Widespread Food Safety, Sanitation, and Training Deficiencies in Dietary Services
Penalty
Summary
Surveyors identified multiple failures in the facility’s food service operations affecting 39 residents who ate meals prepared in the kitchen. The physical kitchen environment had several unsealed holes and gaps in the ceiling, including around an electrical conduit pipe, loose bell fixture with exposed wiring and screw holes, separated crown molding, and an unsealed hole near a ceiling rack over a food preparation table. The ice machine contained a black and brown mucous-like substance along the drip pan edges and dark buildup inside and outside the water tubing. A hospice aide entered the kitchen without a hair restraint and scooped ice from a cooler in the center of the kitchen without being corrected or offered a hair cover by kitchen staff who were present. Surveyors observed multiple breaches of food handling and infection control practices by dietary staff. A dietary aide stepped onto the top of an open box of russet potatoes stored on the bottom shelf of a food preparation table to tie their shoe. Cook staff were seen touching multiple kitchen counter surfaces and the food preparation table with bare hands. One cook pushed the metal lid of a gallon can of pears down into the can and stored it open in the refrigerator, then handled a plate by covering the food-contact surface with their palm and fingers, placed a grilled cheese sandwich on the plate with bare hands, delivered it to a resident’s room, and returned to the kitchen without washing their hands before resuming leftover storage and trash disposal. An open personal Styrofoam drink cup with lid and straw was present on a kitchen shelf, and an unsealed plastic bag of white bread was stored on top of the toaster. Staff interviews revealed significant gaps in dietary training, oversight, and knowledge of food safety standards. One cook stated they did not know the requirements for storing leftover foods, had not been taught how to properly cool leftovers, did not know the temperature danger zone for foods, and were unaware of proper hot and cold holding temperatures, extended menus, or specific dietary requirements for residents on pureed diets. A dietary aide similarly reported not knowing about extended menus, temperature danger zones, or holding temperatures, though they acknowledged that touching plate surfaces and food with bare hands, having personal drinks in the kitchen, and stepping on a box of potatoes were unsanitary. The DON and kitchen staff reported there was no dietary manager, that the activities director and a long-term cook informally monitored kitchen duties and ordered food, that food handler permits were not required, and that some kitchen staff were considered “not trainable.” The DON also stated they were unaware of the holes in the recently renovated kitchen.
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