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F0812
E

Improper Food Labeling, Storage, and Hand Hygiene in Dietary Services

Chicago, Illinois Survey Completed on 11-26-2025

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.

Summary

The deficiency involves the facility’s failure to ensure proper food procurement, storage, labeling, dating, and hand hygiene practices in the kitchen. During an initial kitchen tour, the surveyor and the Dietary Director observed that dry storage food items were generally labeled with orange stickers indicating delivery dates, but multiple boxes of bananas had no delivery date labels. The bananas in two of these boxes were described as yellow with black spots and emitting a noticeable odor through the surveyor’s surgical mask. The Dietary Director confirmed that the boxes should have been dated and acknowledged that staff had not labeled them. In the walk-in cooler, the surveyor observed a tray of pre-cut salmon pieces under a clear plastic cover with no label or date, and two trays of cod (one plain and one with butter and dill) without any labels or dates. A deep stainless-steel pan of chicken in liquid and an opened package of sausage bratwurst were labeled with preparation and discard dates, but both were past their discard dates. On a follow-up kitchen tour, the surveyor again observed the same two boxes of ripe bananas with yellow peels and numerous black spots still on the dry storage shelves. The cook stated that one case would be discarded and the other used for smoothies in a chef demonstration and explained that staff determine how long food is good by referring to posted storage life guidelines. A third box of bananas, described as green/yellow, had arrived that morning but also lacked a delivery date label. When the Dietary Director opened one of the older banana boxes at the prep table, some bananas were found with split peels exposing the flesh and were discarded into the garbage; the Dietary Director again confirmed that the box had not been labeled or dated. The facility’s written policy on dry storage life of foods requires use of manufacturer expiration dates or, if absent, adding specified storage times to the date the food is received, and instructs that products be discarded when quality is unacceptable. The surveyor also observed multiple instances of improper hand hygiene by the cook during preparation of pureed sloppy joe sandwiches for residents on puree diets. The cook washed hands several times at the kitchen handwashing station, but each observed handwashing episode lasted less than 20 seconds, despite the cook’s verbal description of the correct procedure as including 20 seconds of lathering. The cook washed hands briefly, donned gloves, handled bread buns, ladled heated milk over the buns, touched the milk-soaked buns with gloved hands, removed gloves, and repeatedly moved between tasks such as checking milk on the stove, wiping the prep table with a sanitizing towel while gloved, and returning to food preparation, with each handwashing episode again documented as under 20 seconds. The facility’s handwashing policy requires staff to wash hands whenever they become soiled or contaminated, upon entering or returning to the kitchen, before food preparation, when switching between raw and ready-to-eat foods, during food preparation as often as necessary to prevent cross-contamination, and when changing gloves, and specifies that hands should be scrubbed following appropriate techniques. The Assistant Dietary Director later confirmed that kitchen staff are expected to wash hands every time they change tasks, after using the bathroom, or after touching door handles, and to wash for 20 seconds to remove germs, stating that washing for less than 20 seconds could allow germs to be carried to the next task. The Assistant Dietary Director also stated that fresh fruit items must be labeled with the date received and a discard date, and that all leftover prepared foods stored in the kitchen must be labeled with the date and time prepared, discard date and time, and staff initials. The Assistant Dietary Director explained that if ripened bananas with opening peels are kept past their discard date, bacteria can grow and the odor can attract fruit flies, and that leftover foods stored past their discard date cannot be served because bacteria and other contaminants can develop. At the time of the survey, facility records showed that 61 skilled residents were in the facility, with 60 receiving oral diets and one resident receiving tube feedings and nothing by mouth, and the cycle menu documented that pureed sloppy joe sandwiches were the planned hot lunch item for residents on puree diets.

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