Health inspection·February 18, 2025

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure food was served at a temperature to meet resident satisfaction for 4 of 4 residents (R1, R2, R3, and R13) reviewed for food temperatures in the sample of 13. Residents Affected - Some The findings include: R1's face sheet showed he was admitted to the facility on [DATE]. R1's facility assessment dated [DATE] showed he has no cognitive impairment. On 2/18/25 at 12:10 PM, R1 said the food is always cold. R1 said he was told by V8 (Dietary Manger) that the temperature meets state requirements but that by the time it is served its cold. R2's face sheet showed he was admitted to the facility on [DATE]. R2's facility assessment showed he has no cognitive impairment. On 2/18/25 at 12:27 PM, R2 said, The food is not hot most of the time. I have to go heat it up in the microwave a lot. R3's face sheet showed he was admitted to the facility on [DATE]. R3's facility assessment dated [DATE] showed he has no cognitive impairment. On 2/18/25 at 12:30 PM, R3 said the food is usually cold. R3 said, I just eat it anyway but I would like it better warm. R13's face sheet showed he was admitted to the facility on [DATE]. R13's facility assessment dated [DATE] showed he has moderate cognitive impairment. On 2/18/25 at 12:32 PM, R13 said, Usually by the time we get the food it is cold . there is a microwave we can take it to but if everyone has to warm it up the line would be a mile long. On 2/18/25 at 11:46 AM, there was regular texture shredded chicken, regular texture rice, regular texture corn, creamed corn, and two divided plates that had already been served with pureed chicken, pureed rice, and pureed corn on the second floor steam table. V5 (Dietary Aide) said they check temperatures on the steam table prior to serving on the second floor but she had forgotten the thermometer. V5 retrieved the thermometer and proceeded to check temperatures. The regular texture chicken was 117 degrees, the regular rice was 129 degrees, the mechanical soft chicken was 125 degrees, the pureed chicken was 106 degrees, the pureed rice was 118 degrees, and the pureed corn was 104 degrees. The facility's policy and procedure with revision date of 9/18/23 showed, Food Safety and Sanitation . Hot food prepped for serving will maintain a minimum temperature of greater than or equal to 135 degrees Fahrenheit when on the steam table and prior to being served to the residents. Page 1 of 3 145937 145937 02/18/2025 Forest City Rehab & Nrsg Ctr 321 Arnold Avenue Rockford, IL 61108

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure food was held at required temperatures on the second floor steam table and failed to ensure food was served in a manner to prevent cross contamination. This applies to all 94 residents residing on the second floor. The findings include: The facility provided a resident roster on 2/18/25 showing 94 residents residing on the second floor. 1. On 2/18/25 at 11:46 AM, there was regular texture shredded chicken, regular texture rice, regular texture corn, creamed corn, and two divided plates that had already been served with pureed chicken, pureed rice, and pureed corn on the second floor steam table. The regular texture chicken was 117 degrees, the regular rice was 129 degrees, the mechanical soft chicken was 125 degrees, the pureed chicken was 106 degrees, the pureed rice was 118 degrees, and the pureed corn was 104 degrees. R1's face sheet showed he was admitted to the facility on [DATE]. R1's facility assessment dated [DATE] showed he has no cognitive impairment. R2's face sheet showed he was admitted to the facility on [DATE]. R2's facility assessment showed he has no cognitive impairment. R3's face sheet showed he was admitted to the facility on [DATE]. R3's facility assessment dated [DATE] showed he has no cognitive impairment. R13's face sheet showed he was admitted to the facility on [DATE]. R13's facility assessment dated [DATE] showed he has moderate cognitive impairment. On 2/18/25 at 12:10 PM, R1 said the food is always cold. R1 said he was told by V8 (Dietary Manager) that the temperature of the food meets state requirements but that by the time it is served its cold. On 2/18/25 at 12:27 PM, R2 said, The food is not hot most of the time. I have to go heat it up in the microwave a lot. On 2/18/25 at 12:30 PM, R3 said the food is usually cold. R3 said, I just eat it anyway but I would like it better if it was warm. On 2/18/25 at 12:32 PM, R13 said, Usually by the time we get the food it is cold . there is a microwave we can take it to but if everyone has to warm it up the line would be a mile long. On 2/18/25 at 11:40 AM, V5 (Dietary Aide) said they check temperatures on the steam table prior to serving on the second floor but she had forgotten the thermometer. (V5 retrieved the thermometer from the first floor and checked temperatures with the surveyor.) On 2/18/25 at 2:19 PM, V8 (Dietary Manager) said she was unsure what the holding temperatures of hot foods on the steam table should be. V8 said she was not aware that staff were taking the temperatures of the foods on the steam table on the second floor. V8 said there is no temperature log for the second floor steam table. The facility's policy and procedure with revision date of 9/18/23 showed, Food Safety and 145937 Page 2 of 3 145937 02/18/2025 Forest City Rehab & Nrsg Ctr 321 Arnold Avenue Rockford, IL 61108

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Sanitation . Policy: The facility will follow sanitary practices in food preparation and cooking to keep food safe. Identification of potential hazards in the food preparation process and adhering to critical control points can reduce the risk of food contamination and thereby prevent foodborne illness . Hot food prepped for serving will maintain a minimum temperature of greater than or equal to 135 degrees Fahrenheit when on the steam table and prior to being served to the residents. If the food is below 135 degrees Fahrenheit, the staff must reheat the food to 165 degrees Fahrenheit to assure time and temperature control. 2. On 2/18/25 at 11:50 AM, V4 (Dietary Aide) and V5 (Dietary Aide) were behind the steam table in the second floor dining room serving resident meals. V4 was wearing gloves. V4 was opening the container with cheese slices, opening the container with meat slices, touching the bag of bread, touching the handle of a spoon he was using to serve up individual containers of sour cream to put on resident plates, and touching the steam table. V4 then used the same gloved hands to take the lunch meat out of the container, the bread out of the bag, and the cheese out of the container and make a sandwich for a resident. V4 did not change his gloves and perform hand hygiene. V4 then went back to touching the containers and the steam table prior to retrieving more cheese out of the container for a resident. On 2/18/25 at 2:19 PM, V8 (Dietary Manager said, Gloves should be changed between touching items and hand hygiene completed and tongs should be used for picking up meat and cheese to prevent cross contamination. The facility's policy and procedure with revision date of 9/21/23 showed, Food Safety and Sanitation . Handwashing . Policy: Employees with use proper hand washing techniques to prevent the spread of infection, cross contamination, and germs . Employees are required to wash hands: . b. Before starting any task j. Anytime hands are soiled k. After handling soiled dishes and utensils . 145937 Page 3 of 3