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 properly store, prepare, distribute,
and serve food in accordance with the professional standards for food service safety 1 of 1 kitchen
reviewed for safety requirements.1. The facility failed to ensure spoiled strawberries were not stored in the
walk-in cooler. 2. The facility failed to ensure raw meat was not stored on top of ready to eat green apples in
the walk-in cooler. 3. The facility failed to ensure food items in the freezer #1, #2 and dry pantry were
labeled, dated and sealed. These failures could place residents, who received food and beverages from the
kitchen, at risk for health complications, foodborne illnesses, and decreased quality of life.Findings
included:During observation and interview in the kitchen on 07/22/25 with the DM at 10:20 a.m. of the
walk-in cooler indicated there were:on the first shelf were four unopened, clear 30-ounce containers, each
containing strawberries that had a gray hairy like coating. The DM said she did not know when the
strawberries arrived, and it looked like the strawberries were growing mold. The DM stated she had not yet
made rounds in the kitchen for her daily inspection due to surveyor entrance.On the second shelf, an open,
undated, original cardboard box containing an opened clear plastic bag of exposed raw chicken
thighs(approximately 30-40 thighs) thawing on top of an opened cardboard box of ready to eat green
apples(approximately 15-20 apples) which were located on the third shelf, directly under the raw thawing
thighs.Also, on the second shelf, on top of the ready to eat green apples was an opened, undated clear
plastic bag of exposed raw bacon.DM said she did not know when or who put the raw chicken and raw
bacon on the shelf on top of the apple and said she would move the raw meat to another area in the walk-in
cooler. The DM said storing raw meat on top of ready to eat foods can cause cross contamination.During
an observation and interview on 07/22/25 at 10:15 a.m. of the walk-in freezer #1 with the DM indicated
there were:an undated, unlabeled, original packaged, vacuum-sealed clear plastic bag of frozen pork
loin.an original packaged, ripped open, exposed to the elements, half-full gallon bag of shredded parmesan
cheese without a date indicating when opened or due to expire.The DM said she did not know when or who
opened the parmesan bag of cheese that should be labeled and sealed and the pork loin should have a
label on it of what it was and dated. The DM stated this can cause decreased quality and taste.During an
observation and interview on 07/22/25 at 10:40 a.m. of freezer #2 with the DM indicated there were:an
undated, clear plastic 5-pound bag that contained frozen breakfast sausage patties that was ripped open,
not properly sealed and exposed to the elements. The DM said it was breakfast sausage patties.An
undated and unlabeled box of frozen yellowish pudding looking substance with a brown bottom crust. The
DM said it was lemon bars.When asked about the lemon bars and frozen breakfast sausage patties, the
DM tied the plastic bag and said it should be labeled, sealed and dated because anything can leak on it,
could taste freezer burnt and all items needed to be labeled with name of item and date it was
opened.During an observation and interview on 07/22/25 at 11:00 a.m. of the dry storage/pantry with the
DM indicated there were:one,
(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:
676210
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
676210
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/24/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Focused Care at Summer Place
2485 S Major Dr
Beaumont, TX 77707
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 - Many
FORM CMS-2567 (02/99)
Previous Versions Obsolete
original container, 5-pound bag of grits opened and used, not dated when opened. one, original container,
4-ounce bag of potato pearls opened and used, not dated when opened.one, original container, 1-pound
bag of vanilla instant pudding ripped opened in a quart sized ziplock bag, not dated when opened and
used.one, original container, 20-ounce bag of peppered biscuit gravy ripped opened in a quart sized ziplock
bag and used, not dated when opened.The DM said she did not know when or who opened the items and
would discard them. She said it can cause decreased quality and taste. The DM said if used, residents
could get sick.During an interview on 07/22/25 at 11:25 a.m. with the DM, she said she expected all
products in the kitchen to be stored correctly. She said packages of food items should be sealed so as not
to expose food to the elements. The DM said it was the responsibility of all the dietary staff to ensure
products were labeled and stored correctly. The DM said she could not explain why the expired or spoiled
foods had not been removed from the walk-in cooler. The DM said all kitchen staff completed the required
food preparation and food storage trainings. The DM said the potential harm to residents would be food
poisoning, diarrhea, sickness, and bacteria on food. The DM said the failure occurred due to staff not
paying attention. During an interview on 07/30/25 at 4:30 p.m., the Administrator said her expectation was
for kitchen staff to follow policies on food storage, preparation, and that everything was dated. She said the
DM monitored that kitchen staff were following the facility's policy. The Administrator said not storing and
preparing food appropriately could cause residents to be given food beyond the expiration date and not the
correct time frame. The Administrator said it could also affect the freshness and quality of resident's food.
Record review of facility policy revised dated 10/2017 titled, Food Receiving and Storage: Policy: 7. Dry
foods that are stored in bins will be removed from original packing, labeled and dated (use by date).8. All
food stored in the refrigerator or freezer will be covered, labeled and dated (used by date). 11. Uncooked
and raw animal products and fish will be stored separate in drip proof containers and below fruits,
vegetables and other ready to eat foods.Record review of the Food and Drug Administration Food Code,
dated 2022, reflected, . 3-201.11 Safe, Unadulterated, and Honestly Presented. Compliance with Food Law.
FDA considers food in hermetically sealed containers that are swelled or leaking to be adulterated and
actionable under the Federal Food, Drug, and Cosmetic Act .3-302.12 Food Storage Containers, Identified
with Common Name of Food. Except for containers holding food that can be readily and unmistakably
recognized such as dry pasta, working containers holding food, or food ingredients that are removed from
their original packages for use in the food establishment, such as cooking oils, flour, herbs, potato flakes,
salt, spices, and sugar shall be identified with the common name of the food 3-305.11 Food Storage.(B)
.refrigerated, ready-to eat time/temperature control for safety food prepared and packaged by a food
processing plant shall be clearly marked, at the time the original container is opened in a food
establishment and if the food is held for more than 24 hours, to indicate the date or day by which the food
shall be consumed on the premises, sold, or discarded, based on the temperature and time combinations
specified in (A) of this section and: (1) The day the original container is opened in the food establishment
shall be counted as Day 1; and (2) The day or date marked by the food establishment may not exceed a
manufacturer's use-by date if the manufacturer determined the use-by date based on food safety
Event ID:
Facility ID:
676210
If continuation sheet
Page 2 of 2