Health inspection·September 15, 2022

F 0802 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Based on observation, interview, and record review, the facility failed to ensure the food and nutrition services staff maintained current competency in dietetic task operations to safely carry out the kitchen functions in a sanitary manner according to facility policies and standard of practice when: 1. The Dietary Aide (DA) could not correctly demonstrate how to test the dishwashing machine for sanitation. 2. No temperature log for the dishwashing machine These failures had the potential to result in contamination of food leading to widespread food borne illness for 16 residents who consume food from the kitchen. Findings: 1. On 9/14/22 at 10:00 A.M., an interview with DA 1 was conducted. DA 1 stated, she was the assigned dishwasher for the shift. DA 1 stated, she would check the temperature of the dishwasher machine before starting the wash. DA 1 further stated, she would test the machine water by using a test strip; if the color of the test strip was dark the machine was good if not dark, add solution and run the machine again. DA 1 stated I do not record the temperature or the test strip, no one told me that it needed to be recorded. On 9/15/22 at 9:00 A.M., an observation and interview with DA 2 was conducted. DA 2 demonstrated how he tested the sanitizer strength in the dishwasher machine. DA 2 took a test strip from a test strip container, he placed the strip in the machine water, waited for 15-30 seconds and removed the test strip from the water. DA 2 compared the test strip color against the sanitizer color indicator. DA 2 stated, the deep green color test strip indicated 300-400 parts per million (ppm) and that was the proper sanitizing level. DA 2 checked the temperature gauges on the dishwashing machine. The temperature reading was 150 degrees. DA 2 stated, I think the machine temperature is ok, I do not know what the temperature is supposed to be, so I do not know if it is not ok. 2. On 9/15/22 at 9:10 A.M., an interview with DA 2 was conducted. DA 2 stated, he did know that he had to record the dishwasher machine temperature. There was no record of temperatures logged. On 9/15/22 at 9:15 A.M., an observation and interview with DA 1 was conducted. DA 1 started to use the dishwasher. The first run was a rack of serving trays. DA 1 did not checked the temperature gauges before, during or after the wash. DA 1 then placed a rack of glassware and did not checked the Page 1 of 4 555906 555906 09/15/2022 Meadowbrook Village Christian Retirement Community 100 Holland Glen Escondido, CA 92026

F 0802 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some temperature gauges before, during, or after the wash. DA 1 stated, she did not remember receiving an in service from the vendor. DA 1 stated another DA trained her how to use the dish machine. DA 1 stated, I do not touch any knobs on the machine. DA 1 stated, I do not record the temperature of the machine or the test strip. DA 1 further stated, she did not know about the machine sanitization. On 9/15/22 at 10:24 A.M., a concurrent observation and interview with the DM was conducted. The DM stated, it was the expectation that staff follow the facility policy and procedure for the dishwasher machine. The DM stated, the dishwashing machine is a high temperature dishwashing machine and the temperature needs to be 180 degrees. The DM stated, DA 2 should have placed the test strip onto the wet plate and not in the dish machine water. The DM further stated, there was a different test strip for the dish washer machine. The DM stated, the vendor came every 2 weeks to check the machine but could not what speak to what the vendor was checking or provide a log from the vendor of what was being checked. The DM further stated, we do not have temperature logs for the dishwashing machine. The DM stated, it was important for dishes to be sanitized to prevent residents from getting potential food borne illnesses from dirty dishes. There was no competency, in-service, or education provided by the facility regarding the dishwashing machine when requested. A review of the facility policy and procedure, dated 01/01/18, Dishwashing machines: Temperature ., the document indicated, .To record temperatures on a daily basis for all three meals times. 1. Temperatures shall be recorded after the first rack goes through the dish machine for each meal.4. For high temperature dish machines record the final rinse temperature, which must be at minimum of 180 degrees . 555906 Page 2 of 4 555906 09/15/2022 Meadowbrook Village Christian Retirement Community 100 Holland Glen Escondido, CA 92026

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 record review, the facility failed to ensure sanitary conditions were maintained during food storage when: Residents Affected - Some 1) A container of opened pitted prunes was not discarded. 2) A gallon of tea concentrate had no label. 3) An opened container of cottage cheese and an opened container of maraschino cherries were not discarded after the best use by date. 4) A gallon of light unsulphured molasses was not discarded after the best by date. 5) A quart of thickened lemon-flavored water was not discarded after the best used date and uncovered liquids were stored in the refrigerator. These failures had the potential to cause widespread food borne illness among residents who consume food from the kitchen. Findings: 1. On 9/14/22 at 9:30 A.M., an observation and interview was conducted with the Dietary Manager (DM) inside the main kitchen. Inside the single door refrigerator, a container with a container of pitted prunes with a prepared date of 8/9/22 was found. The DM stated, the prunes should have been discarded after a month. Per the facility's Produce shelf life (processed or bag) documentation posted in the main kitchen dated 3/14/14, pitted prunes once opened it was good for 4 days. 2. On 9/14/22 at 9:35 A.M., an observation and interview with the DM was conducted inside the main kitchen. A gallon of tea concentrate was found inside the refrigerator, no label or date of when the tea was opened. The DM stated, the staff should labeled all food items when opened to ensure food safety. 3. On 9/14/22 at 9:40 A.M., an observation and interview with the DM was conducted in the main kitchen. The Deli refrigerator had a container of maraschino cherries labeled with a used by date of 9/8/22 and a 5 pound container of cottage cheese, labeled with a best by used date of 9/7/22 were found. The DM stated, the staff should have discarded the cherries after 9/8/22 and the cottage cheese should have been taken out after the best used by date, to ensure residents were served safe food items. 4. On 9/14/22 at 9:45 A.M., an observation and interview with the DM was conducted in the main kitchen. Inside the standing freezer, a container of unsulphured molasses labeled best by 4/8/21 was found. The DM stated, the staff should have checked the shelf life of the molasses and discard accordingly. Per the facility's Dry Storage Life of Foods 2019 posted in the main kitchen, molasses could be 555906 Page 3 of 4 555906 09/15/2022 Meadowbrook Village Christian Retirement Community 100 Holland Glen Escondido, CA 92026

F 0812 used for 2 months from the opened date. Level of Harm - Minimal harm or potential for actual harm 5. On 9/14/22 at 10:10 A.M., an observation and interview with the Registered Dietitian (RD) was conducted in the dining area. Inside the refrigerator, an opened container of thickened lemon water labeled best if used by 9/13/22. The RD stated, the thickened lemon water should have been discarded. In addition, inside the refrigerator, there were 4 double handled cups filled with liquid and no lid cover. The RD stated, staff should have covered the cups to ensure food safety. Residents Affected - Some On 9/14/22 at 10:15 A.M., an interview with the RD was conducted. The RD stated, the kitchen staff should follow and discard foods according to the manufacture's best by or best used by dates to ensure food served to the residents were safe and to avoid food borne illness. Per the facility's policy and procedure dated 2018, titled Labeling / date Marking and Safe Storage of Refrigerated and Frozen Foods, . 1. Any foods removed from original container will be properly labeled .3(c) .commercially processed foods must be dated when opened and are good for 7 days, or until the expiration date . 555906 Page 4 of 4