Abbington Arlington Assisted Living

Based on observation, staff interviews, and policy review, the facility failed to ensure safe storage of medications when medications for Resident #37 were left at the bedside without staff supervision. This affected one Resident (#37) of four reviewed for medications. The facility census was 38.

Findings include

Review of the medical record for Resident #37 revealed an admission date of 10/27/23. Diagnoses included multiple myeloma, anemia, type two diabetes, hypertension and cognitive communication deficit.

Review of the physician orders dated 10/01/25 revealed the following orders due at 8:00 A.M.: Acyclovir 400 milligram (mg) tablet with instructions to take one tablet twice daily, Amlodipine 10 mg tablet with instructions to take one tablet once daily, Aspirin 81 mg tablet with instructions to take one tablet once daily, Calcium 600/200 Vitamin D3 5 microgram (mcg) tablet with instructions to take one tablet twice daily, Carvedilol 25 mg tablet with instructions to take one tablet twice daily, Fenofibrate 200 mg capsule with instructions to take one capsule daily before breakfast, Fluoxetine 40 mg capsule with instructions to take one capsule once daily, Hydrochlorothiazide 25 mg tablet with instructions to take one tablet once daily, an order dated 10/07/25 for Anastrozole 1 mg tablet with instructions to take one tablet once daily, an order dated 10/28/25 for Vitamin B-12 1000 mcg tablet with instructions to take one tablet once daily, an order dated 02/03/26 for Levetiracetam 500 mg tablet with instructions to take one tablet every 12 hours, and an order dated 02/03/26 for Allopurinol 300 mg tablet with instructions to take one tablet once daily.

Review of the assessment dated 10/30/25 revealed the resident should not self-administer medications due to medical, physical, or cognitive reasons and medications should be managed by pharmacy services and administered by facility nursing staff.

Review of the functional assessment dated 03/18/26 revealed the resident needed occasional orientation and daily reminders and required supervision.

Observation and interview on 04/01/26 at 11:20 A.M. with Licensed Practical Nurse (LPN) #17 revealed Resident #37's was due for her pre-lunch insulin. Upon entrance to the residents room, a cup of pills was observed sitting on the residents bedside table. The nurse instructed the resident to take her morning medications and the resident took her medications. The LPN confirmed those were her morning medications and reported the resident should have taken the medications at medication pass time. LPN #17 confirmed the medications provided during the morning medication administration included Acyclovir, Amlodipine, Aspirin, Calcium/Vitamin D3, Carveilol, Fenofibrate, Fluoxetine, hydrochlorothiazide, Anastrozole, Vitamin B-12, Levetiracetam and Allopurinol.

Interview on 04/01/26 around 2:30 P.M. with Service Coordinator #16 reported the facility had no residents approved to store medications or approved to keep medications at bedside to take at a later time. The Service Coordinator confirmed staff should observe residents when passing out medications and ensure residents took the medications.

Review of the undated facility policy titled Medication Administration revealed the facility shall provide for the administration of medications to residents who did not self-administer medications. The ordered medications shall be administered and if not administered, the staff responsible shall document on the Medication Administration Record (MAR) why it was not administered. The policy also stated all prescriptions shall be kept in locked storage areas.

Based on observation, staff interview, and policy review, the facility failed to ensure food and utensils were stored in a safe and sanitary manner, employees use proper hand hygiene when handling food products, ensure the thermometer was sanitized between use, and cooking surfaces were free from buildup of food debris. The affected all 38 residents who received food and beverages from the facility kitchen. The facility census was 38.

Finding include:

1. Observation on 04/01/26 at 12:10 P.M. revealed heavy grease and old food debris build up throughout the grill area on and behind the stove, and on the flat top grill. An electrical outlet behind the stove was covered in grime and grease and a rag was observed on the floor below the outlet, behind the stove, and was soiled with grease.

Interview on 04/01/26 at 12:10 P.M. with Dietary Cook #28 confirmed the cook top and stove were soiled with dried and burnt food products. He confirmed they had been soiled for years and were original to the facility. He confirmed the wall and outlet were covered in grease splatter.

2. Observation and interview on 04/01/26 at 8:30 A.M. revealed the ice scoop was stored in the ice machine. Dietary Cook #28 confirmed that the scoop was inside the machine. He stated the handle had broken off the side of the ice machine and staff were supposed to store the ice scoop on top of the ice machine and not inside.

