Health inspection·August 24, 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 and prepare food in accordance with professional standards for food service safety in the facility's only kitchen reviewed for food and kitchen safety. The facility failed to label and date food products io the refrigerator and thaw foods appropriately. There failures could place residents at risk for food-born illness. Findings included: Observations on 8-22-2023 at 8:30 AM of the facility's refrigerator revealed parmesan cheese and sliced American cheese loosely wrapped, exposed to the air, without labels to signify the date in which the product was opened and when it was supposed to expire. Observations on 8-22-2023 at 8:30 AM of the facility's freezer revealed two large containers of ice cream that were not labeled or dated. The outside of the ice cream tubs were covered in a 1/2 inch layer of frost. Interview on 8-22-2023 at 8:35 AM with the KM revealed she knew that food was supposed to be labeled and dated but was unsure how long the facility policy allowed food to be stored in the refrigerator. She stated that she would check the items that were undated for freshness and either throw them out or affix a label and date. KM stated that they were responsible for ensuring that food subject to spoilage were properly packaged, labeled, and dated. Observations and on 8-22-2023 at 11:15 AM in the facility's kitchen revealed one medium sized package of frozen turkey thawing in a large metal sink basin in 120-degree Fahrenheit water. The turkey in the 120 Degree Fahrenheit was not thawed out; a second medium sized frozen turkey, still frozen solid, was left out at room temperature to thaw on a cart just outside of the freezer door. Interview on 8-22-2023 at 11:15 AM with the KM revealed that soaking the frozen turkey in120-degree Fahrenheit water was not the correct way to thaw food. The KM stated that the correct way to thaw out a frozen turkey was to place it refrigerator in a sheet pan and thawed over the course of 2-3 days. The KM removed the turkey from the 120 degree Fahrenheit water, opened it, and began to cut it with a large serrated knife. The turkey was still visably frozen. The KM put the other frozen turkey, the one that was left out at room temperature to thaw on a cart, back in the freezer Page 1 of 3 675712 675712 08/24/2023 Avir at Itasca 409 S Files St Itasca, TX 76055

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Record review of the KM food handlers card revealed a valid date from 7-21-2021 to 7-7-2024 and a Hospitality Manager Diploma dated July 2021. Interview on 8-24-2023 at 8:39 AM with the ADM revealed that she wanted more training about the kitchen requirements so they could provide better supervision. She stated that she did not want anyone to get sick. She stated that food borne pathogens could cause residents to get sick, which could lead to dehydration unintended weight loss, and result in the resident having to be isolated. Record review of the facility's Food and Preparation Service policy, which was dated July 2014, reflected the proper procedure for thawing foods. The policy reflected that food could not be thawed at room temperature. The policy reflected to thaw in the refrigerator in a drip proof container; submerge the item in cold running water (70 degrees Fahrenheit or below); thaw in a microwave oven and then cook and serve immediately; or thaw as a continued cooking process. Record review of the facility's Food Receiving and Storage policy, which was dated July 2014, reflected that all stored in the refrigerator and freezer were to be covered, labeled, and dated. 675712 Page 2 of 3 675712 08/24/2023 Avir at Itasca 409 S Files St Itasca, TX 76055

F 0912 Level of Harm - Potential for minimal harm Residents Affected - Some Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Based on observation, interview and record review, the facility failed to provide at least 80 square feet per resident in multiple resident bedrooms for 8 of 82 (Rooms #'s 16, 17,18, 19, 20, 21, 22 and 23) resident rooms reviewed for square footage. Rooms 16, 17,18, 19, 20, 21, 22 and 23 which were double occupancy were not 80 square feet per resident. This practice could result in overcrowding in resident rooms. Findings include: During an interview on 08/22/2023 at 10:35 AM with the ADM, she stated she requested a room waiver for semiprivate rooms 16, 17,18, 19, 20, 21, 22 and 23 that were less than 80 sq. ft. per resident. She stated there had been no changes in the rooms. During an observational tour of the resident rooms on 08/22/2023 at 11:11 AM revealed 8 semi-private resident rooms did not provide 80 square feet per resident. The rooms with less than 80 square feet were rooms #16,17, 18, 19, 20, 21, 22 and 23. Review of the HHSC/DADS Form 3740 Bed Classification dated 08/22/2023 revealed rooms 16, 17,18, 19, 20, 21, 22 and 23 were licensed for two residents. 675712 Page 3 of 3