Health inspection·June 24, 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, prepared, distribute and serve food in accordance with professional standards for food service safety when .1. Dishes were stacked on top of each other while wet; and,2. Pots, pans, and food holding containers were dirty and damaged from use; and,3. A container of scoops, serving ladles, and utensils were left open; and,4. A steamer container had a yellowish residue located inside of it; and,5. A stove top had black sticky grime and food residue on top of it.These failures had the potential of leading to food borne illness in the 94 residents eating facility prepared meals.Findings:1. During a concurrent observation and interview on 6/24/25 at 9:09 AM with the Dietary Services Supervisor (DSS), in the kitchen, a stack of pots and food holding containers were stacked on top of each other while wet. The DSS confirmed that the dishes were still wet. During an interview on 6/24/25 at 12:44 PM with Dietary Aide (DA) 1, DA 1 stated she washed the dishes that morning. DA 1 confirmed that the pots and other dishes that were stacked still had water on them and were not fully air dried. During an interview on 6/24/25 at 1:06 PM with [NAME] 1, [NAME] 1 stated that all dishes should be completely dry and not have water on them. [NAME] 1 also stated that there was a risk for bacteria to grown on the dishes if not dried properly.During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated there was an infection control risk if the dishes were not completely dry. The DSS stated the residents could be at risk for food borne illnesses with dishes not being properly dried. During an interview on 6/24/25 at 2:15 PM with the Director of Nursing (DON), the DON stated the residents could be at a high risk for infections if the kitchen had unsanitary practices occurring. According to the Food and Drug Administration (FDA) Food Code 2022, Section 4-901.11 Equipment and Utensils, Air-Drying Required, .After cleaning and sanitizing, equipment and utensils: shall be air-dried .2. During a concurrent observation and interview on 6/24/25 at 10:04 AM with the DSS, in the kitchen, various pots, pans, and food holding containers were dirty. The DSS confirmed that the various dishes and food equipment were dirty and some pans were damaged by use. The DSS stated some of the pots and pans needed to be replaced. During an interview on 6/24/25 at 12:55 PM with DA 2, DA 2 stated that some of the pots and pans were damaged from use. DA 2 also stated that it was not good to use dirty or damaged pots and pans to cook. DA 2 further stated that bacteria could get in the food if those damaged cooking tools were used.During an interview on 6/24/25 at 1:06 PM with [NAME] 1, [NAME] 1 stated that the dirty pots and pans should not be used. [NAME] 1 also stated that the pots and pans should have been cleaned to prevent cross contamination. [NAME] 1 further stated that some of the pans were too oily and not safe to use. [NAME] 1 expressed that a fire could break out if oily and dirty pans were used. During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated that he needed to come up with a better cleaning schedule for the pots and pans. The DSS also stated that it was the responsibility of the dietary aides to clean the pots and pans after each use. During a review of the facility's undated document titled, SANITATION, the Page 1 of 3 056216 056216 06/24/2025 Guardian Care and Rehabilitation Center 410 Eastwood Ave Manteca, CA 95336

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Policy and Procedure indicated, .All utensils, counters, shelves, and equipment shall be kept clean, maintained in good repair and shall be free from breaks, corrosions, open seam, cracks, and chipped areas .During a review of the facility's undated document titled, KITCHEN SAFETY, the Policy and Procedure indicated, .All chipped enamel ware should be discarded in favor of stainless steel or other non-chip pots and pans. All chipped or cracked dishes should also be discarded when found .According to the 2022 Food and Drug Administration (FDA) Food Code Section 4-202.11, .showed multi-use food contact surfaces shall be: smooth; free of breaks, open seams, cracks, chips, inclusions, pits and similar imperfections; free of sharp internal angles, corners, and crevices; and finished to have smooth welds and joints .3. During a concurrent observation and interview on 6/24/25 at 10:04 AM with the DSS, in the kitchen, a container of scoops, serving ladles, and utensils was left open. The DSS confirmed that the container was left open. During an interview on 6/24/25 at 1:06 PM with [NAME] 1, [NAME] 1 stated that the utensils drawer should always be closed when not in use. [NAME] 1 stated that the clean utensils could become dirty.During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated that the utensils drawer should have been closed. The DSS also stated that particles could get into the drawers and therefore