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, prepare, distribute, and serve
food in accordance with the professional standards for food service safety for 1 of 1 kitchen (Kitchen #1)
reviewed for kitchen sanitation. The facility failed to ensure the current menu for 01/11/2026- 01/17/2026
was posted for residents to see.The facility failed to ensure the wall above the food in the kitchen prep area
was not coated with grey dust and debris. The facility failed to ensure the storage food rack in the kitchen
food prep area was free from visible dust, yellow and brown sticky colored residue.The facility failed to
ensure [NAME] A followed the facility recipe for stewed okra/ tomatoes. These failures could place residents
at risk for cross contamination and food-borne illness.Findings Include: During an observation on
01/13/2026 at 9:45 a.m. indicated the menu for week 01/04/2026- 01/10/2026 was posted in the dining
area. During an observation in the kitchen on 01/13/2026 at 9:50 a.m. indicated the wall above an
uncovered pan of rice in the kitchen prep area was coated with grey dust and debris. The storage/
seasoning rack in the kitchen prep area was coated with dust, and yellow/ brown sticky colored residue.
During an observation on 01/13/2026 at 10:15 a.m. indicated stewed okra and there were no tomatoes nor
onions in the stewed Okra/ tomatoes. During an interview on 01/13/2026 at 10:20 a.m. with the Dietary
Manager, she said she was responsible for updating the menu every Monday. She said she was off Monday
01/12/2026 and was unable to change the schedule. She said she did not have a backup staff member who
updated the menu when she was not there. She said the current weeks menu should always be posted so
residents would know what to expect to eat at mealtime. She said she could not remember the last time the
wall or storage/ seasoning rack in the kitchen prep area was cleaned. She said there is no set time it should
be cleaned. The Dietary Manager said it should be cleaned when visible debris or dust is seen. She said
she was responsible for ensuring the kitchen was clean and sanitary. The Dietary Manager said she was
responsible for contacting maintenance and informing them that the high wall in the prep area needed
cleaning. She said the potential associated risk would be for dust to get in the resident's food. She said
[NAME] A did not follow the recipe for the stewed okra and tomatoes. She said she told [NAME] A to add
sausage to the okra for extra flavor. She said the potential associated risk would be residents not receiving
proper nutrient. During interview with Resident #1 on 01/13/2026 at 10:35 a.m. she said the menu had not
been posted for approximately 1-2 weeks. Resident #1 said when the menu was posted it was not the
correct week. She said it made her upset that she did not know what she is going to eat for the day and
week. During an interview on 01/13/2026 at 12:15 p.m. with the Maintenance Regional Supervisor, he said
the wall above the food in the kitchen prep area should not have had any grey dust or debris on it. He said
the storage/ seasoning rack in the kitchen food prep area should have been free from dust and sticky
residue. He said the potential associated risk would be food contamination. He said maintenance staff were
responsible for cleaning the high ceiling walls, ensuring they were free from debris. During an
(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:
675172
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
675172
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/13/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Cascades at Port Arthur
6600 Ninth Ave
Port Arthur, TX 77642
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)
F 0812
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
interview on 01/13/2026 at 1:30 p.m. with [NAME] A, she said she did not follow the recipe for the stewed
okra with tomatoes. She said a lot of residents did not like tomatoes in their okra. She said she put tomato
sauce, white vinegar, sausage, and seasoning for the okra. She said the Dietary Manager instructed the
cooks what to add or take away from the recipes. During an interview on 01/13/2026 at 1:45 p.m. with the
Administrator, he said the menu posted should be current for residents. He said he expected everything in
the kitchen to be cleaned daily and free of debris and dust. He said all kitchen staff were responsible for
keeping the kitchen clean. He said maintenance was responsible for cleaning the walls above the wall
storage/ seasoning rack. He said recipes should be followed. He said the potential associated risks would
be residents not knowing what they'll ate for the day, getting dust in their food, and them not getting their
approved diet. During record review of the stewed okra/ tomatoes recipe on 01/13/2026 at 2:00 p.m.,
indicated diced tomatoes, okra, onions chopped, granulated sugar, and black pepper were the needed
ingredients. During record review of the facility's policy title Sanitation, dated November 2022, indicated in
part: Policy Statement: The food service area is maintained in a clean and sanitary manner.Policy
Interpretation and Implementation-All kitchens, kitchen areas and dining areas are kept clean, free from
garbage and debris, and protected from rodents and insects.All utensils, counters, shelves and equipment
are kept clean, maintained in good repair and are free from breaks, corrosions, open seams, cracks and
chipped areas that may affect their use or proper cleaning. Seals, hinges and fasteners are kept in good
repair.All equipment, food contact surfaces and utensils are cleaned and sanitized using heat or chemical
sanitizing solutions. During record review of the FDA Food and Code dated year of 2022 entitled: 3.
Assessing Contaminated Equipment and Potential for Cross- Contamination. Indicated in- part: This risk
factor involves the proper storage and use of food products and equipment to prevent cross-contamination.
The cleaning, sanitization, and storage of food-contact surfaces of equipment and utensils in a manner to
prevent transmission of foodborne pathogens or contamination is also included in this risk factor.
Event ID:
Facility ID:
675172
If continuation sheet
Page 2 of 2