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

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See other F0812 citations
Kitchen sanitation, food safety, and temperature monitoring 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

The facility failed to keep the kitchen hood clean, removed moldy cantaloupe from storage only after it was observed, allowed a staff drink to be stored in the kitchen freezer, and observed an employee washing hands for only four seconds with visible substance still on the arm before serving food. Food and refrigerator temperature logs were incomplete, and the activities refrigerator was found with condensation, black buildup, and temperatures above the safe range while the AD reported freezer temperatures were not being checked.

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.
Unsanitary Kitchen Food Storage and Handling
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

Unsanitary food handling and storage conditions were observed in the main kitchen. Food was stored under pipes with ice buildup dripping onto items, several meat packages were left unsealed, cereal drawers were open, a foam cleanser sat on a prep table with food, rotten bananas were present, melted butter was left uncovered, a bag of buns touched the floor, and the Dietary Supervisor entered without a hair restraint or beard guard.

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 and Ice Machine 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 items in the walk-in cooler were found with expired use-by dates, missing labels or dates, and signs of spoilage, including discolored lettuce and opened cheese products left improperly stored. Surveyors also observed pink and brown substances on the kitchen ice machine baffle above the ice trough. The Head [NAME] acknowledged the storage issues and that the ice machine needed cleaning, while the DDM and Administrator stated that food labeling, dating, spoilage checks, and ice machine sanitation were expected.

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.
Dishwasher Temperatures Not Monitored
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

Dishwasher temperatures in the main kitchen were not monitored to required levels. The log showed repeated wash and final rinse temps below the required range, and during observation the dish machine again ran below spec, with the wash cycle reaching 143 degrees and then 141 degrees and the rinse cycle reaching 177 degrees before not registering. The dining supervisor and food service unit supervisor both stated staff had not notified them about the low temps, despite staff saying they were supposed to record the readings and report out-of-range temps.

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.
Dishwasher Rinse Cycle Failed to Reach Required Sanitizing Temperature
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

Dishwasher Rinse Cycle Failed to Reach Required Sanitizing Temperature: The facility failed to ensure 1 of 1 dishwasher reached the required high-temp rinse range. During observation, the wash cycle reached 153°F and the final rinse reached 150°F, below the posted 180-195°F requirement. The CD confirmed the machine should reach 180°F, and the temp log showed multiple rinse cycles below 180°F with no indication of correction.

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 Sanitation and Food Labeling 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 Sanitation and Food Labeling Failures: Surveyors observed a fryer, toaster oven, wall behind the dishwashing station, and hot holding trays/cookie sheets with heavy grease and grime buildup. Multiple canned goods, pantry snacks, prepared gravy, and prepared pureed chicken were also found without required use-by or expiration dates. Dietary staff and ADM stated staff were responsible for cleaning, labeling, and dating food items, but several items were left undated and the dietary mgr was unavailable.

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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