Health inspection·January 20, 2023

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on kitchen food service observations, staff interviews, facility document review, and facility policy and procedure review, the facility failed to follow proper sanitation and food handling practices to prevent the outbreak of foodborne illness, with the potential to affect all residents who consumed foods from the facility, by failing to date mark numerous open food packages in the dry storage room, the refrigerator, and the freezer. Food handling and sanitation is important in health care settings serving nursing home residents. Unsafe food handling practices represent a potential source of pathogen exposure. The findings include: A tour of the kitchen was conducted on 1/17/2023 at 8:20 a.m. During the tour, no date markings were observed on a bin filled with fresh vegetables, an open box filled with pineapples and melons, another open box filled with asparagus, or an open bag of brussels sprouts and carrots on the shelf in the walk-in refrigerator. There was no date marking observed on one open package of blueberries sitting on a shelf in the walk-in freezer. In the dry storage room, there was no date marking observed on one open bag of corn starch. On the opposite side in the dry storage room, on the bottom shelf, there were no date markings identified on four open pasta bags. The bread rack next to tray line had three open bundles of bread with no date markings. These observations were made again on 1/17/2023 at 12:47 p.m., 12:48 p.m., and 12:49 p.m. During the same time, new observations of a bin filled with carrots, one package of cauliflower and five lemons placed on top of a box, and an open box of tomatoes were on the shelf in the walk-in refrigerator with no date marking. (Photographic evidence obtained) A follow-up tour of the kitchen was conducted on 01/19/23 at 10:45 a.m. In the dry storage room, there was no date marking observed on one open bag of corn starch. On the opposite side in the dry storage room, on the bottom shelf, there were no date markings identified on four open pasta bags. The bread rack next to the tray line had two open bundles of bread with no date markings. No date markings were observed on the open bag of celery, vegetable bin filled with vegetables, open box of asparagus, open box of melons, or one package of cauliflower and five lemons placed on the shelf in the walk-in refrigerator. There was no date marking observed on one open package of blueberries or one open bag of biscuits sitting on a shelf in the walk-in freezer. (Photographic evidence obtained) An interview was conducted on 01/20/23 10:17 a.m. with Dietary Aide (DA) A, who confirmed that the facility policy for date marking was to ensure open food was covered, labeled, and dated, and that leftover bread was wrapped, date marked, and discarded after three days. An interview was conducted on 01/20/23 at 10:38 a.m. with [NAME] B, who stated he and the Director Page 1 of 2 105820 105820 01/20/2023 University Crossing 6210 Beach Blvd Jacksonville, FL 32216

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many of Dining were responsible for food storage. He confirmed once a food item was opened, it was to be wrapped and dated before going back into the refrigerator, freezer, or dry storage shelf. Opened bread was to be wrapped and dated before placing it back on the rack. An interview was conducted on 01/20/23 at 10:51 a.m. with Director of Dining C, who stated currently it was a collective responsibility of all staff to maintain food storage standards. She confirmed that the facility policy for food storage and date marking was that opened foods should be labeled and dated. Opened bread was wrapped/twisted and dated. A review of the facility's policy and procedure entitled Food and Supply Storage (dated 1/2023), revealed: All food, non-food items and supplies used in food preparation shall be stored in such a manner as to prevent contamination to maintain the safety and wholesomeness of the food for human consumption. Procedures: Cover, label and date unused portions and open packages. Complete all sections on a [NAME] orange label or use the Medvantage/Freshdate labeling system. Products are good through the close of business on the date noted on the label . Date and rotate items; first in, first out (FIFO). Discard food past the use-by or expiration date. (Copy obtained) Reference: FDA Food Code 2022 Annex 5. Conducting Risk-Based Inspections Annex 5 - C. Intervention Strategies for Achieving Long-term Compliance. 4. Establish First-In-First-Out (FIFO) Procedures. Page 31. https://www.fda.gov/media/164194/download (Accessed on 1/23/2023): Product rotation is important for both quality and safety reasons. First-In-First Out (FIFO) means that the first batch of product prepared and placed in storage should be the first one sold or used. Date marking foods as required by the Food Code facilitates the use of a FIFO procedure in refrigerated, ready-to-eat, TCS foods. The FIFO concept limits the potential for pathogen growth, encourages product rotation, and documents compliance with time/temperature requirements. . 105820 Page 2 of 2