3. Observation and interview on 04/01/26 at 8:30 A.M. with Dietary Cook #28 confirmed several items with labels stating refrigerate after opening including three bottles of mustard, two bottles of barbeque sauce, chocolate syrup, caramel syrup, and lemon juice were all opened and stored on the prep counter of the kitchen. There were also undated opened items in the dry storage room including apple cider vinegar, cereal containers of raisin bran, cheerios, and frosted flakes, and a container of sugar. Expired items observed included mustard expired 10/20/25 and more than five packs of tortilla shells with expiration dates of 12/20/25, 02/10/26, and 03/25/26. An opened bag of frozen chicken was stored inside the upright freezer was not dated or properly sealed. Dietary Cook #28 confirmed the above concerns and he threw away the expired items. He also stated that he wasn't aware that the items were expired and that the food delivery service they used had recently delivered the tortilla shells. Dietary Cook #28 confirmed several opened items on the counter had printed on the bottles to refrigerate after opening, and were not refrigerated.

Review of the policy for dry storage revealed foods should be stored with the label facing forward front. It also revealed that when restocking shelves, put the new case in the back and the old case in the front so that the older foods will be used before it has a chance to spoil, and to practice the first in first out (FIFO) method of stock rotation. The policy stated to dispose of food in questionable quality, and to label and date all incoming foods. It stated the refrigerator and freezer regulations revealed to store food in covered containers, and label and date all foods, throw away any food kept beyond the use by or expiration date, and keep food in clean wrappers or containers.

4. Observation on 04/01/26 at 12:01 P.M. reveled Dietary Cook #28 did not properly use hand hygiene when touching food. He completed temperatures of all food items then obtained sandwiches out of the fridge and started to plate food items touching grilled cheese and Italian sandwiches, all with the same gloved hands. While plating food for lunch, the serving spoon for the beef and noodle mixture fell into the pan of food. It was picked up by Dietary Cook #28's gloved hand and rested again on the side of the serving pan. When doing this Dietary Cook #28 soiled his gloves and without changing gloves or completing hand hygiene, he again touched the grilled cheese sandwiches and Italian subs.

Interview on 04/01/26 at 12:10 P.M. with Dietary Cook #28 revealed he didn't typically change his gloves during meal service and confirmed he had gravy on his gloves when touching other food items and kitchen equipment.

Review of the dietary handwashing policy confirmed that employees with soiled or contaminated hands should wash hands often to properly protect both the employee and residents.

5. Observation and interview 04/01/26 at 11:50 A.M. revealed Dietary Cook #28 took a temperature of the beef and noodles, wiped the thermometer with a dry paper towel, took the temperature of mixed vegetables, wiped the thermometer with a dried paper towel, then took temperature of the Italian sub and grill cheese sandwiches, and wiped the thermometer with a dried paper towel, instead of a sanitizer wipe to clean the thermometer in between items. Dietary Cook #28 reported the facility had no sanitizing wipes to use to clean the thermometer between items.

This is an example of continued non-compliance from the surveys dated 02/20/25 and 04/10/25.

Based on observation, staff interview, review of facility policy, review of the dishwasher manual instructions, and review of Hazardous Analysis Critical Control Point (HACCP) guidelines, the facility failed to ensure the dish washing machine was working properly to clean and sanitize dishes. The affected all 38 residents who received food and beverages from the facility kitchen. The facility census was 38.

Finding include:

Observation and interview on 04/01/26 at 8:30 A.M. with Dietary Cook #28 revealed he was actively washing dishes. The machine had a plaque on it stating the temperature should read a minimum of 120 degrees Fahrenheit (F) for the wash cycle and a minimum of 120 degrees F for the rinse cycle with the required 50 parts per million (ppm) concentration of the chlorine chemical. A cycle was started and the temperature for the wash cycle was 110 degrees F and the temperature for rinse was 115 degrees F. Dietary Cook #28 watched the temperature and confirmed the temperature showed a wash cycle of 110 degrees F and a rinse cycle temperature of 115 degrees F. He stated that he was not aware of what the temperature of the dishwasher should be and stated he was not aware of any issues with the dishwasher. Continued observation of the plaque on the machine revealed that the required chemical concentration for the dishwasher was 50 ppm chlorine and was to be tested with chlorine sanitizer test strips. The cook ran the dish machine three times and tested the sanitizer concentration of the dishwasher using quaternary chemical test strips after the sanitizing cycle and consistently obtained a reading above 400 ppm. The cook stated the test strips should read between 400 ppm to 500 ppm.

Interview on 04/01/26 at 3:10 P.M. with Executive Director #12 confirmed that the concentration of the dishwashing machine was chlorine with readings between 75-100 ppm. She stated the Dietary Cook #28 was using the wrong sanitizer test strips.

