cms_GA: 3364

In collaboration with The Seattle Times, Big Local News is providing full-text nursing home deficiencies from Centers for Medicare & Medicaid Services (CMS). These files contain the full narrative details of each nursing home deficiency cited regulators. The files include deficiencies from Standard Surveys (routine inspections) and from Complaint Surveys. Complete data begins January 2011 (although some earlier inspections do show up). Individual states are provides as CSV files. A very large (4.5GB) national file is also provided as a zipped archive. New data will be updated on a monthly basis. For additional documentation, please see the README.

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rowid facility_name facility_id address city state zip inspection_date deficiency_tag scope_severity complaint standard eventid inspection_text filedate
3364 LIFE CARE CENTER 115654 176 LINCOLN AVE FITZGERALD GA 31750 2017-09-21 371 F 0 1 MB2E11 Based on observation, staff interviews, and review of facility policy, it was determined the facility failed to use sanitizer in the three-compartment sink while washing dishes, failed to label and date food and condiments stored in the walk- in cooler, failed to ensure food temperatures were at safe levels prior to serving prepared food to residents, and failed to adequately monitor dishwasher temperatures and sanitizer levels on the dishwashing machine. These failures put 103 residents who consume oral food out of 105 residents residing in the facility, at risk for developing a food borne illness. The findings include: Review of an undated policy titled, Food Safety Requirements-Use and Storage of Food and Beverage Brought In For Residents, Food Procurement indicated the following: It is the policy of this facility to provide safe and sanitary storage, handling, and consumption of all foods including those brought to residents by family and other visitors. It further indicated that food service workers, cooks, dietary aides, dishwashers, food prep aides, or any persons who are in the kitchen working with any type of food, are responsible for adhering to the food safety requirements. The policy also listed factors implicated in foodborne illnesses to include Inadequate cooking and improper holding temperatures promotes the growth of pathogens that may cause foodborne illness, as well as improper sanitation of equipment used in preparation of food. Review of the policy titled, Nutrition Services Manual dated 06/2015, 10.9 indicated for the dish machine, The dish machine is maintained in a clean and sanitary condition. The dish machine is set up for washing dishes/utensils following manufacturer's directions. Temperatures and chemical strength will be checked at each meal and recorded on the Dish Machine/Sanitizer Log. 10.42 indicated for the pot and pan sanitizer concentration log, The cook or dietary aide, after setting up a three compartment sink and before washing pots and pans, utilizes appropriate test strips for the chemical being used and records the results of the test after the appropriate date and time. 10.40 indicated for the refrigerator/freezer temperature log, morning cook upon arrival and evening cook before closing department for the evening record temperature of the walk in refrigerator and walk in freezer. An initial tour of the kitchen was conducted on 9/18/17 at 9:20 a.m. with Dietary Cook A[NAME] The three-compartment sink was being utilized to wash pots and pans by Dietary Cook BB. The sanitizer sink contained clear water and a submerged metal bowl. Dietary Cook BB performed a sanitizer check with a test strip she obtained from the wall. The test strip did not change colors (the color indicates the parts per million(ppm) of sanitizer added to the solution.) Dietary Cook BB read the test strip container and stated, the test strip should turn green between 200-400 ppm. She denied putting any sanitizer in the sink prior to beginning the dish washing process. Dietary Cook BB stated I'm new and this is only my third time doing dishes. The sink was already done for me. Dietary Cook AA stated, a capful of sanitizer needs to be added and then re-tested . Dietary Cook AA provided a spray bottle of Redi San RTU (hard surface cleaner) and pulled a plastic cap off another chemical bottle and told Dietary Cook BB to use that to measure. Dietary Cook AA and Dietary Cook BB were unable to provide any logs for previous monitoring of the sanitizer in the three-compartment sink. Dietary Aide CC was working in the dish room next to the dish machine. She stated, this is a hot machine and it has to reach 120 degrees before it can be used according to the man who comes to check the machine. There were no visible directions posted on or near the machine. Dietary Aide CC stated, logs are supposed to be kept in a book on the wall. Review of the log book on the wall revealed one notation for 9/15/17 and the wash temperature was listed as 120 and the rinse temperature was 137. Dietary Aide CC could not provide