Health inspection·February 25, 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 Based on observation, interview and review of facility policy, the facility did not ensure palatable food was served to all residents receiving meals from the kitchen. This affected six residents (#24, #28, #29, #32, #43 and #87) of six residents reviewed for food service. The facility census was 113. Residents Affected - Some Findings include: An observation was conducted on 02/25/25 at 12:35 P.M. to 1:33 P.M. of the kitchen food production, kitchen environment and lunch tray line meal service. The lunch consisted of chicken cutlet, spinach, chocolate chip cake and substitutes available were hamburger or ham slices, mixed vegetables, potato salad and ice cream. All hot foods on tray line reached acceptable temperature above 165 degrees Fahrenheit ( F) prior to the start of meal service. A second set of temperatures were not taken to monitor the temperatures of the food on tray line throughout the observation. A test tray was requested as the last resident's food was plated and ham slice, potato salad and mixed vegetables were placed for the test tray. The food cart left the kitchen at 1:33 P.M. with the test tray and arrived to the unit at 1:40 P.M. When the test tray reached the floor at 1:40 P.M. the test tray was placed in the dining room where food temperatures were taken by Dietary Manager (DM) #503 using a calibrated facility thermometer. The temperature of the ham slice was 106 degrees F and was barely warm to taste. The cold potato salad was 75 degrees F and was not cold. The mixed vegetables were 136 degrees F and tasted warm. DM #503 verified the food temperatures at the time of the test tray. An interview was conducted on 02/25/25 at 1:46 P.M. with Resident #28 who revealed he did not like the food, and the hot food was not hot. An interview was conducted on 02/25/25 at 1:48 P.M. with Resident #87 who stated the food is horrible. An interview was conducted on 02/25/25 at 1:51 P.M. with Resident #32 who revealed hot foods were served cold. An interview was conducted on 02/25/25 at 1:52 P.M. with Resident #24 who revealed the food did not taste good. An interview was conducted on 02/25/25 at 4:48 P.M. with Resident #29 who revealed they ordered food out because the food is not good. An interview was conducted on 02/25/25 at 5:07 P.M. with Resident #43 who stated the hot food is always cold. Page 1 of 3 365033 365033 02/25/2025 Cedarwood Plaza 12504 Cedar Road Cleveland Heights, OH 44106

F 0804 Level of Harm - Minimal harm or potential for actual harm Review of the facility policy titled Food Temperatures at Point of Service, dated 01/06/25 revealed hot food items must be cooked, held and served at appropriate temperature. Food temperatures were taken often to monitor safe food holding temperature at or below 41 degrees F for cold foods, and at or above 135 degrees F for hot foods. Residents Affected - Some This deficiency represents non-compliance investigated under Complaint Number OH00162967 365033 Page 2 of 3 365033 02/25/2025 Cedarwood Plaza 12504 Cedar Road Cleveland Heights, OH 44106

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 and interview, the facility did not ensure food was stored, prepared and served under sanitary conditions. This had the potential to affect all 111 residents receiving meals from the kitchen excluding Resident #36 and #51 who the facility identified as eating nothing by mouth. The facility census was 113. Findings include: An observation was conducted on 02/25/25 from 12:35 P.M. to 1:33 P.M. with Dietary Manager (DM) #503 of the facility kitchen. In the main freezer there was bread stored in a clear plastic bag with no label or dates, and an open bag of French fries in a clear plastic bag with no label or date on it. Observation of the dry food storage area revealed an open, two-pound bag of powdered sugar that was wrapped in ripped plastic wrap without a date or label and the powdered sugar was spilling out of the bag when it was picked up to check for a label and date. Pumpernickel bread and sausage buns were observed with no dates or labels on the bread items. A 55 ounce bag of tortilla shells were observed on the bread shelf with a use by date of 12/13/24. An unlabeled plastic container with a green lid had a brown substance in the plastic container stored in the dry storage room that was not labeled or dated. Live gnats were observed hovering by the bread in the dry food storage areas. Next to the dish machine live gnats were observed flying around the dish machine. Four wet oven trays were observed sitting on the pot and pan rack along with dried and clean pots and pans. There was a heavy build-up of black grime on the floor under the dish machine and a heavy build-up of dried food particles and black grime were observed on the bottom of the walls where the walls met the floor throughout the kitchen. In addition, two tray carts used to transport resident food had a large amount of dried white substance resembling dried milk on each cart indicating the carts had not been kept clean and sanitary. An interview was conducted on 02/25/25 at 1:33 P.M. with DM #503 who confirmed the above findings at the time of the observations. This deficiency represents non-compliance investigated under Complaint Number OH00162967 365033 Page 3 of 3