Health inspection·August 14, 2025

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to update periodically and follow menus in accordance with professional standards for 3 of 3 meals served. 1. The facility failed to update the facility menu since Fall/Winter 2024.2. The facility failed to follow the menu for week 5 of the Fall/Winter 2024. These failures could place residents at risk for weight loss, decreased nutritional intake, loss of desire, interest, and satisfaction in meals.Record Review on 8/12/2025 at 10:30 AM of Fall/Winter 2024 menus provided by facility revealed the following: Week 5, Day 31, Tuesday, lunch: Beef stew, mashed potatoes, mixed green salad, wheat bread, and baked apple slices.Week 5, Day 32, Wednesday, lunch: Lemon Pepper Chicken, lima beans, brussels sprouts, wheat bread, and chocolate tart.Week 5, Day 33, Thursday, lunch: Swedish meatballs, parsley noodles, roasted broccoli, wheat roll, and chilled fruit cup.Observation on 8/12/2025 at approximately 12:45 PM of test tray reflected a bowl of Swedish meatballs, mashed potatoes, a bowl of white beans in juice, and toast. Observation on 8/13/2025 at approximately 12:45 PM of test tray reflected a piece of baked chicken, mashed potatoes, broccoli, and chocolate pudding. Observation on 8/14/2025 at approximately 12:45 PM of test tray reflected a bowl of Swedish meatballs, noodles, broccoli, roll, and a small bowl of sliced peaches. During an interview on 8/14/2025 at 2:58 PM, the DM employed by the facility for three years stated, The facility received the menus from corporate and they were slow getting the menus out and had made changes. We were supposed to get them in May and there were multiple changes. She said menus should have been followed because it was a resident right and their diet. She said it was not acceptable to serve the same entree within the same week. She identified the risk to residents as they would have not eaten and may have lost weight. During an interview on 8/14/2025 at 3:08 PM, the DT employed by corporate for one year stated the menus were sent from corporate to the DM who ordered the food items. She said she was not okay that the same entree was served twice this week.Record review of the facility's undated policy titled Menu Planning, Policy Number: 01.002 revealed the following: Policy: The facility believes that nutrition is an important part of maintaining the well-being and health of its residents and is committed to providing a menu that is well-balanced, nutritious, and meets the preferences of the resident population. A standardized menu which meets the nutritional recommendations of the residents in accordance with the recommended dietary allowance of the Food and nutrition Board of the National Research Council, National Academy of Sciences will be used. Modifications for resident population and preferences may be made as appropriate. Procedure: 1. Menus will be prepared by each facility by [NAME] using the Menu Matrix program. Menus are updated twice each year with Spring-Summer and Fall-Winter cycles and are updated intermittently based on resident preferences. The menus will be for a five-week cycle and will include a week-at-a-glance menu.2. Alternates may include a comparable entree, vegetable, and a starch.3. The menus are reviewed and approved by the Consultant Dietitian. Page 1 of 4 455503 455503 08/14/2025 Rosewood Heights 5700 E Central Texas Expwy Killeen, TX 76543

F 0803 Level of Harm - Minimal harm or potential for actual harm Intermittent changes must also be reviewed and approved by the Consultant Dietician.The menu will be signed and dated by the Consultant Dietician. An approved, signed copy of the menus will be kept on file in the Nutrition and Foodservice Manager's office. Residents Affected - Some 455503 Page 2 of 4 455503 08/14/2025 Rosewood Heights 5700 E Central Texas Expwy Killeen, TX 76543

