Food Storage, Temperature Monitoring, and Cross-Contamination Failures
Summary
Sanitary conditions in the kitchen and food storage areas were not maintained. During the initial tour, surveyors observed missing floor tiles at the kitchen entry, flaking paint on multiple ceiling areas including above the handwashing sink, three flies in the kitchen, an open tub of butter beside an open bag of biscuits, and food waste on the floor. In the pantry, an opened package of spaghetti had no date, flour was scattered on a container, floor, shelves, and a transport cart, and the spice drawer contained 16 open spice containers that were not dated. Several spices were expired, including smoked paprika, thyme, and pumpkin spice. Dietary staff stated that cooks were responsible for dating opened items and discarding expired items, and that the night cook had gone through the spice drawer the prior night. Food preparation and holding practices were also inconsistent with required temperature monitoring. Surveyors observed heating table temperatures were not checked or recorded while foods were being held for residents, and no food temperatures were checked before service. The rice was temperature checked before being pureed, but not after preparation, and no temperature was documented for meals served on multiple days. The temperature logs showed no recorded temperatures for mechanical soft or pureed meals on several dates, and one supper meal had a main entree at 50 degrees, vegetables at 40 degrees, and dessert at 80 degrees. Staff interviews confirmed that pureed and mechanical soft foods should have been temperature checked after preparation and before serving, and that cold items such as tuna salad should not be served above 41 degrees. Unsafe food handling was directly observed during meal preparation and service. One dietary employee chopped lettuce, coughed into her shirt while holding it with a gloved hand, and then returned to chopping without hand hygiene or changing gloves. The same employee used a knife that had been used on chicken to open plastic wrap on a barbeque sauce bottle and then resumed chopping chicken without washing or changing knives. Another dietary employee delivered a cheeseburger to a resident without checking its temperature, and the resident and spouse reported that it was cold. Residents also reported that hot food was often not hot and meats were often cold when served. Staff interviews confirmed expectations for hand hygiene after coughing, changing gloves, and avoiding cross-contamination with utensils used for food preparation.
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