Failure to Maintain and Properly Clean Essential Equipment
Penalty
Summary
The facility failed to maintain essential equipment in a safe and operable condition as required by its policies and federal regulations. In Medication Room A, a leaking sink faucet was observed, with water pooling at the base and visible discoloration on the sink strainer and surrounding area. Both the RN and DON confirmed the ongoing leak and associated staining, and the Director of Maintenance acknowledged that the issue could have been addressed if it had been reported by nursing staff. In the main kitchen, the ice machine was found to have black particles on the deflector and grooves, despite records indicating recent cleaning by both an outside vendor and facility staff. The Director of Maintenance confirmed that dietary staff were not using the manufacturer-recommended cleaning and sanitizing products for the ice machine bin and exterior, contrary to both facility policy and manufacturer instructions. Additionally, significant ice build-up was observed in the walk-in freezer in the main kitchen, the freezer in the satellite kitchen, and the freezer of the refrigerator used for residents' food brought from outside. The Culinary Director and Director of Maintenance attributed the ice build-up in the main kitchen freezer to a faulty door, which was pending replacement, and cleaning logs indicated regular cleaning, though the issue persisted. The facility also failed to ensure that food temperature measuring devices were properly calibrated. During an observation, a Dietary Aide was seen incorrectly calibrating a digital thermometer, and the CDM confirmed the calibration was not performed according to manufacturer instructions. The thermometer was subsequently used to check food temperatures, raising concerns about the accuracy of temperature monitoring. These failures collectively demonstrate lapses in equipment maintenance, cleaning, and calibration protocols as outlined in facility policies and relevant regulatory standards.