Health inspection·March 10, 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. Based on observation, interview, and record review the facility failed to ensure sanitizer concentration solution met standards and failed to discard expired food items. This applies to all 28 residents that consume food in the facility. Findings Include: 1. On 03/08/23 at 02:44 PM, V3 Food Service Supervisor tested the red sanitization buckets using Hydrion QT - 40 test strips. One red sanitizing bucket registered 0 ppm (parts per million). V3 stated it was sitting too long and that's why it read 0 ppm. On 03/09/23 at 11:57 AM, V3 stated the test log for the three-compartment sink is used for the sanitization buckets as well. V3 stated they were using that bucket yesterday and they didn't change that bucket every two hours as they were supposed to. The facility policy Safety & Sanitation Protection from Contamination dated 1/29/19 states Red Sanitizer Buckets are to be maintained at any station where food production is occurring. The facility policy Sanitizing food Contact Surfaces revised date 1/23 was reviewed. Use sanitizer at a concentration of 200 - 400 ppm. If the concentration of sanitizing solution does not meet the standards listed above, the solutions is mixed manually, and each batch is tested and recorded. Red Sanitizing Buckets are replaced every 2 hours. The 3-compartment sink log V3 states also covers the Red Sanitizing Buckets shows the Red Sanitizing Buckets were not changed and logged every two hours as per facility policy. 2. On 03/07/23 at 10:35 AM, during a tour of the first main kitchen items noted: In prep refrigerator: Open bag of hamburger buns (12 count 6 left) good through 3/6 2lb package of bread dated 1/9/23 noted with mold 30 loaves of bread without a received on or use by date. One (1/2 loaf) opened loaf of bread without a received on, opened on, or use by date. Page 1 of 2 145804 145804 03/10/2023 Oak Trace 250 Village Drive Downers Grove, IL 60516

F 0812 10 12 count hamburger buns without a received or use by date Level of Harm - Minimal harm or potential for actual harm 6 bags of bagels without a received or use by date 8 loaves of raisin bread without a received on or use by date Residents Affected - Many Worcestershire sauce one gallon opened on 1/11/23 expired on 2/11/23 Soy sauce opened on 1/22/23 expired on 2/22/23 On 03/07/23 at 10:58 AM, during tour of lower-level dry goods storage 2 jars of capers 32 oz noted with broken seals. On 03/07/23 at 11:04 AM, during tour items noted in produce cooler Open bag of cheese opened on 2/6/23 expired on 2/12/23 Open bag shredded white cheese no manufacture label no opened on or use by date. Open carton of liquid egg yolk 32 fluid oz no opened on or use by date metal pan labeled cheese open 2/14/23 use by 2/20/23 Horseradish 32 oz jar opened on 12/25/22 no use by date. On 03/07/23 at 11:12 AM, item noted in freezer Opened bag of pepperoni wrapped in plastic wrap. Opened on 12/25/22 no use by date. The facility policy: Storage of Food and Supplies dated December 7, 2020 Was reviewed. Discard food past the use by, sell-by, best-by, or enjoy by date. Cover, label and date unused portions and open packages. Complete all sections on a Unidine Universal Date Label or use an approved labeling system. Do not hold cured meat in the freezer. The facility lists refrigerated storage life of foods dated January 2023 was reviewed. Liquid eggs are good for 3 days after opening. Cheese is good for 6 days after opening. Horseradish is good for 2 months after opening. Pepperoni is good for three weeks after opening. 145804 Page 2 of 2