Citation #1: C0240 - Resident Services Meals, Food Sanitation Rule
Visit History:
t Visit: 12/9/2024 | Not Corrected
1 Visit: 3/24/2025 | Not Corrected
Regulation:
OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule
(1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules).
Inspection Findings:
Based on observation, and interview, it was determined the facility failed to maintain the kitchen in good repair and in a sanitary manner in accordance with Food Sanitation Rules, OAR 333-150-000. Findings include, but are not limited to:
Observation of the facility kitchen was reviewed on 12/09/24 from 11:00 am am through 2:00pm and found the following:
a. An accumulation of food spills, splatters, loose food and trash debris, dirt, dust, and/or black matter was visible on or underneath the following:
* Reach in coolers and freezers
* Metal shelves storing spices;
* Metal shelves storing pots/pans/dishes
* Interior of crock pot;
* Shelving storing clean dishes;
* Hood vents above stove; and
* Separate food storage area floors.
b. The following areas were in need of repair:
* Area in ceiling next to hood vent with water damage.
c. Large number 10 can of food was found severely dented. Staff 2 (Cook/Person In Charge) was unaware of not using dented canned foods.
d. Multiple care staff and staff 2 were observed multiple times to potentially contaminated hands or single service gloves by touching hair/face/clothes/dirty rags/surfaces/handling cell phone/etc without washing hands and/or changing gloves. Care staff were observed entering and exiting kitchen area without first washing hands.
e. Staff 1 (Person In Charge/PIC) observed preparing and serving food without effective facial hair restraint as required. Care staff were not wearing aprons during meals to protect from potential contamination.
f. Hard shell eggs were observed stored directly over ready to eat and drink items.
g. Multiple potentially hazardous foods observed stored not dated when opened.
h. Staff observed delivering resident food and beverages to residents rooms uncovered and not protected from potential contamination.
i. Designated Person In Charge (Staff 2) was not able to demonstrate adequate knowledge in surface sanitation chemicals/concentrations. Facility did not have sanitizer strips to validate surface sanitation solutions were effectively sanitizing. Staff 2 was not able to describe correct changing times for sanitation solutions. Staff 2 was also not able to effectively discuss illnesses to exclude staff working with food as required.
j. Facility did not have a process for ensuring leftovers were reaching appropriate cold storing temperatures within correct time frames as outlined in the food code. PIC was not able to discuss the correct time and temperature benchmarks to ensure safe cooling. Multiple leftovers were observed stored in reach in coolers.
k. Kitchen and care staff were observed drying clean and sanitized dishes with towels that had been potentially contaminated by drying hands on a towel after washing and after hands were in contact with sanitizing solution.
l. Multiple dry food items along with single service plates/bowls were stored in a mechanical room which is prohibited per Food Code.
m. Reach in cooler had a bin where raw meats were thawing. There was a cloth rag in the bottom of the bin that was wet and discolored with what looked like bloody juices from thawing meats. There was a strong odor from the bin. Staff 2 was unaware that cloth materials should not be utilized/stored in cold food storage areas.
At 1:00 pm, surveyor reviewed above areas with staff 2 (Cook/ Person In Charge) who acknowledged areas in need of attention. Staff 1 (Administrator) was informed of above areas at approximately 1:45 pm and they acknowledged the identified areas.
OAR 411-054-0030 (1)(a) Resident Services Meals, Food Sanitation Rule
(1) The residential care or assisted living facility must provide a minimum scope of services as follows: (a) Three daily nutritious, palatable meals with snacks available seven days a week, in accordance with the recommended dietary allowances found in the United States Department of Agriculture (USDA) guidelines, including seasonal fresh fruit and fresh vegetables; (A) Modified special diets that are appropriate to residents' needs and choices. The facility must encourage residents' involvement in developing menus. (B) Menus must be prepared at least one week in advance, and must be made available to all residents. Meal substitutions must be of similar nutritional value if a resident refuses a food that is served. Residents must be informed in advance of menu changes. (C) Food must be prepared and served in accordance with OAR 333-150-0000 (Food Sanitation Rules).
This Rule is not met as evidenced by:
Plan of Correction:
A. A kitchen cleaning list has been created, there are weekly end of shift, and monthly tasks on the check list. Staff has been trained at a staff meeting on what tasks are to be done and in what intervals. This includes but not limited to basic cleaning of floors, walls, cooler, hood vents,freezer and all storage shelves.
Policy will be in place to ensure all current and new staff understand the expectations and cleaning proceedures for the kitchen.
This will be reviewed quarterly for one year to ensure compliance.
Administrator will ensure the corrections are completed and monitored.
B. The area with water damage next to the hood has been reported to maintence and will be fixed.
C. There is now a binder in the kitchen that is a quick referrence for tempertures, hand hygene, cooling, dented cans, wearing aprons and facial hair restraints. Kitchen cooks will read and sign monthly. Administrator or RCM will ensure compliance.
D. Staff has been trained on proper hand hygene and the facility policy for hand hygene was put out for all staff to sign and is part of the policies and procedures. It is also part of the new kitchen binder. Cook and administrator will ensure that empoyees are following the policy and all new hires will be trained on hand hygiene.
E.Hair and facial hair restraints are available in the kitchen and all staff have been educated on the policy for using aprons when passing food. This policy was gone over with staff at an all staff meeting and is posted in the new kitchen binder. Cook and/or PIC of kitchen meal will monitor staff at every meal or snack time and admin will review quarterly with staff at all staff meeting.
F. Hard shell eggs have been moved to the bottom shelf of the fridge. Policy of where to store items in the fridge has been updated and a list of where items belong in fridge has been posted in kitchen. Cook puts away groceries weekly and will ensure food is in the proper places.
G. Staff have been trained at an all staff meeting on how to date and label food properly. This is posted in the kitchen and in the kitchen binder. Cook/ PIC will make sure that the open food is dated, if not dated then discarded daily.
H. We have purchased covers for dishes and cups, to be used when delivering food to residents rooms. Cook/PIC will ensure that food is covered when it is being delivered to resident rooms. There is a sign posted to remind staff to cover food.
I. Kitchen staff have been trained on surface sanitation and illnesses that would exclude staff from kitchen duty. The policy is also posted in the kitchen binder, for quick reference. Cooks will read and initial book monthly.
J. The process for cooling and heating up leftovers and the temperatures for the process have been gone over with the PIC and the cook. This process is posted in the kitchen binder, the cooks will read it monthly and sign. Administrator or RCM will ensure that the book has been read and signed monthly.
K. Staff has been trained on proper hand hygiene and hand hygiene reminder is posted in the kitchen next to handwashing sink. PIC of kitchen will ensure that staff are washing hands properly and report to administrator if further training is needed.
L Facilility will work with Policy Analyist and Licensing to come up with a solution for the food stored in mechanical room due to space limitation.
M. Raw meat bins in cooler are on a cleaning schedule. They will be checked daily for cleanliness and washed weekly. PIC and cook will ensure this is completed.