypeDocument TypeInspection DatePages
ACLS Annual and Follow-up No Deficiencies Cited 10/28/2015
ACLS Follow-up Statement of Deficiency 5/19/2015 3
ACLS Complaint and Follow-up Statement of Deficiency 3/13/2015 47
ACLS Annual Statement of Deficiency with Plan of Correction 12/12/2014 7
ACLS Annual Statement of Deficiency 12/12/2014 6
Constr Biennial Statement of Deficiency with Plan of Correction 5/10/2016 5
Constr Biennial Statement of Deficiency 5/10/2016 5

Star Rating

Star Ratings are based on the results of DHSR inspections and some inspections by the County Department of Social Services (DSS).

StarsScoreIssue DateMeritsDemeritsInspection Type 
Three Stars (3) 96 12/22/2015 6 0 Annual View Worksheet
One Star (1) 77.5 6/9/2015 8.75 0 Follow-up View Worksheet
(ZERO STARS) (0) 68.75 4/6/2015 1.25 21 Complaint View Worksheet
Two Stars (2) 88.5 1/8/2015 2.5 4 Annual View Worksheet
Three Stars (3) 93 4/10/2014 7.5 0 Follow-up View Worksheet
Two Stars (2) 85.5 2/11/2014 3.5 18 Annual View Worksheet
Four Stars (4) 100.5 9/18/2012 0 2 Complaint View Worksheet
Four Stars (4) 102.5 2/9/2012 2.5 0 Annual View Worksheet
Three Stars (3) 100 2/6/2009 0 0 Annual View Worksheet

Penalties

Penalties imposed during the last 36 months are listed.

Penalty Issued DatePenalty AmountPenalty TypeReason for IssuanceCurrent StatusAmount PaidDate of Payment
Rule CitedNature of Violation
8/18/2014 $1,000.00 Type A2 10A NCAC 13G .0317 (d) Building Service Equipment; G.S. 131D-21 (2) Declaration of Residents' Rights Facility failed to ensure the hot water temperatures at all fixtures used by residents were maintained at a safe temperature no greater than 116 degrees (F) Paid in Full $1,000.00 9/2/2014
8/20/2015 $1,000.00 Type A2 10A NCAC 13G .1206 Health Care Personnel Registry; G.S. 131D-21 (4) Declaration of Residents' Rights Facility failed to protect residents by not reporting and investigating allegations of abuse, neglect and drug diversion to the Health Care Personnel Registry for one former staff. (collection letter sent 7/8/16) 8/24/2016 & 12/30/2015 Settlement Agreement for $500.00; Appealed 09/14/2015