Health inspection·August 27, 2025

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview, and record review, the facility failed to store, prepare, and serve food in a safe and sanitary manner when:1. Muffins with mold (mold is a type of fungus that can grow on food) were served on breakfast trays, and six residents consumed them.2. Dry goods were improperly stored when expired cocoa powder was in the storage area, a gravy packet had leaked, chocolate chips were in an open plastic bag without a date when it was opened.3. Deli meat in a refrigerator was ten days past its use by date.4. Frozen pancakes and frozen egg rolls did not have a date when they were received.5. Trash cans were uncovered during tray line (name of process where food was served on resident's plates). This failure had the potential to cause food-borne illness in 64 of 64 vulnerable residents.Findings:1. During an interview on 8/26/25 at 2:15 p.m., [NAME] A stated she received a report from Dietary Aide B (DA B) that moldy muffins were served to residents on [NAME] A's day off.During an interview on 8/26/25 at 4 p.m., Licensed Nurse C (LN C) stated the moldy muffins were served on a weekend. LN C was informed about the muffins during stand-up (a daily meeting where staff discussed significant events). LN C stated the Director of Nursing (DON) put residents who ate the moldy muffins on a 72-hour alert charting. LN C stated eating moldy muffins could have had serious effects on an immunocompromised (a condition where the system to protect the body from infections and other harmful substances was not working as well as it should) resident, or a resident with gastrointestinal (GI - having to do with the digestive tract) issues.During a concurrent record review and interview on 8/27/25 at 10:18 a.m., the DON confirmed the names of six residents (Resident 1, Resident 2, Resident 3, Resident 4, Resident 5, and Resident 6) who were on alert charting after eating moldy muffins.During an interview on 8/27/25 at 11:10 a.m., Resident 1 stated he was served a moldy muffin, and he ate it because he thought the black spots were blueberries. Resident 1 stated a Certified Nurse Assistant (CNA) later told him the black spots were mold and not blueberries.During an interview on 8/27/25 at 11:18 a.m., Licensed Nurse D (LN D) stated CNA E reported mold on the muffins during breakfast service on 8/17/25. LN D and other nursing staff removed the muffins from the breakfast trays after six residents had already consumed all or part of the moldy muffins. The muffins were individually wrapped, and it was obvious there was white or black mold on the muffins when they were unwrapped by the CNAs delivering the breakfast trays.During an interview on 8/27/25 at 11:45 a.m., DA B stated a CNA had reported the moldy muffins on the breakfast trays to [NAME] F who then stopped putting them on the breakfast trays.A record review of the facility's policy titled Food Storage revised on 12/1/21 indicated, .prepare.and serve food in accordance with professional standards for food service safety.A record review of the Food & Drug Administration (FDA) 2022 Food Code, Annex 4, Table 2a indicated, Naturally occurring chemical hazards [in food] include mycotoxins [natural toxins produced by certain types of mold.].found in.corn products.other grains. require control measures.[including] do not use spoiled or moldy food. 2. During a concurrent observation and interview on 8/26/25 at 11 a.m. in the dry storage area Page 1 of 2 055499 055499 08/27/2025 Rocky Point Care Center 625 16th Street Lakeport, CA 95453

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many of the kitchen, the Food Service Manager (FSM) confirmed a container of cocoa powder expired on 8/3/25; a package of gravy mix had thick, brown leakage on the outside of the package; an open bag of chocolate chips with a disposable plastic cup in the bag and no date to indicate when the bag was opened. The FSM stated the chocolate chips were stored incorrectly. The FSM stated the chocolate chips should have been taken out of the plastic bag, stored in an airtight container with a tight lid, and an open date and a use-by-date label should have been placed on the container. The FSM disposed of the three items.A record review of the facility's policy titled Food Storage revised on 12/1/21 indicated, .All open food items will have an open date and use-by-date per manufacturer's guidelines. 3. During a concurrent observation and interview on 8/26/25 at 12:25 p.m. in the refrigerator area of the kitchen, the Food Service Manager (FSM) confirmed a plastic bin containing packages of previously frozen lunch meat was labeled on 8/17/25 for use by 8/18/25. The FSM disposed of the lunch meat.A record review of the facility's policy titled, Procedure for Freezer Storage dated 2018, indicated .Once thawed.cured meats [curing involves adding salt and preservatives and is a common form of processing for lunch meats] to be used within 5 days. 4. During a concurrent observation and interview on 8/26/25 at 12:30 p.m. in the freezer area of the kitchen, the FSM confirmed a package of frozen pancakes, and a package of frozen egg rolls did not have a received date on them. The FSM stated the food items were improperly stored in the freezer. The FSM stated that improper food storage increased the risk of food born illness for the residents and disposed of both items. A record review of the facility's policy titled, Procedure for Freezer Storage dated 2018, indicated, All frozen food should be labeled and dated. 5. During a concurrent observation and interview on 8/26/25 at 12:20 p.m. in the kitchen during tray line, the FSM confirmed four trash containers were uncovered, including one that had trash overflowing on to the floor. The FSM stated the trash containers should have been covered. The FSM asked Dietary Aide B (DA B) where the lid to the trash container was. DA B stated he did not know where the lid was.A record review of the FDA Food Code 2022, Section 5-501.113, Covering Receptacles indicated, Receptacles and waste handling units for REFUSE, recyclables.shall be kept covered: (A) Inside the FOOD ESTABLISHMENT if the receptacles and units: (1) Contain FOOD residue and are not in continuous use; or (2) After they are filled. 055499 Page 2 of 2