into the residents food.4. During a concurrent observation and interview on 6/24/25 at 10:04 AM with the DSS, in the kitchen, a steamer holding water was observed to have a yellowish residue located inside of it. The DSS confirmed that the steamer had a yellowish residue. During an interview on 6/24/25 at 1:19 PM with [NAME] 2, [NAME] 2 stated that the steamer should always be cleaned after trayline (the process of putting food on plates to serve to the residents). [NAME] 2 stated that the steamer was not working for a couple of days and maybe the staff forgot to clean it. [NAME] 2 further stated that bacteria could grow if the steamer was not cleaned properly. During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated the facility had a drainage system issue recently. The DSS also stated that a bonding adhesive (a process of joining materials together using an adhesive substance that creates a strong bond between the surfaces) was used on some of the steam tables. The DSS further stated that the bonding adhesive residue should have been cleaned out. The DSS expressed that the residents could have been placed at risk of food borne illnesses by not cleaning the residue thoroughly. During a review of the facility's undated document titled, STEAMERS AND STEAM KETTLES, the Policy and Procedure indicated, .Do not allow accumulation of food particles or hard water scale to collect inside the compartment .5. During a concurrent observation and interview on 6/24/25 at 10:03 AM with the DSS, in the kitchen, a stove top had black sticky grime and food residue on top of it. The DSS confirmed that it was a build-up of grease on the stove top oven. During an interview on 6/24/25 at 1:19 PM with [NAME] 2, [NAME] 2 stated open grease oil build-up was not acceptable. [NAME] 2 also stated that dirty and contaminated grease could pose a fire risk. During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated the flat stove top should have been cleaned right after breakfast was over. The DSS also stated that grease could drip and become a fire hazard. The DSS further stated that the residents could be placed at risk of food brine illnesses with food particles not being cleared off the stove top promptly. During a review of the facility's undated document titled, SANITATION, the Policy and Procedure indicated, . The kitchen staff is responsible for all the cleaning with the exception of ceiling vents, light fixtures, and the hood over stove, which will be cleaned by the maintenance staff .During a review of the facility's undated document titled, KITCHEN SAFETY, the Policy and Procedure indicated, .Grease fires are common and dangerous . 056216 Page 2 of 3 056216 06/24/2025 Guardian Care and Rehabilitation Center 410 Eastwood Ave Manteca, CA 95336

F 0814 Dispose of garbage and refuse properly. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure garbage and refuse was properly contained when 1 of 2 outside dumpster lids were observed to be propped open with a stick for a census of 91.This failure had the potential to expose the residents' environment to pests, odors, or diseases.Findings:During a concurrent observation and interview on 6/24/25 at 10:10 AM with the Dietary Services Supervisor (DSS) in the outside dumpster area of the facility, a dumpster was observed to have the lid propped open. The DSS confirmed that the dumpster had the lid propped open with a stick. During an interview on 6/24/25 at 1:19 PM with [NAME] 2, [NAME] 2 stated that the dumpster lids should always be closed. [NAME] 2 also stated that if the dumpster lids are not closed, cats, rats, and other rodents could enter the dumpster. [NAME] 2 further stated maggots could grow in the dumpster if not properly closed. During an interview on 6/24/25 at 1:35 PM with the DSS, the DSS stated there was an infection control risk if the dumpster was left open. The DSS also stated that rodents and wild animals could get in the dumpster and spread disease. During an interview on 6/24/25 at 2:15 PM with the Director of Nursing (DON), the DON stated the dumpster lids should always be closed. The DON also stated that it was an infection control risk if dumpster lids were left open. During a review of the facility's undated document titled, MISCELLANEOUS AREAS, the Policy and Procedure indicated, .Garbage and trashcans must be inspected daily that no debris is on the ground or surrounding area, and that the lids are closed .During a review of the facility's undated document titled, Infection Prevention and Control, the Policy and Procedure indicated, .maintain a safe, sanitary, and comfortable environment for personnel, residents, visitors, and the general public .During a review of the Food and Drug Administration (FDA) Food Code 2022, 5-501.15 Outside Receptacle .(A) Receptacles and waste handling units for refuse .used with materials containing food residue .shall be designed and constructed to have tight-fitting lids, doors, or covers . Residents Affected - Many 056216 Page 3 of 3