Deficiency in Cold Food Temperature Monitoring
Penalty
Summary
The facility failed to ensure that food was stored, prepared, distributed, and served in accordance with professional standards for food service safety. During a kitchen observation, it was noted that the facility did not monitor the temperature of cold food items such as sandwiches, potato salad, and pudding at the time of meal service. The facility's policy requires that cold foods be maintained at a temperature of 41 degrees Fahrenheit or below, except during necessary periods of preparation and service. However, there was no documented evidence that cold food temperatures were taken during the meal service. Interviews with the Executive Chef and Registered Dietitian revealed that cold food temperatures were not routinely obtained because the food was held in the refrigerator, and the refrigerator temperature was used as a proxy. However, when tested, the temperatures of several food items not stored in the refrigerator were found to be above the required range, with a tuna sandwich at 50 degrees Fahrenheit, a ham sandwich at 48 degrees Fahrenheit, potato salad at 48 degrees Fahrenheit, and pudding at 50 degrees Fahrenheit. The Executive Chef acknowledged that these temperatures posed an increased risk of foodborne illness. The General Manager of the vendor company providing dietetic services confirmed that cold food should not exceed 41 degrees Fahrenheit and should be held on a bed of ice if not refrigerated, indicating a potential for harm if these standards are not met.
Plan Of Correction
Plan of Correction: Approved January 10, 2025 I. The following actions were accomplished for the residents identified in the sample: No residents were identified in the Statement of Deficiencies. On 12/4/24, any cold food items that were above 41F degrees were removed from trayline and replaced with new product. The Food Service Director and RDO toured the kitchen to identify any other food item temperature concerns. No other items were identified. II. The following corrective actions will be implemented to identify other residents who may be affected by the same practice: All residents have been identified as potentially being affected by the same practice. Effective 12/4/24, in-service education was provided to Dietary Staff and RDs related to cold food holding procedure on trayline and monitoring of cold food temperatures at every meal. This education included monitoring cold food temperatures on the trayline at each meal, and procedures for holding cold food that is not being held in a refrigerated unit, including holding food on ice or using ice blankets. III. The following system changes will be implemented to assure continuing compliance with regulations: The Director of Food Service reviewed and revised, as needed, the Food Service policies and procedures related to monitoring of cold food temperatures at mealtimes and holding of cold foods on trayline. Effective 12/4/24, the Director of Food Service/Designee will implement a system of holding all cold food items on tray line in refrigerator unit, or on other cold source including ice or ice blankets, and monitoring of cold food temperatures at every meal on a temperature log sheet to ensure cold food temperatures are being held appropriately and remain 41F degrees and below daily for 4 weeks, weekly for 2 months, then quarterly. Corrective action, including staff re-education, will be implemented as necessary. The Staff Educator/Director of Food Service/Designee will provide additional education to all dietary staff whenever issues related to holding, monitoring and recording of cold food temperatures are identified. The Director of Food Service will review findings with the Administrator monthly for three months then quarterly. Effective 12/4/24, the Food Service Director/Designee will monitor cold food holding and monitoring and recording of cold food temperatures daily for 4 weeks, weekly for 2 months, then quarterly. Corrective action, including staff re-education, will be implemented as necessary. The Staff Educator/Director of Food Service/Designee will provide additional education to all food service workers whenever issues related to cold food holding and monitoring and recording of cold food temperatures are identified. IV. The facility’s compliance will be monitored utilizing the following quality assurance system: The facility will develop an audit tool to monitor compliance with cold food holding on cold source and monitoring and recording of cold food trayline temperatures on temperature log during meal service. The Director of Food Service/Designee will conduct monitoring of cold food holding and monitoring and recording of cold food temperatures monthly for three months then quarterly for the next three quarters. The Director of Food Service/Designee will conduct competency evaluations of all Food Service workers to ensure they are following established protocols and have a clear understanding of the protocols. On-site education will be provided as necessary to ensure staff compliance. Competency evaluations will be conducted on all new Food Service Workers upon completion of orientation and twice yearly thereafter. The Food Service Supervisor/Designee will report cold food holding and monitoring and recording cold food temperatures audit findings to the QAPI Committee monthly for the next 3 months then quarterly for the next 3 quarters. At the end of the fourth quarter, a decision will be made by the QAPI Committee regarding the need to continue auditing and at what frequency. Additional corrective action will be implemented as deemed necessary by the QAPI Committee. Completion Date: 01/31/2025 Responsibility: Director of Food Service