Unsanitary food handling practices were observed in the kitchen when a cook plated food without a beard restraint, a receptionist entered the kitchen and got ice without a hair restraint, and the cook repeatedly touched food with a gloved hand and wiped it on a dirty apron without sanitizing or changing gloves. The paper meal ticket was also placed on the plate during plating, and the DM confirmed staff should wear hair and beard restraints as applicable, sanitize hands after touching dirty items, and keep meal tickets from touching food.
Surveyors observed a drink and snack cart with a pitcher of milk placed on ice that was not labeled or dated, which a CNA confirmed. In the kitchen, two dietary aides were seen preparing food without required beard restraints. The Dietary Manager acknowledged that all items leaving the kitchen are expected to be labeled and dated and confirmed that the aides were not wearing beard restraints as required.
Surveyors identified unsanitary food and beverage practices, including an RN serving drinks to residents while gripping cups by the rim with bare hands and reporting no specific training on dining service, despite facility expectations that cups be held by the side to prevent cross contamination. A kitchen tour further revealed expired canned corn, a cracked container of frozen strawberries left open to air, an expired and unsealable gallon of milk, and large amounts of spilled dressing and barbecue sauce on the sides of bulk condiment containers in the refrigerator, contrary to the Dietary Manager’s stated expectations for weekly date checks, proper storage, and prompt cleanup of spills.
Staff failed to follow safe food handling and hand hygiene practices during meal service, including a nurse who assisted a resident by hand and then served another resident’s meal without hand hygiene, and multiple staff who touched drink cups by the rims while serving. A CNA assisted a resident with a clothing protector and then served another resident without washing or sanitizing hands, and a hospitality aide touched a resident’s shoulder before serving another resident’s meal without hand hygiene. In an interview, an LVN confirmed that staff are expected to wash or sanitize hands after touching potentially dirty surfaces and that dishes should not be touched by the rims when serving.
Surveyors found that food and beverages in the north and south nutrition room refrigerators were not consistently labeled, dated, or discarded when expired. Observations showed unlabeled pitchers of beverages, unlabeled pudding cups, and multiple pre-packaged sandwiches, nutritional supplement shakes, and fruit containers stored past their labeled dates. Facility policy required all snacks to be labeled with resident name, current date, and use-by date, and for pantries to be stocked only with covered, labeled, and dated items. The DM reported that Dietary Aides were responsible for checking and removing expired snacks three times daily, and the Administrator stated her expectation that residents not receive expired foods and acknowledged that consuming expired foods could cause illness.
Incomplete food safety logs and improper food handling were observed in the kitchen and nourishment room. Required sanitizer bucket, 3-compartment sink, dish machine, and refrigerator/freezer temperature logs were not consistently completed, open food items were left exposed in the freezer, raw meat was stored above prepared pudding cups in the refrigerator, and a DM handled a chicken sandwich with bare hands while checking its temperature.
Surveyors found that kitchen staff did not consistently follow sanitary food preparation and storage practices, including a staff member working without required facial hair protection and multiple opened frozen food items (such as tater tots, meatballs, and French fries) stored in unlabeled and undated bags. The dietary supervisor confirmed expectations that all staff wear hairnets and beard nets in the kitchen or when serving food, and a dietary aide acknowledged that the freezer items should have been labeled and dated. These practices were identified as affecting all residents on the facility census and were described as likely to lead to foodborne illnesses if safe food handling and storage were not followed.
Surveyors found that food service sanitation practices were deficient when a plate warmer used for clean dishes contained dried food particles, dried liquid splashes, and trash, and the stove and oven used for meal preparation were visibly soiled with dried food, liquid splashes, dirt, grease, and baked-on food stains. The DM acknowledged that the condition of the plate warmer, stove, and oven was dirty and did not meet his expectations, affecting food preparation and service for all residents.
Surveyors found that staff failed to follow required food service safety procedures when they did not document refrigerator and freezer temperatures for both a morning and an evening shift, and did not record dish machine temperatures or chemical sanitization concentration for a breakfast dishwashing cycle. The dietary director confirmed that staff were expected to check and document these temperatures and sanitization levels each morning, evening, and after each meal, but this was not done, potentially affecting all residents who consumed food prepared in the kitchen.
Surveyors found that the facility did not consistently follow safe food storage and handling practices, potentially affecting all 107 residents. During a kitchen observation, a box of frozen hamburger patties was found stored in the freezer left open to the air, and the Dietary Manager acknowledged it should not have been left open. In a separate observation, a dietary aide with facial hair was serving lunch without a beard guard, and the Dietary Manager confirmed that a beard guard should have been worn.
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