Health inspection·April 28, 2023

F812 Food Safety Requirements The facility must store, prepare, distribute and serve food in accordance with professional standards for food service safety.

F925 Maintains Effective Pest Control Program The facility must maintain an effective pest control program so that the facility is free of pests and rodents. On, March 1, 2023, at 5:45 p.m., an unannounced visit was made to the facility to investigate a complaint regarding physical environment. The facility failed to maintain a safe and sanitary environment in the facility' s kitchen (food storage and food preparation area) and failed to maintain an effective pest control program (measures to eradicate and contain common household pests) by failing to ensure the facility did not have rodent (small animals capable of transmitting/spreading disease, such as rats or mice) droppings (fecal matter) on the floor throughout the kitchen area. This deficient practice had the potential to result in food contamination, which directly affects 22 of 22 residents residing in the facility. This increases the risk of contracting rodent-borne illnesses (diseases caused by rodents, such as hantavirus infections or leptospirosis [diseases that cause high fever, headache, bleeding, nausea, vomiting, and organ failure]). A review of the facility's Daily Census, dated March 17, 2023, indicated that the facility was housing 22 patients. On March 17, 2023, at 2:08 p.m., during an observation, a kitchen closure sign, from Los Angeles County Environmental Health (EH) was posted in the facility ' s lobby. On 3/17/2023, at 2:10 p.m., during a general observational tour of the facility ' s kitchen, in the presence of the Building and Grounds Director (BGD), Department of Public Health (DPH) Environmental Health (EH) inspector, and Food Service Director (FSD), there were rodent droppings (no specific count) throughout the kitchen floor. The DPH EH inspector indicated where he observed evidence of rodent infestation during this tour. On 3/17/2023, at 2:18 p.m., during a concurrent observation of the area labeled "Ansul Cabinet" (a small room separated from the rest of the kitchen by a door) and interview with BGD, there were 20 or more rodent droppings on the floor located behind the cooking equipment (stoves/ovens). Inside the "Ansul cabinet", There was a hole on the right side of the wall, just above the floor, measuring about two inches in diameter. The BGD stated, he was not aware of the rodent droppings and/ or the hole on the right side of the Ansul cabinet. On 3/17/2023, at 2:25 p.m., during a concurrent observation in the kitchen and interview, there were 50 or more rodent droppings observed behind the cooking equipment (stoves/ovens). The FSD stated, there was a metal panel that was originally in place which blocked the view of the space behind the cooking equipment that is why FSD was not aware that there "this many" rodent droppings behind the cooking equipment. On 3/17/2023, between 2:27 and 2:50 p.m., during a concurrent observation of the facility's kitchen and interview with FSD, there were 30 or more rodent droppings along the walls inside the kitchen perimeter. During the observation, the rodent droppings were underneath the dish washing machines and dishwashing sinks, below the storage rack for the soda fountain syrups, and below food preparation tables. Glue traps (traps with a sticky surface to catch rodents) were also observed under the dish washing sinks and one glue trap under the dish washing sink was observed with rodent droppings on its sticky surface. The FSD stated, the droppings were across the kitchen area. On 3/17/2023, at 4:30 p.m., during an interview with Kitchen Dishwasher (KD), stated the dishwashers are responsible for moping the kitchen, but it was general practice to mop around the floor mats and not to remove them to clean underneath. The floor mats made moping underneath the counters difficult. The mats are removed once a week to clean underneath the equipment. A review of the DPH EH Official Inspection (facility's kitchen) Report dated 3/17/23, indicated the kitchen will be closed due to violations observed during this investigation. The inspection report indicated suspension of kitchen due to vermin (pests or insects that spread disease) infestation. A review of the facility's previous pest control service reports from September 2022 to February 2023 indicated, a pest control technician applied routine treatments to the facility and that there was no indication of active pest infestation. A review of the facility's Pest Control policy revised 11/1/2017, indicated the facility will maintain an ongoing pest control program to ensure the building and grounds are kept free of insects, rodents, and other pests. The policy indicated, a pest control company will "visit and inspect the facility at least once a year" and staff will report any signs of pests to the housekeeping supervisor. A review of the Centers for Disease Control and Prevention (CDC), Guidelines for Environmental Infection Control in Health Care Facilities, updated 7/23/2019, indicated, health facilities must develop pest-control strategies for areas prone to pest infestations, such as the kitchen. Health facilities shall contract for routine pest control services from credentialed pest-control specialists and tailor the treatments to the need of the facility. A review of the facility's cleaning policy titled "Cleaning and Disinfection of Environmental Surfaces", revised 10/24/2022 indicated, the facility will ensure that the cleaning and disinfection of environmental surfaces are in accordance with the CDC and Occupational Safety & Health Administration (OSHA). The facility failed to maintain a safe and sanitary environment in the facility' s kitchen and failed to maintain an effective pest control program. The above violations had a direct or immediate relationship to the health, safety, or security of all patients.