Deficient Food Safety and Sanitation Practices in Dietary Services
Penalty
Summary
Surveyors observed multiple failures in food safety and sanitation practices within the facility's dietary department. Staff members operating the dishwashing machine were repeatedly seen handling soiled dishes and equipment with their bare hands, then immediately touching clean dishes and utensils without performing hand hygiene. This practice was observed with several dietary staff, including the cook and dietary aides, over multiple days. The dietary manager was present during some of these observations and did not intervene or remind staff to wash their hands between handling soiled and clean items. Staff interviews confirmed that they were trained on proper handwashing techniques and the facility's policies required handwashing after handling soiled equipment, but staff did not consistently follow these procedures. Additionally, the facility failed to ensure that cold liquids, such as milk, were held at the required temperature of 40 degrees Fahrenheit or below prior to serving to residents. During meal preparation, cartons of milk and other cold items were removed from refrigeration and placed on trays, where they sat in meal carts for at least fifteen minutes before being served. When the temperature of a milk carton was checked, it was found to be 63.2 degrees Fahrenheit, well above the required holding temperature. Further checks of milk stored in the refrigerator also revealed temperatures above the acceptable limit. The refrigerator used for staging food did not have a thermometer present during initial observations, and staff were unaware of its absence. Facility policies reviewed by surveyors clearly outlined the need for proper handwashing and temperature control of cold foods. The policies specified that staff must wash hands after handling soiled equipment and that cold foods should be maintained at or below 40 degrees Fahrenheit. Despite these policies and staff training, the observed practices did not align with the established procedures, resulting in noncompliance with federal food safety requirements.
Plan Of Correction
Specific Corrective Action To ensure staff completed hand hygiene between soiled dish handling and receiving of clean dishes when operating the dish machine, the dietary manager immediately educated all present dishwasher operators on proper hand hygiene and handling of dishes. On 7/31/2025, all kitchen staff that utilize the dishwasher attended an inservice training (Attachments Hand 1). On 7/18/2025, the dietary manager posted educational material near the dishwashing area to remind employees of the importance of proper hand hygiene and the correct way to handle clean dishes (Attachment J). To ensure liquids such as milk were held at a temperature of 40 degrees Fahrenheit and below prior to serving to residents, the dietary manager immediately discarded all beverages deemed outside the proper temperature range during the survey and replaced them with beverages at the proper temperature. The staff member present was educated on when beverages should be placed on the cart and a cool housing was provided to hold beverages before placing on a tray or serving to the residents. The dietary manager also checked that all of the coolers had a thermometer. On 7/18/2025, the dietary manager went over the Taste and Temperature Control Policy with the staff (Attachment K). On 7/31/2025, the dietary manager held an inservice on proper holding temperatures for hot and cold items (Attachments L. and M). Method to Assess Other Residents All residents of this facility have the potential to be affected by these practices. The facility's dietary manager or designee will conduct random weekly inspections to ensure policies and procedures are being followed. Systematic Review Onboarding education for new dietary staff has been updated to include an emphasis on these practices. Annual education of existing staff will stress hand washing procedures and proper holding temperatures. Quality Assurance Dietary Manager or designee will be responsible to ensure compliance of the process to the Administrator. Results of random inspections will be reviewed by the Risk Management/Quality Assurance Committee until such time that consistent substantial compliance has been achieved as determined by the committee. Findings of this process will be discussed with the Resident Council.