Health inspection·April 4, 2023

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, and serve food in accordance with professional standards for food service safety in the facility's kitchen, reviewed for kitchen sanitation. 1. The facility failed to ensure refrigerated foods were properly labeled and dated. 2. The facility failed to ensure pantry foods were properly labeled and dated. 3. The facility failed to ensure expired foods were not in the pantry and refrigerator. 4. The facility failed to ensure food service workers wore gloves. These failures could place residents at risk for food-borne illness. Findings include: Observation of the kitchen staff on 4/4/23 at 9:18 AM revealed the following: Two dietary service workers were not wearing gloves while preparing resident food. Observation of the refrigerator on 4/4/23 at 9:22 AM revealed the following: -Five gallons of milk with best by date 4/1/23. -75 4-ounce cartons of chocolate milk had no date. -Two heads of lettuce had no date. -4 large food service bags of cole slaw mix, had no date. -1 food service box of fresh tomatoes had no date. -3 gallons of maple syrup were open, with no date. -1 gallon of fruit punch had no date. -1 gallon of lemonade had no date. Page 1 of 4 675049 675049 04/04/2023 Avir at Pampa 1504 W Kentucky Ave Pampa, TX 79065

F 0812 -19 ½ dozen fresh eggs, had no date. Level of Harm - Minimal harm or potential for actual harm -4, 5-pound containers of cottage cheese with best by date 3/25/23. -10 individual glasses of apple juice, covered, with no date. Residents Affected - Many -10 individual glasses of tomato juice, covered, with no date. -5, 1-gallon food service containers of mayonnaise had no date. -1 gallon of Worcestershire sauce, was opened with an expiration date of 2/21/23. Observation of the walk-in pantry on 4/4/23 at 9:51 AM revealed the following: -1 Food Service box of dry pasta, was opened to the air, with an expiration date of 9/21. -6 boxes of wild rice pilaf, had no date. -1 open bag of Fritos corn chips had no date and was closed with a paper clip. -1 open bag of dry mashed potato flakes had no date and was closed with a paper clip. -10 Food Service canisters of oatmeal, had no date. -1 Food Service bag of bread pudding mix, had no date. -2 Food Service loaves of white bread, had no date. -15 Food Service bags of hot dog buns, had no date. -4 Food Service bags of hamburger buns, had no date -2 Food Service bags of turkey gravy mix, had no date. -2 Food Service bags of peppered gravy mix, had no date. -1 Food Service container of chicken base mix, had no date. Observation of residents who were in the dining room at the time of the noon dining service revealed 2 residents were witnessed dipping their personal cups into the facility's ice maker, without using the ice scoop . There were no interventions by staff to keep residents from doing this. In an interview with the facility Administrator on 4/4/23 at 10:28 AM after State Surveyor intervention, revealed the Administrator immediately reprimanded residents for using the ice machine on their own, posted a sign on the machine which indicated residents were not to use the machine without assistance and the ordering of an ice machine which dispenses ice versus having to use a scoop to put ice into a glass . 675049 Page 2 of 4 675049 04/04/2023 Avir at Pampa 1504 W Kentucky Ave Pampa, TX 79065

F 0812 Level of Harm - Minimal harm or potential for actual harm In an interview on 4/4/23 at 11:01 AM, the Dietary Manager stated she started in the position about a month ago and she had been trying to train staff on food storage and the need to rotate things that were outdated. She stated residents could become sick if they were served foods that were expired or undated. The Dietary Manager stated residents could become sick if a food service worker did not properly sanitize their hands and don gloves before contact with resident foods . Residents Affected - Many Record review of the Food and Nutrition Services and Kitchen Sanitation to Prevent the Spread of Viral Illnesses policies and procedures, dated 3/3/20, revealed gloves are to be worn at all times, by kitchen staff and are to be changed: 1. Between each food preparation task. 2. After touching items, utensils or equipment not related to task. 3. After touching hair, face, or another source of contamination. 4. When leaving food preparation area for any reason. 5. When damaged, soiled or when interrupted. 6. Every hour for all tasks taking longer than one hour. Record review of the Food Storage policy and procedures, dated 2018, 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 guidelines. Procedure: 1. Dry storage rooms d. To ensure freshness, store opened and bulk items in tightly covered containers. All containers must be labeled and dated. f. Where possible, leave items in the original cartons placed with the date visible. 675049 Page 3 of 4 675049 04/04/2023 Avir at Pampa 1504 W Kentucky Ave Pampa, TX 79065

F 0812 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. Level of Harm - Minimal harm or potential for actual harm 2. Residents Affected - Many Refrigerators d. Date, label and tightly seal all refrigerated foods using clean, nonabsorbent, covered containers that are approved for food storage. e. Use all leftovers within 72 hours. Discard items that are over 72 hours old. 675049 Page 4 of 4