Failure to Manage Garbage Resulting in Blocked Exit Routes
Summary
The facility failed to ensure proper disposal and management of garbage, resulting in a significant accumulation of trash at the back of the building that obstructed exit routes. A community-reported complaint to the Rhode Island Department of Health alleged that large amounts of trash were blocking the entire back side of the facility, including exit doors used as fire exits. Photographs from the complainant showed multiple black and white trash bags, including bags containing yellow personal protective gowns, piled along the back entrance shared with the main kitchen. The garbage covered the entire platform surface, extended to the ground below, and blocked the exit ramp, with multiple large garbage bins filled to capacity. Interviews and record review revealed that the contracted garbage removal company had placed services on hold after non-payment by the facility, with the last pickup occurring in late November and not resuming until early January. The representative from the garbage removal company confirmed that weekly Thursday pickups had been suspended due to non-payment. The Assistant Director of Maintenance acknowledged that garbage had not been picked up during this period and confirmed that the photographs accurately depicted the accumulation of garbage and blocked exit routes. The Administrator also acknowledged the photographs showing the large accumulation of garbage at the back entrance. When the surveyor later observed the back entrance, no garbage accumulation was present and exit routes were unobstructed, leading to a determination of past noncompliance.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
Improper Garbage Containment and Disposal: An outdoor dumpster had no lid or cover and was overflowing with garbage during an observation with the NHA. The facility failed to properly contain and dispose of refuse in the trash receptacle.
Improper Dumpster and Grease Refuse Area Sanitation: Surveyors observed trash debris around dumpsters, a heavy greasy buildup on the oil/grease refuse container, and a large fly concentration near the refuse area. Staff said Maintenance and Housekeeping shared responsibility for keeping the area clean, but the area was not maintained free of litter and attractants. Flies were also observed in the kitchen and a resident reported flies in his room, while residents in Council reported flies landing on food and disturbing sleep.
The facility failed to keep kitchen garbage sealed when three garbage cans that were not in active use were observed uncovered during repeated kitchen observations. The Administrator verified the cans should have been covered, and the facility policy required garbage containers to have tight-fitting lids and remain covered when stored or not in continuous use. The issue was cited as non-compliance affecting residents who received food from the kitchen.
Improper Garbage and Refuse Disposal: A green dumpster was observed with its door open behind an open gate, trash was scattered around the area, and two uncovered blue barrels contained tied bags of linens. A second large dumpster was filled to the brim with boxes and debris, with a wheelchair, pallets, and a mattress nearby. The ADM and Maintenance Director acknowledged the area was not secured or kept clean, and the facility stated it did not have an official waste management policy.
Improper dumpster waste disposal and unsanitary dumpster area: The dumpster area had a large puddle of green, foul-smelling water under the dumpsters, one dumpster was overflowing with trash and could not be closed, and a kitchen staff member threw an empty box onto the puddle. Later, a bag of trash was left on the ground next to the dumpsters. The MS, DS, and ADM stated the area should remain clean and the dumpster lids should stay closed.
Uncovered Garbage Can in Kitchen: A large gray garbage can on wheels was observed halfway under the dirty dish counter without a lid, and it was 1 of 2 garbage cans observed in the kitchen. The Kitchen Manager stated she did not know the can needed to be covered and believed it was acceptable to store it under the counter without a lid.
Improper Garbage Containment and Disposal
Penalty
Summary
The facility failed to properly contain and dispose of garbage in one outdoor dumpster. During an observation and interview with the Nursing Home Administrator, the dumpster was found to have no lid or cover and was overflowing with garbage. The deficiency was cited because the facility did not properly manage the outdoor trash receptacle to prevent the potential for rodent and insect infestation.
Improper Dumpster and Grease Refuse Area Sanitation
Penalty
Summary
The facility failed to keep the Dumpster/Oil & Grease Refuse Area clean and free of debris. On 6/22/2026, surveyors observed small particles of trash around the two dumpsters, including a balled-up piece of aluminum foil, a piece of a clothes hanger, and a small bottle with an eye-dropper. In the same area, there was a concentration of about 30 to 40 flies in a small grassy section within the pavement near the dumpsters. The Dietary Supervisor stated Maintenance was responsible for maintaining the area and said Maintenance rinsed the dumpster area daily. Surveyors also observed a build-up of greasy particles on the outside of the oil/grease refuse container. The build-up was around the top opening of the container and extended to the top of the opening's cover, measuring approximately two inches. The Dietary Supervisor stated the build-up should be washed down when the dumpsters were washed down, which should be daily or as needed, and said it did not appear the oil/grease refuse container had been washed daily when observed. The facility's pest control records showed fly treatment was last documented on 02/18/2026, despite later records dated 04/29/2026 and 06/08/2026. During the survey, a fly was observed in the kitchen on the plate lowerator, and later flies were observed flying in the kitchen during meal preparation and trayline activity. RI #8 complained of flies in his room, and during Resident Council, residents reported flies landing on food and waking them while sleeping. Staff interviews confirmed flies were present near the dumpsters and that the area could allow flies to enter the building.