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. Based on observation, interview, and record review, the facility failed to store food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for Food and Nutrition Services. 1. The facility failed to ensure that expired foods were discarded.2. The facility failed to ensure food items were labeled and dated.3. The facility failed to ensure that serving utensils and dishes were not stored in a clean area.These failures could place residents at risk for foodborne illness.Observation on 8/12/2025 at 8:30 AM of the walk-in refrigerator reflected the following:- Lemons in a black container with no date had mold on them.- Raspberries dated 8/4/2025 on the box in their original container were molded.- Bell Peppers in a black container with no date had mold on them.- Grapes in a box dated 7/11 were in their original bag and had mold on them.- Half a squash wrapped in plastic was undated.Observation on 8/12/2025 at 8:30 AM of the pantry reflected the following:- hot dog buns had an expiration date of 5/11/2025.- Tortillas had expiration date of 7/31/2025.- The storage container with sugar in it was undated.Observation on 8/12/2025 at 8:45 AM 1 of 1 kitchen reflected the following:- Clean serving utensils stored in a clear container had food debris in with the serving utensils. An interview on 8/14/2025 at 2:30 PM, DA A said everyone needed to look for old or moldy food in the kitchen and throw it away. When new food arrived, should put old food in front and new food in back. Everything in the kitchen needs a date label, even food on trays. There was a list on the door of the walk-in cooler that indicated how long food can be stored in the cooler. DA A mentioned getting food safety training both today and last month. DA A stated that if residents were served out-of-date or moldy food items, they may become ill.An interview on 8/14/2025 at 2:40 PM, DA B said everyone checks for expired kitchen products daily. She ensures proper labeling, rotates stock with new food items in the front and older food items in the back. Staff follows the list posted on the cooler door. When she stocks the food, she rotates the food with the old in the front and the new in the back. DA B said that expired food can cause resident illness.An interview on 8/14/2025 at 12:47 PM, CK C said that checking for expired kitchen food is everyone's duty. CK C said when she is checking for expired food, she looks at the dates, or if the food looks bad, She discards food that is out of date or does not look good. She follows first-in-first-out which is old food items in the front and new food items in the back. CK C recognizes that expired or moldy food consumption could cause illness or death among residents.An interview on 8/14/2025 at 2:52 PM, CK D revealed CK D emphasized checking kitchen food daily for mold and expiration dates, discarding anything out of date. All items should be labeled, dated, and arranged with older items in front. She follows a cooler list indicating food storage limits and received food safety training on 7/16/25. Serving expired food risks resident illness.An interview on 8/14/2025 at 10:58 AM, DM said kitchen staff check for expired products daily. DM does a regular check to make sure that this is getting done. DM enforces first-in-first-out rotation where food is arranged with older items in front and maintains cooler storage guidelines. Monthly in-service trainings occur, with DM stressing that moldy or expired food can sicken residents.An interview on 8/14/2025 at 3:08 PM, DT revealed that all staff must check for expired kitchen items, though DM is primarily responsible. During her last inspection, she found no expired products. She emphasized that moldy or expired food could sicken residents.An interview on 8/14/2025 at 4:15 PM, ADM revealed that all kitchen staff are responsible for checking for out-of-date and old food. She said that the DM is responsible for making sure that the staff are checking for out-of-date items. She said kitchen staff should be checking daily for out-of-date and moldy items in the kitchen. DM is responsible for training the staff in food safety regularly. She said that residents could get seriously sick if 455503 Page 3 of 4 455503 08/14/2025 Rosewood Heights 5700 E Central Texas Expwy Killeen, TX 76543

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some they are served out-of-date or moldy food.A record review of the food handling policy, undated, revealed. Policy: To ensure that all food served by the facility is of good quality and safe for Consumption, all food will be stored according to the state, federal, and US Food Codes and HACCP[KA7] (Hazard Analysis Critical Control Point) guidelines. d. To ensure freshness, store opened and bulk items in tightly covered containers. All containers must be labeled and dated.e. Store scoops covered in a protected area near the food containers. Wash and Sanitize scoops weekly or as needed.g. Use the first-in, first-out (FIFO) rotation method. Date packages and place new items behind existing supplies, so that the older items are used first.e. Use all leftovers within 72 hours. Discard items that are over 72 hours old. 455503 Page 4 of 4