Health inspection·March 13, 2024

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to store, prepare, distribute, and serve food under sanitary conditions in the facility's only kitchen. The dietary staff did not accurately test the dish machine for chlorine sanitizing with the correct test strips from 02/27/24 until 03/11/24. This failure could place residents who ate food from the kitchen at risk of foodborne illness. Findings included: During an observation and interview in the kitchen on 03/11/2024 at 09:45 AM, DA A was going to demonstrate checking the sanitizing on the dish machine and she had a container of testing strips on top of the machine. She said she had not tested the machine yet this morning. She was finished with washing the breakfast dishes. She ran the machine and took a test strip from the container and tested the water containing the sanitizer. The test strip was a yellow color and had no reaction. Observation of the label on the container of strips indicated the strips were for use on QAC (quaternary ammonium compounds) sanitizer and not chlorine sanitizer. DA A said she had been using those strips to test the dish washing machine since the RD told them they could use the QAC strips. She said those were the only test strips she had to use and not the purple ones. A review of a Facility Dish Machine Temperature and Sanitizing Log dated March 2024 and posted on the wall by the dish machine indicated the sanitizer had been tested every day from 03/01/24 to 03/11/24 three times a day and test results for sanitizing were noted at 50 ppm when using strips that were unable to test for the presence of chlorine. During an observation and interview on 03/11/24 at 11:25 AM DA A said she found some chlorine test strips on a shelf in the kitchen. She demonstrated checking the sanitizer in the dish machine and it was sanitizing at 100 ppm. During an interview on 03/12/24 at11:15 AM, DM said her RD told her she could use the quaternary test strips used at the 3 compartment sink on her chlorine sanitizing dish machine because her chlorine strips were out of date. During an interview on 03/12/24 at 03:30 PM the DM said the RD came in on 02/27/24 and did a kitchen sanitation quality review and dining observations. She said she had been using the quaternary strips on the machine since that date. She said the machine should be tested 3 times a day, once for Page 1 of 2 675011 675011 03/13/2024 Avir at Jacksonville 305 Bonita St Jacksonville, TX 75766

F 0812 Level of Harm - Minimal harm or potential for actual harm each meal where dishes would be washed. She said she had no written policy regarding when to test the machine other than the log sheet. She said the service vendor came to the facility on [DATE] and did a routine maintenance check and the machine was sanitizing properly on that day. She said the service vendor came on 03/11/24 at 3:45 PM to bring chlorine testing strips and did a full maintenance check at that time and the machine was sanitizing. Residents Affected - Many quaternary solution was used primarily for three compartment sinks and test strips for quaternary compounds indicated sanitizing was occurring when the solution was testing at 200-400 ppm. FDA Food Code, dated 2013, viewed at FDA.gov indicated Low temperature machines using chlorine as a chemical sanitizer should have a concentration between 50 ppm and 100 ppm and be measured using the appropriate chemical test kits. The effectiveness of chemical sanitizers is determined primarily by the concentration and pH of the sanitizer solution. Therefore, a test kit is necessary to accurately determine the concentration of the chemical sanitizer solution. 675011 Page 2 of 2