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K0324
E

Failure to Conduct Semi-Annual Kitchen Exhaust Hood Cleaning

Erie, Pennsylvania Survey Completed on 01-23-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that kitchen exhaust hood cleanings were conducted at the required semi-annual intervals. During a document review on January 23, 2025, it was revealed that there was a lack of documentation indicating that the kitchen exhaust hood cleaning had been performed as required. An interview with the maintenance supervisor on the same day confirmed that the semi-annual kitchen hood cleaning had not been conducted within the required time frame.

Plan Of Correction

A semi-annual kitchen exhaust hood cleaning will be scheduled no later than February 14, 2025. Education was provided to the Maintenance Director by the Administrator on January 24, 2025 regarding kitchen semi-annual exhaust hood cleaning. An audit will be completed no less than quarterly by the Maintenance Director to ensure that the semi-annual kitchen exhaust hood cleaning is completed and will be monitored by the Administrator. Results of the audit will be presented at the quarterly QAPI meeting and recommendations will be implemented.

See complete original report
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