Observation and interview on 04/01/26 at 3:10 P.M. with Executive Director #12 confirmed the dishwashing machine was not reaching the required temperature of 120 degrees F. She confirmed the temperature for the wash cycle was currently 80 degrees F and 100 degrees F for the rinse cycle. She stated she was not aware of any issues with the dish washer and that she would call it in to be serviced.

Review of the facilities policy titled chlorine and quaternary sanitizing test strip procedures dated 06/15/99 indicates that proper routine use of quaternary test strips ensures that manually washed dishware is effectively sanitized, supporting safe and sanitary food service practices. The review also confirms that chlorine sanitizing is utilized during the automatic dishwasher rinse cycle. This system uses a chlorine-based sanitizer. To verify proper concentration, a two-inch test strip is dipped into the rinse cycle water during operation. The target range for effective chlorine sanitizing is 75-150 ppm, which corresponds to the color marking of approximately 100 ppm (blue/lavender) on the test strip.

Review of the dish washer manual instructions titled the American Dish Service dated 04/28/21 revealed the dish washer is a chlorine sanitizing dishwasher and the rinse temperature should be 120 degrees F.

Review of policy HACCP guidelines revealed for a chemical sanitizing system, the recommended water temperatures for the wash cycle were 120 degrees F to 130 degrees F and for the rinse cycle was 120 degrees F.

Based on observation, staff interview, pharmacist review and facility policy review, the facility failed to ensure medications were properly disposed of upon the resident's discharge from the facility. This affected two (Residents #40 and #41) of four residents reviewed for medications. The facility census was 37.

Findings include:

Interview on 04/10/25 at 12:34 P.M. with Service Coordinator #108 revealed medications for Residents #40 and #41 were kept at the facility after discharge. She stated the facility retains non-narcotic medications as a backup and disposes of them once expired. She acknowledged Resident #40's medications were kept and later discarded around the end of December

Based on observation, staff interview, and facility policy review, the facility failed to maintain proper food storage, sanitation, and safe food handling practices in the kitchen. This had the potential to affect all 37 residents residing in the facility who receive food from the kitchen.

Findings include:

During an initial observation on 04/10/25 from 7:45 A.M. to 7:58 A.M., the following concerns were noted in the kitchen: the ice machine scooper was stored inside of the machine with the ice. Moldy bell peppers were observed in the refrigerator. Two bags of fried shrimp and two bags of chicken were observed thawing in an empty sink with no running water. The oven had a visible layer of grime on its doors.

Interview on 04/10/25 at 7:58 A.M. with Cook #118 confirmed the scoop was stored inside the ice machine on top of ice, there were moldy bell peppers in the refrigerator, fried shrimp and chicken were thawing improperly in the sink, and the oven had a visible layer of grime on its door.

Review of the kitchen's cleaning schedule revealed on Wednesday, the oven is deep cleaned with the observation taking place on Thursday.

This violation represents non-compliance investigated under Complaint Number OH00163854.

This is an example of continued non-compliance from the survey dated 02/20/25.

Based on observation, staff interviews, and review of facility policy, the facility failed to serve food in a safe and sanitary manner. This had the potential to affect all 37 residents living in the facility. The facility census was 37.

Findings include:

Observation of lunch food service on 02/20/25 from 11:58 A.M. to 12:08 P.M. revealed that the plates being used for lunch service were visibly soiled with food particles and oily stains. There were three stacks of plates that were stacked below the food serving line, and they were observed to be touching Cook #104's clothing. The plates that were soiled were placed directly on top of each other in a stack under the service line. Cook #104 was observed pulling visibly soiled plates from under the service line and plating sandwiches directly on to the soiled plates. Five soiled plates were plated with sandwiches in preparation for lunch service to residents.

Interview with Cook #104 on 02/20/25 at 12:06 P.M. confirmed that the plates used for meal service were not clean. When surveyor asked Cook #104 why the plates were soiled, he stated that he was not certain, but possibly from food particles and liquids falling from tray line and on to the plates.

Interview with the Executive Director, who was in the kitchen at the time, on 02/20/25 at 12:07 P.M. confirmed that visibly dirty plates were being used for meal service. The Executive Director revealed that she would be educating the kitchen staff about not using visibly soiled plates. Interview with Executive Director on 02/20/25 at 4:40 P.M. revealed that she had made the kitchen staff re-wash the plates.

Review of an undated facility policy titled, Dietary Policies and Procedures