any additional logs for the dish machine. The Food Service Director (FSD) arrived at the facility on 9/18/17 at 9:45 a.m. and the kitchen tour continued. There was a temperature log posted outside the walk-in cooler and the walk-in freezer. The temperature was listed as 0 every day from 9/1/17 - 9/19/17 for both the walk-in cooler and freezer. The FSD confirmed the temperatures were not being logged twice daily as they should be and she did not know why they were listed as 0. The walk-in cooler contained eight clear plastic squeeze bottles marked ranch that were partially full and contained no open date. There were also five red plastic bottles (three without lids) that had no label or open date. Three yellow plastic bottles with no lids and a dried brown substance around the top that were not labeled or dated. There was a gallon size, clear canister, sitting on the shelf with a clear plastic wrap laying across the top. The canister was half full, with a thick, brownish purple substance that was not labeled or dated. The FSD confirmed all the unlabeled food items should be thrown out. Interview with the FSD on 9/18/17 at 2:58 p.m., in the kitchen, revealed she found some sanitizer in the back of the storage shed that was to be used in the three-compartment sink. She stated I don't know how long it hasn't been used and I can't find any logs. The dish machine is a low temperature machine and the sanitizer is located under the machine. It is supposed to be checked along with the temperature prior to running the dishes. A second observation of the kitchen was conducted on 9/19/17 at 8:00 a.m. Dietary Cook DD was plating the last of the breakfast trays to go out to the residents. Dietary Cook DD was asked what the food temperatures were prior to plating the breakfast. She stated, to be honest, I didn't take them. When she was asked to take the food temperatures prior to plating the rest of the trays, Dietary Cook DD left the area and returned with a thermometer and stuck it into the eggs without cleaning or calibrating. When asked if she calibrated the thermometer, she replied I don't know what that means and I'm not sure this is the right thermometer. Dietary Cook DD was unable to complete the task of taking food temperatures. Dietary Cook DD was unable to produce any food temperature logs when asked and she stated, to be honest with you, I haven't taken any temperatures. She provided a book of blank temperature logs. There were no completed temperature logs for the month of (MONTH) (YEAR). There were documented breakfast and lunch temperatures on 7/31/17, 8/3/17, 8/5/17, and 8/7/17. A breakfast temperature was documented on 8/6/17 and there were no notations for any supper temperatures on any of the logs that were made available. During the observation, the FSD was observed washing dishes in the three-compartment sink. There was no sanitizer log available and the FSD stated I did it, but I didn't write it down. She did not provide the test information. The walk-in cooler was observed with the FSD and there were 23 plastic bowls containing an unidentified tan chunky substance that was not labeled or dated. There were no temperature logs posted for the walk-in cooler or freezer and the FSD stated I took it down yesterday and I haven't put another one up yet. Interview with the Registered Dietician (RD) on 9/19/17 at 10:05 a.m., in the dietary office, revealed she works for a private consulting company and has been coming to the facility twice a month for seven years. The RD revealed the first visit of the month is to complete assessments and the second visit is to complete the kitchen inspection and provide any training that is needed. The RD further revealed that a copy of the kitchen inspection is given to the FSD. The typical items that are identified on inspection include food temperatures not being taken, portion sizes not being right, not reading the diet cards, and sanitation issues. The RD stated I have done in-services over and over. Honestly, I assume they just aren't paying attention to me. I think the FSD tries but maybe she is overwhelmed. Every month this is a problem and they don't fix it. Review of the kitchen inspection reports that the RD provided revealed issues had been identified in the facility since (MONTH) (YEAR). Interview with the Administrator on 9/19/17 at 2:35 p.m., in her office, revealed she is new to the facility since 5/15/17 and identified issues in the kitchen immediately. The Administrator further revealed that she has been meeting with the FSD one on one, three to four times a week to go over kitchen issues that have been identified. She stated the FSD doesn't have the training for the job. I go over the Dietary Managers Instruction Manual with her and then I do a follow up and things still aren't done. I have instructed the staff on dishwashing and I just reviewed sanitation and food preparation. The FSD is going to be asked to step down. I have someone else in mind to put in the position who has more experience. 2020-09-01