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

Food Service Sanitation Deficiencies

White Blossom Care CenterSan Jose, California Survey Completed on 03-13-2026

Summary

The facility failed to ensure proper sanitation during food storage and preparation when three ice machines were observed to be unclean, a kitchen food preparation table was sanitized with a solution that tested below the required strength, and an industrial can opener and its base were not clean. These findings were identified through observation and interview in the kitchen and nursing station pantry areas, and the report states the failures had the potential to increase the risk of food contamination for residents who ate food by mouth. In the kitchen, the ice machine had black residue along the water distribution tube cover and yellow residue on the evaporator plate frame. Black residue wiped off onto a paper towel, and the Maintenance Supervisor stated the ice machine was not considered clean. Thick, dark brown residue was also observed on one drainpipe under the ice machine, and the residue was removed during the observation. The Maintenance Supervisor stated the drainpipes were not checked the last time the ice machine was cleaned and later stated he needed to pay more attention to the drainpipes and clean as needed. At two nursing station pantry rooms, the ice machine dispensers had crusty white, yellow, and pinkish residue around the chutes, and the surfaces were rough to touch. In the kitchen, a Dietary Aide used a cloth soaked with sanitizer to wipe a food preparation table, but the sanitizer tested at 50 ppm, below the 200-400 ppm range posted by the manufacturer. An industrial can opener had orange residue on the blade, and its base had black, brown, and orange residue build-up in the seam where it attached to the table. The Dietary Manager stated the can opener was cleaned once a day, not after each use, and that it did not appear to be getting cleaned every day.

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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