F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F

Food Storage, Sanitation, and Hair Restraint Failures in Dietary Services

Bertram Nursing And RehabilitationBertram, Texas Survey Completed on 11-26-2025

Summary

Surveyors identified a deficiency in the facility’s food service operations related to improper storage, labeling, dating, sanitation, and handling of food items in the kitchen. During an initial kitchen tour, surveyors observed a pan of raw chicken in the walk‑in refrigerator covered with plastic wrap but lacking any label or dates indicating when it was pulled to thaw or when it should be used. In the same tour, a reach‑in refrigerator contained a dried, crusted yellow substance covering the entire bottom, indicating it had not been cleaned as expected. In the canned food storage room, multiple cans of pineapple chunks and chocolate pudding had severe dents near the lip and sides, including one can with a finger‑deep dent and sharp points, and these cans were stored with regular stock rather than in a separate dented‑can area. In dry storage, a box of sweet potatoes marked with a date that represented the received date contained spoiled product with large black areas, white fuzzy patches, and gnats throughout the potatoes. On the bread and miscellaneous items rack, surveyors found multiple 12‑count bags of hot dog buns with a best‑by date that had already passed, as well as additional bags with no visible date at all. Four large opened bags of chips, including one in a clear zip‑seal bag, had no open date or use‑by date. A cook stated that the bread rack was supposed to be checked every three days for expired items and that all items on the rack and in the refrigerator should be labeled with item identification and dates, but acknowledged that the rack likely had not been checked since several days prior and began discarding some of the obviously stale buns during the observation. The cook also stated that dented cans were supposed to be set aside and not kept with usable cans, and that the reach‑in refrigerator was expected to be cleaned weekly, but she could not identify the yellow substance in the bottom of the unit. Surveyors also observed failures in personal protective practices and ongoing food quality control. A cook with a quarter‑inch beard was seen preparing desserts and assisting with plating meal trays while wearing a hairnet but no beard guard. He later stated that the expectation was for dietary staff to always wear hairnets and beard guards in the kitchen, and that hairnets and beard guards were normally stocked on a kitchen window shelf but were not readily available at the time, which he said contributed to him forgetting to put one on. The dietary manager confirmed his expectation that dented cans be removed from regular stock and placed in a designated area for return, but the cart he used for dented cans had no clear identification. He also stated that items in refrigerators should be marked with open or pulled dates and use‑by dates, and that sanitation of kitchen equipment and refrigerators was to occur daily and every shift. On a follow‑up observation, surveyors found that several bags of hot dog buns with a best‑by date that had already passed remained on the bread rack next to fresh bread, and the buns were hard and stale. When questioned, the dietary manager reported being told that a best‑by date was different from an expiration date and that it was up to the facility when to discard such items, and he left the stale bread on the rack. The facility dietitian later stated that bread should not be kept much longer than about a week past its best‑by date, that she would not want residents to receive stale bread, and that staff should pay attention to color, texture, and smell and discard items that feel stale or show spoilage. The dietitian and the administrator both stated expectations that food items be labeled and dated with received, opened, and use‑by dates, that frozen items pulled to thaw be dated, that dented cans be separated and returned, that refrigerators and equipment be cleaned daily and as messes occur, and that dietary staff always wear hairnets and beard guards. Facility policies and FDA Food Code excerpts reviewed by surveyors required opened foods to be labeled and dated, dented cans to be stored separately and not used, perishable foods to be used within specified time frames, frozen items thawed under refrigeration and dated, and dietary staff to wear hair restraints, all of which contrasted with the observed practices in the kitchen.

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Resources

Below are regulatory guidelines relevant to this citation:

See other F0812 citations
Unsafe Food Storage and Dishwashing Practices
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Unsafe Food Storage and Dishwashing Practices: Surveyors observed dented cans in dry storage, a walk-in freezer at 10 F with ice cream, buns, and popsicles soft or showing signs of melt/refreeze, and a handwashing sink trash can that required hand contact to open. Staff were seen carrying used paper towels across the kitchen to overflowing trash cans, and a Dishwasher moved between dirty and clean dish tasks, handled cigarettes in a puddle, and unloaded clean items without changing gloves or performing hand hygiene. The DON/Administrator and Dietary leadership acknowledged the concerns during interview.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Kitchen Food Storage and Sanitation Failures
E
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Kitchen staff failed to follow food storage and sanitation standards when unlabeled, undated food items were found in the walk-in freezer and refrigerator, an uncovered garbage can was observed next to the prep table, and a DC was not wearing a hair restraint over his mustache area. Staff interviews confirmed that labeling, dating, covering the garbage can, and wearing hair restraints were expected responsibilities, and facility policies required covered, labeled, and dated refrigerated and frozen foods as well as proper personal cleanliness in food prep areas.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Food Storage, Labeling, and Hand Hygiene Failures
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Food storage, labeling, and sanitation practices were not followed in the kitchen. Sanitizer buckets tested outside the manufacturer range, numerous prepared and packaged foods were found unlabeled, missing open or use-by dates, or expired across multiple storage areas, and a cook handled raw chicken with contaminated gloves after touching a speaker without removing the gloves or performing hand hygiene.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Improper Hair Restraints During Food Preparation and Service
E
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Improper Hair Restraints During Food Preparation and Service: Kitchen staff were observed serving and preparing meals without properly covering all hair. One staff member wore a beanie that left braids uncovered while assisting with the noon meal, and another wore a headband with hair uncovered while preparing the noon meal. Interviews confirmed staff understood hair restraints were required to keep hair out of food, and the facility policy required all employees in food prep areas to wear a hairnet or hair covering.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Unsafe Food Storage in Kitchen and Nourishment Room Freezer
D
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Unsafe food storage was identified in the main kitchen and in 1 of 2 nourishment rooms. The walk-in freezer had no stand-alone thermometer, and the 300 Hall nourishment room freezer registered 30 degrees Fahrenheit with 7 thawed ice cream bars stored inside. The Kitchen Manager acknowledged the missing thermometer and confirmed the thawed items.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Food Storage, Labeling, and Kitchen Sanitation Deficiencies
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Food storage, labeling, and sanitation deficiencies were observed in the kitchen and a serving kitchenette. Undated and unlabeled food items were found in refrigerators and freezers, milk was present past its best-by date, food debris and sticky residue were noted in freezer areas, a ceiling vent was dirty, and cooks with beards were observed without beard nets. The DD verified the findings, and staff stated items past date should be discarded and food items should be labeled and dated when stored.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
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