Health inspection·March 28, 2024

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, menu spreadsheet review, and policy review the facility failed to serve palatable meals at appetizing temperatures. This affected 117 residents receiving meals from the kitchen as two residents (#67 and #108) were ordered nothing-by-mouth (NPO). The facility census was 119. Residents Affected - Many Findings include: Review of a menu for week two, Tuesday corresponding to 03/26/24 revealed the following for the lunch meal: barbeque pork shoulder, tater tots, coleslaw, biscuit, and a spiced pear bar. Interview on 03/25/24 at 10:20 A.M. with Resident #116 revealed food was terrible, did not taste good, and was often cold. Interview on 03/25/24 at 10:32 A.M. with Resident #68 revealed the food sometimes was not warm. Interview on 03/25/24 at 10:42 A.M. with Resident #5 revealed the food was sometimes cold. Observation of the lunch meal on 03/26/24 starting at 11:30 A.M. revealed [NAME] #414 took temperatures of the foods to be served with the facility's self-calibrating electronic thermometer as follows: pork 186 degrees Fahrenheit (F); tater tots 179 degrees F; and coleslaw 32 degrees F. Tray service began at 11:35 A.M. Staff utilized plates out of a plate warmer as well as heated dome bottoms. The staff plating food was not being attentive to the communication from the tray line staff, and the [NAME] continued to plate trays for regular diets despite the tray line staff saying they needed modified diet plates. The plates that were not needed immediately sat on the top of the servery until utilized, which was approximately ten minutes left uncovered. Towards the end of tray line, kitchen staff ran out of heated dome bottoms as well as dome lids. Seven trays were sent to the units with no heated dome bottoms and an addition 14 trays were sent to the units without heated dome bottoms as well as dome lids. The 14 trays that had no dome lids were covered with aluminum foil prior to leaving the kitchen. A test tray was requested for the C-unit cart which was started at 12:35 P.M. and was the last tray plated. The cart was taken immediately to the C-unit and dropped off at 12:36 P.M. All trays were passed, and test tray was sampled with Dietary Manager #384. Temperatures of the foods to be sampled were as follows: pork 118.1 degrees F; tater tots 106.5 degrees F; and coleslaw 51.7 degrees F. The pork and tater tots were lukewarm and did not taste palatable at this temperature. Dietary Manager #384 stated at the time of the observation that the sampled food was under minimum serving temperature. Dietary Manager #384 was informed during the test tray observation that the tater tots, pork, and coleslaw were not palatable at the temperatures they were served at and did not disagree. Page 1 of 2 365381 365381 03/28/2024 Wickliffe Country Place 1919 Bishop Rd Wickliffe, OH 44092

F 0804 Review of the facility list of resident diets revealed Residents #67 and #108 were NPO. Level of Harm - Minimal harm or potential for actual harm Review of the facility policy, Dining and Meal Service, dated 06/08/22, revealed individuals will be provided with nourishing, palatable, attractive meals and will support each individual's daily nutritional and special dietary needs. Residents Affected - Many This deficiency represents non-compliance investigated under Complaint Number OH00151785. 365381 Page 2 of 2