Uncovered Kitchen Garbage Containers
Penalty
Summary
The facility failed to ensure kitchen garbage was sealed. During an initial kitchen tour, three garbage cans that were not actively in use were observed uncovered. The Administrator verified that the three kitchen garbage cans were not actively in use and should have been covered. On two later observations, three garbage cans that were not actively in use were again verified as uncovered. Review of the facility policy titled Garbage and Rubbish Disposal stated that all garbage containers shall be provided with tight fitting lids and must be kept covered when stored or not in continuous use. The deficiency was cited as non-compliance under Complaint Number 3053748 and was identified as affecting 47 of 47 residents who received food from the kitchen.
Improper Garbage and Refuse Disposal
Penalty
Summary
The facility failed to dispose of garbage and refuse properly for 2 of 2 dumpsters reviewed. During observation, one green garbage dumpster was seen with its door open behind an open white and metal gate, with trash scattered on the ground in front of it. Two large blue plastic barrels were uncovered and contained tied clear plastic bags that appeared to hold linens. Nearby, there was a broken white PVC shower chair, and outside the gate there was a dilapidated red shed that was open in front, missing part of its roof, filled with what appeared to be water-damaged materials, and leaning to one side. A second dumpster, described as approximately 40 feet long, was observed filled to the brim with cardboard boxes piled behind it and in the grass behind it. A black wheelchair was folded in front of the dumpster, a stacked pile of wooden pallets was on the side, and there were white plastic bags, debris, and a gray and navy-blue mattress around it. The Administrator stated the waste management company had already come and was scheduled to return later in the week, could not recall the exact day, and did not know why the green dumpster door was open, why trash was on the ground, or why the blue barrels were uncovered. The Maintenance Director said the gate should have been closed, the barrels should have been covered or emptied, and the trash area needed to be kept clean. Record review showed the haul-off dumpster was last serviced on 06/01/2026, and the facility stated it did not have an official waste management policy.
Improper Dumpster Waste Disposal and Unsanitary Dumpster Area
Penalty
Summary
The facility failed to ensure the trash bins were properly covered and kept in sanitary receptacles in accordance with its policy and procedure titled, Sanitation and Infection Control: Waste Control and Disposal. During an observation on 6/23/26 at 11:57 AM, the dumpster area had a large puddle of green, foul-smelling water pooled underneath the dumpsters. One of the two dumpster bins was overflowing with trash and the lid was unable to close. During a later observation on 6/23/26 at 1:45 PM, a kitchen staff member was observed throwing an empty box labeled Apple Juice Base onto the puddle of green, foul-smelling water in the dumpster area and then walking away. During interviews on 6/23/26, the Maintenance Supervisor stated the dumpster area was supposed to remain clean and the dumpster lid should remain closed to prevent attracting pests, and said the green, foul-smelling puddle had been an ongoing issue for two months. The Dietary Supervisor stated it was not convenient or sanitary for kitchen staff to step into the puddle each time they had to throw trash into the dumpsters and that doing so posed a sanitation issue and risked tracking disease into the kitchen. During another observation on 6/26/26 at 1:51 PM, a large bag of trash was observed on the ground next to the dumpsters. The Administrator stated the trash should have been placed in the dumpster because it was unsanitary to leave trash on the ground.
Uncovered Garbage Can in Kitchen
Penalty
Summary
The facility failed to ensure garbage cans were properly covered with lids in the kitchen to minimize attracting pests and rodents. During observation, a large gray garbage can on wheels was seen halfway under the dirty dish counter without a lid, and this was identified as 1 of 2 garbage cans observed in the kitchen. The deficiency was cited under U.S. Food and Drug Administration 2022 Food Code 5-501.113, Covering Receptacles, which requires refuse receptacles inside the food establishment to be kept covered when they contain food residue and are not in continuous use or after they are filled. During interview, the Kitchen Manager stated she did not know the garbage can needed to be covered and said she believed it was acceptable to store it under the counter without a lid.
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