Failure to Ensure Kitchen Staff Wore Hair Restraints During Food Service
Penalty
Summary
A deficiency was identified when a dietary aide was observed in the kitchen emptying food from residents' plates without wearing a hairnet. The aide admitted to forgetting to put on a hairnet and acknowledged that it should have been worn to prevent hair from contaminating the food. This observation was made during a survey and was confirmed through an interview with the dietary supervisor, who stated that all kitchen staff are required to wear hairnets while in the kitchen to prevent hair from landing on food. A review of the facility's policy and procedure on food handling practices indicated that staff are expected to practice good personal hygiene, including the use of appropriate hair restraints during any food service activities such as cooking, preparing, and assembling food. The failure to follow these sanitary requirements had the potential to contaminate clean surfaces, food preparation areas, and food served to all 117 residents in the facility.
Plan Of Correction
How corrective actions will be accomplished for those residents found to have been affected by the deficient practice: On July 10, 2025, a hairnet was immediately provided to Dietary Aide (DA) 1, who resumed duties only after becoming compliant with the facility's hairnets policy. On the same day, DA 1 was given a 1:1 re-education regarding the requirement to wear hairnets while in the kitchen. How the facility will identify other residents having the potential to be affected by the same deficient practice: All residents who received meals prepared in the facility's kitchen were identified as potentially at risk due to this deficient practice. On July 11, 2025, a full observation of kitchen staff was conducted by the Registered Dietitian (RD) to ensure that all staff were wearing appropriate hairnets. No additional non-compliance was noted. What measures will be put into place or what systematic changes the facility will make to ensure that the deficient practice does not recur: On July 11, 2025, all dietary staff received mandatory in-service training on proper personal hygiene and sanitation practices, including the importance of wearing hair restraints and following infection control procedures during all aspects of food preparation. Ongoing Observations: The Dietary Supervisor or designee will conduct observations of kitchen staff for compliance with hairnet use: daily for 3 consecutive days, then weekly for 2 weeks, then monthly thereafter. How the facility plans to monitor its performance to make sure that solutions are sustained: The Dietary Supervisor and Facility Administrator will review results from ongoing kitchen staff observations to ensure adherence to food safety protocols. Kitchen staff observation results and compliance trends will be reported to the QAPI committee monthly. The QAPI Committee will monitor and evaluate compliance for a minimum of 3 months, or until 100% compliance is achieved and sustained. How corrective actions will be accomplished for those residents found to have been affected by the deficient practice: Immediate Action: On 7/10/25, cease all kitchen operations and food preparation. Facility leadership and the infection control team were promptly notified on 07/10/2025. On 7/10/25, posted visible signage: KITCHEN CLOSED for SANITATION. Starting on 7/10/25, all resident meals were catered from outside services.