Health inspection·July 3, 2019

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Based on observation and interview, the facility failed to provide residents with knives during meals. This affected three residents (Residents #4, #5 and #141) of 15 residents observed eating in the dining room. The facility census was 21. Findings include: During observation of the main dining room on 07/02/19 at 11:51 A.M., residents were served paper plates, plastic forks, regular spoons, and no knives. During interview on 07/02/19 at 11:51 A.M., [NAME] #141 stated the residents were served paper plates and plastic forks because there was a leak in the kitchen and the dishes were not all clean. She verified they had plastic forks and no knives. During observation on 07/02/19 at 12:11 P.M., Resident #4 and Resident #17 were trying to cut their burritos with their plastic forks, which did not work. No staff offered to cut them. During interview on 07/02/19 at 12:11 P.M., Resident #5 had eaten the contents of her burrito only, but not the tortilla. She stated it would have been better if she had a knife to cut her burrito. During interview on 07/02/19 at 12:25 P.M., both Resident #4 and Resident #17 stated it was too hard to cut burritos with a plastic fork. During interview on 07/02/19 at 12:30 P.M., [NAME] #141 stated residents were not given knives, only spoons and forks. Page 1 of 2 366360 366360 07/03/2019 Vineyards at Concord, The 119 West High Street Frankfort, OH 45628

F 0812 Level of Harm - Minimal harm or potential for actual harm 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 policy review, the facility failed to store, label, date, and serve food properly to avoid food borne illnesses. This had the potential to affect all 21 residents in the facility. Residents Affected - Many Findings include: Initial tour of the kitchen completed on 07/01/19 from 9:15 A.M. to 9:45 A.M. revealed the following items in the refrigerator were being stored opened and undated: A bag of celery with celery stalks exposed; a bag of carrots; a bag of red grapes with some grapes exposed; and a bag of romaine lettuce hearts During interview on 07/01/19 at 9:30 A.M., [NAME] #141 verified all of the above items were opened and did not have a date on it. Review of the freezer on 07/01/19 at 9:32 A.M. revealed the following items were being stored in opened bags and undated: A bag of sausage patties; a bag of white shrimp; a bag of fish sticks were opened with some of the fish sticks exposed; a bag of pepperoni; a bag of french fries; and a bag of shredded cheddar cheese. An interview with the Administrator on 07/01/19 at 9:37 A.M. verified the above items were being stored in opened bags and were not dated. Observation of [NAME] #141 preparing and serving lunch meal on 07/01/19 at 12:02 P.M. revealed [NAME] #141 pulled three plates from the top of a stack of plates that were visibly wet with water on them and used them to serve the lunch meal to residents. [NAME] #141 also provided a tray cover to an aide that visibly had water still in it. [NAME] #141 dumped the water out of the tray cover into the sink and then provided the tray cover to the aide. The aide used the tray cover to cover a resident's meal and then delivered the meal to the resident's room at 12:04 P.M. Interview with [NAME] #141 on 07/01/19 at 12:05 P.M. confirmed the above observations. Observation of [NAME] #141 at 12:20 P.M. revealed tongs were used to serve chicken breasts to the residents. The tongs fell completely into the serving dish and were completely covered in chicken broth. [NAME] #141 used the serving spoon from the broccoli to get the tongs out of the chicken broth and then continued to use the same spoon to serve broccoli to the residents. Interview with [NAME] #141 on 07/01/19 at 12:23 P.M. confirmed the above observation. Review of the facility policy titled Food Purchasing, Receiving, and Storage, dated September 2014, stated food will be dated and stored promptly. All food supplies will be stored in areas protected from contamination by condensation, leakage, drainage, rodents, and vermin. Food will be purchased, received, and stored in such a manner as to assure quality and safe food, prevent contaminations and spoilage, assure proper billing, and promote health. 366360 Page 2 of 2