Health inspection·September 9, 2025

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 store, prepare, distribute, and serve food in accordance with the professional standards for food service safety for 1 of 1 kitchen reviewed for kitchen sanitation. The facility failed to ensure refrigerated and freezer items were properly stored, labeled, and dated.This failure could place residents at risk of food-borne illness. Findings included:Observation of the freezer on 09/09/25 at 9:54 AM revealed the following:1. (1) bag of unidentified food, no label or date. 2. (1) opened freezer bag of French fries, no label or date.3. (1) bag of hamburger patties, no label or date.4. (1) bag of hashbrowns, open to air, no label or date. 5. (1) bag of meat, no label or date.6. (1) opened, half-eaten ice cream sandwich, open to air, no label or date.7. (2) clear cups with lids, orange substance inside, no label or date. Observation of the walk-in refrigerator on 09/09/25 at 10:03 AM revealed the following: 1. (1) sealed container of vegetable base, no date or label.2. (6) packages of butter, one opened and in a baggie, no date or label.3. (2) bowls of water containing celery and carrots. No date or label. 4. (1) bowl containing whole onions, peppers, and tomatoes. No date or label.5. (1) box of cucumbers, no date or label. In an interview on 09/09/25 at 10:08 AM, [NAME] A stated he had worked at the facility since January 2025 and everyone was responsible for labeling and dating food. He stated a possible negative outcome for not labeling and dating food could be that residents could get sick and they could serve out of date food. In an interview on 09/09/25 at 10:10 AM, the DM stated he had worked at the facility since April of 2025 and everyone who worked in the kitchen was responsible for labeling and dating food. He stated a possible negative outcome for not doing that could be a resident could become sick or die from food poisoning. In an interview on 09/09/25 at 1:17 PM, [NAME] B stated it was everyone's responsibility to label and date food, that it was a group effort. She stated if food was not labeled or dated, they would not know when the food was brought into the kitchen or when it expired. In an interview on 09/09/25 at 2:59 PM, the ADM stated the facility does not have a policy for labeling and storage of food. In a phone interview on 09/09/25 at 3:16 PM, the RD stated she does in services and trainings on labeling and dating at the facility with employees of the kitchen and a handout should be available in the DM's office, and she also provided it to the ADM.In an interview on 09/09/25 at 3:46 PM, the ADM provided the in-service handout along with signatures of employees who attended the training done by the RD and stated that it was the policy that the kitchen followed. Record review of Dietary In-service, dated 01/30/25, revealed the following information in part:12 employee signatures. 1). Dietary staff will understand the importance of preventing cross contamination by storing food properly.2). Food must be properly stored to prevent contamination and freezer burn by closing all food products in the freezer and properly sealing all opened boxes and containers. a). All items in the freezer must also be dated when received. b). All items when removed from boxers are placed in sealed containers and labeled/dated. c). All items placed in the refrigerator to thaw must be redated with the date into (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 455480 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455480 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Heritage Convalescent Center 1009 Clyde St Amarillo, TX 79106 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)