Health inspection·January 25, 2024

F 0802 Level of Harm - Minimal harm or potential for actual harm Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Based on observation, interview, and record review, facility failed to ensure kitchen staff were competent in job duties related to testing the sanitization solution concentration in the low temperature dishwasher. Residents Affected - Some This failure has the potential for improper cleaning and sanitization which could lead to increase in risk for food-borne illness for 57 out of 57 residents. Findings: During a concurrent observation and interview on 1/22/24 at 9:30 a.m., in the kitchen, with Certified Dietary Manager (CDM) and Dietary Aide (DA1), DA1 was observed testing the sanitizer solution concentration of the low-temperature dishwasher. DA1 was observed letting the dishwasher run for two cycles, then taking the litmus test strip and dipping the strip on the residual water left on the plate covers for 5 seconds. CDM reminded DA1 that litmus paper should be dipped in the water at the bottom of the dishwasher. DA1 then dipped the litmus paper into the rinse water reservoir. CDM stated that DA1 should not test the rinse water reservoir since it is contaminated and the litmus paper needed to be dipped into the water at the bottom of the dishwasher. During the same observation and interview, DA1 stated sanitizer concentration in the dishwasher needs to be 120 ppm (parts per million). A review of facility's Dietary Aid job description, dated 2003, indicated the Dietary Aide performs a number of kitchen duties including Perform dishwashing/cleaning procedures . A review of facility's policy and procedure, titled Sanitization, dated 2008, indicated low-temperature dishwasher b. final rinse with 50 parts per million (ppm) hypochlorite (chlorine) . Page 1 of 4 056457 056457 01/25/2024 Greenridge Post Acute 2150 Pyramid Drive El Sobrante, CA 94803

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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, distribute, and serve food safely when the low-temperature dishwasher did not have sanitizer running through it on final rinse and when sanitization concentrations were not recorded on the sanitization log. This failure has the potential of placing 56 out of 57 residents at risk for food born illnesses. Findings During a concurrent observation and interview on 1/22/24 at 9:38 a.m., with Dietary Aide (DA1) and Certified Dietary Manager (CDM), in the kitchen, the bottle of chlorine sanitizer connected to the low-temperature dishwasher was empty. CDM stated the kitchen staff need to be checking sanitizer levels every day. CDM also stated that items that were previously washed need to be rewashed in order to prevent contamination. DA1 and CDM unable to state when the last time sanitizer level was checked. CDM stated that kitchen staff are to check the temperature and sanitizer concentrations before, during, and after shifts and record it in the log. During a record review of facility document titled Food and Nutrition: Dish Machine Temperature log - Low Temperature Machine (undated), indicated there were missing entries for 1/11/24, 1/20/24, 1/21/24, and 1/22/24. The temperature log also records sanitizer concentrations; for the dishwasher, the rinse concentration is 50-100 parts per million (ppm). The U.S Food and Drug Administration Food Code, dated 2022, indicted the presence of adequate detergents and sanitizers is necessary to effect clean and sanitized utensils and equipment . 056457 Page 2 of 4 056457 01/25/2024 Greenridge Post Acute 2150 Pyramid Drive El Sobrante, CA 94803

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure residents' rooms were safe, functional, sanitary and comfortable when, Hot water in the bathrooms in rooms [ROOM NUMBERS] was too hot and Air vent registers in rooms 29 A, 25 A, 21 A, 20 A, 18 A, 16 A, 10 A, 8 A, and 2 B were covered with thick brownish matter. These failures resulted in resident rooms 4,12, 29 A, 27 A, 25 A, 21 A, 20 A, 18 A, 16 A, 10 A, 8 A and 2 B not being safe, functional, sanitary and comfortable. Findings: 1. During an observation on 1/22/24 at 1:20 p.m., in the bathroom for room [ROOM NUMBER], the hot water felt too hot and measured 129.4 degrees Fahrenheit (F) (a measure of temperature used in the United States). 2. During an observation on 1/22/24 at 1:35 p.m., in the bathroom in room [ROOM NUMBER], the hot water felt too hot and measured 125.6 degrees F. 3. During a concurrent observation and interview on 1/22/24 at 1:58 p.m., with Administrator (ADM) and Maintenance Supervisor (MAINT) in the bathroom in room [ROOM NUMBER], the hot water felt too hot to the touch and measured 123.6 degrees F. ADM agreed the temperature was too hot at 123.6 degrees. 4. During a concurrent observation and interview on 1/22/24 at 2:03 p.m., with ADM and MAINT in the bathroom for room [ROOM NUMBER], the hot water felt too hot to the touch and measured 129.4 degrees F. ADM agreed the temperature was too hot at 129.4 degrees. 5. During an interview on 01/23/24 at 11:58 AM with ADM and Maintenance Supervisor from a sister facility (MAINT 1), both stated the hot water temperatures had been lowered, were no longer too hot and were below 120 degrees F in the resident bathrooms. 6. During an interview on 1/24/24 at 12:16 p.m. with MAINT, MAINT stated the hot water temperature should not be too hot because a resident could get burned. 7. During a review of the facility's policy and procedure (P&P) titled, Water Temperature, Safety of, dated Revised December 2009, indicated, 4. Maintenance staff shall conduct periodic tap water temperature checks . 5. If at any time water temperatures feel excessive to the touch.staff will report this finding to the immediate supervisor. 6. Direct-care staff shall be informed of risk factors for scalding/burns that are more common in the elderly. 056457 Page 3 of 4 056457 01/25/2024 Greenridge Post Acute 2150 Pyramid Drive El Sobrante, CA 94803

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 8. During a concurrent observation and interview on 1/24/24 at 11:40 a.m., with Director of Nursing (DON) in rooms 16 A and 27 A, the air vents registers were covered with thick brownish matter. DON stated the air vent registers needed to be cleaned. 9. During an interview on 1/24/24 at 12:25 p.m. with Maintenance Supervisor (MAINT), MAINT stated he cleaned the registers monthly. 10. During an observation on 1/25/24 at 8:30 a.m. in rooms 2 B, 8 A, 10 A, 16 A, 18 A, 20 A, 21 A, 25 A, 27 A and 29 A the air vent registers were covered with thick brownish matter. 11. During a review of The Standard Practice for Inspection and Maintenance of Commercial Building HVAC Systems, dated 2018, page 8 indicated: b. Inspect grilles, registers, and diffusers for dirt accumulation .Clean as needed to remove dirt build up semiannually .replace if missing or damaged. 056457 Page 4 of 4