| 5836 |
ROSE BLUMKIN JEWISH HOME |
285059 |
323 SOUTH 132ND STREET |
OMAHA |
NE |
68154 |
2016-08-24 |
371 |
L |
1 |
0 |
Inf |
> LICENSURE REFERENCE NUMBER 175 NAC 12-006.11E Based on observation, record review and interview; the facility failed to maintain food temperatures in a range to prevent food borne illness. The facility staff identified 86 of 87 resident who ate out of the facility kitchen. The facility staff identified a census of 87. Findings are: Observation on 8-12-2016 at 11:30 AM revealed a weekly Deli style lunch was being offered to the facility residents and outside community. An interview was conducted on 8-12-2016 at 11:40 AM with the Director of Food Service (DFS). During the interview the DFS confirmed food for the weekly Deli was prepared in the facility kitchen. When asked if the facility residents could have their lunch from the Deli, the DFS stated yes. On 8-12-2016 at 11:55 AM an interview was conducted with the Assistant Director of Food Service (ADFS). During the interview when asked if a resident could have their meal served from the Deli, the ADFS stated yes. The ADFS reported if residents wanted to eat from the Deli, the staff would take the food order sheet to the residents' nurse to see if what was ordered was with in the diet for the resident. Observation on 8-12-2016 at 12:05 PM revealed the Deli style lunch was being served to those community members and residents who had placed lunch orders. Further observation of the meal service revealed there was a pan of raw Tuna steak. There was brownish liquid partially covering the Tuna Steak and upon request, Cook G using the facility thermometer, obtained the temperature of the Tuna steak. Cook G reported the Tuna Steak was 50 degrees. Continued observation of the Deli service revealed Egg Salad and Tuna Salad were available for community members and residents to order. The Egg salad and the Tuna salad were observed to be sitting on top of a pan of ice. When requested, Cook B using the facility thermometer, obtained the the temperature of the Egg Salad with a resulting temperature of 48 degrees. Cook B then obtained the temperature of the Tuna Salad with the resulting temperature of 48 degrees. The DFS who was assisting with the Deli service was informed of the resulting temperatures of the Tuna and Egg Salad. The DFS stated that's not cold enough and instructed Cook B to retake the temperature of the Egg and Tuna Salad. Cook B using the facility thermometer, obtained the temperature of the Egg Salad with a result of 50 degrees and the Tuna Salad was 52 degrees. Cook B reported the results to the DFS at 12:13 PM on 8-12-2016. The Tuna Salad, Egg Salad and Tuna Steaks were not removed and discarded. Observation on 8-12-2016 at 1:40 PM revealed the deli service was completed. Cook B obtained the temperature of the remaining Egg Salad with a result of 56 degrees and the remaining Tuna Salad temperature was 58 degrees. An interview with the DFS was conducted on 8-12-2016 at 1:40 PM. During the interview the DFS confirmed the Tuna Salad, Egg Salad and Tuna Steaks were too warm and further confirmed the foods were served to residents and guests. An interview on 8-12-2016 at 1:45 PM was conducted with the Catering Coordinator (CC). During the interview the CC reported the food temperature had not been taken for the Deli foods. On 8-12-2016 at 3:35 PM the facility staff identified and provided order sheets of 6 residents who ate from the Deli on 8-12-2016. B. Record review of the facility Production Area Cook sheet revealed start and end temperatures of the specific food items for the facility residents meals revealed the following: -5-19-2016; Pasta Salad Creamy D, starting temperature was 60 degrees, no ending temperature was recorded. -5-19-2016; Coleslaw Creamy D, starting temperature was 60 degrees, no ending temperature was recorded. -5-21-2016; Macaroni Salad, starting temperature was 60 degrees, no ending temperature was recorded. -5-21-2016; Pureed Macaroni Salad, starting temperature was 60 degrees, no ending temperature was recorded. -5-24-2016; Turkey Sandwich, starting temperature was 60 degrees, no ending temperature was recorded. -5-24-2016; Ground Turkey Sandwich, starting temperature was 60 degrees, no ending temperature was recorded. -6-02-2016; Coleslaw Creamy, starting temperature was 59 degrees and the ending temperature was 67 degrees. -6-04-2016; Borscht (soup), starting temperature was 63 degrees and ending temperature was 69 degrees. -6-04-2016; Coleslaw Creamy and Cucumber Onion in Sour Cream, starting temperature was 53 degrees for both and ending temperature for both was 61 degrees. -8-05-2016; Prime Rib, starting temperature was 132 degrees and ending temperature was 146 degrees. -8-09-2016; Ground Chicken Salad, starting temperature 61 degrees and ending temperature was 70 degrees. -8-09-2016; Pureed Chicken Salad, starting temperature was 58 degrees and ending temperature was 69 degrees. -8-11-2016; Coleslaw Creamy, starting temperature was 56 degrees and the ending temperature was 63 degrees. An interview on 8-12-2016 at 4:55 PM was conducted with the FSD. During the interview,review of the recorded food temperatures was completed. The FSD confirmed the cold food temperatures were too warm. The FSD further confirmed the Turkey sandwich was a cold sandwich and should have been below 41 degrees. Record review of the facility recipes printed on 8-24-2016 for Egg Salad, Turkey Salad, Chicken Salad, Creamy Pasta Salad,Tuna Salad and Coleslaw Creamy revealed these foods were to be maintained at a temperature of 40 degrees or lower. On 8-24-2016 at 9:13 AM a follow up interview was conducted with the ADFS. The ADFS reported during the interview that food temperatures were taken to keep foods out of the danger zone. The ADFS confirmed the recorded food temperatures were not being monitored prior to 8-12-2016. According to the USDA Food Safety and Inspection Service (FSIS) found at www.fsis.usda.gov, the danger zone of food was between 40 degrees and 140 degrees as the bacteria grows rapidly in this range. Additional information from the FSIS revealed that to prevent illness,hot foods should be kept at or above 140 degrees and cold food at or below 40 degrees. C. Record review of a Resident Illness sheet revealed between 5-25-2016 and 6-7-2016, 23 residents were identified as having diarrhea or vomiting. D. Record review of a Staff Illness sheet revealed between 5-24-2016 and 6-04-2016, 14 staff members were identified with diarrhea or vomiting. According to information at www.foodsafety.gov, symptoms of food poisoning include upset stomach, abdominal cramps, nausea, vomiting, diarrhea, fever and dehydration. On 8-12-2016 at 5:15 PM the facility Administrator provided a signed Plan of Correction to abate the immediacy of the situation and protect residents from food borne illness. This abatement statement revealed the following information: -1. The egg and tuna salad identified during the deli service was disposed. -2. Temperature of all foods will be checked and recorded before leaving the kitchen. If any food item is outside of the accepted temperature range, that food will be discarded. The cook checking the food temperatures will immediately notify the Food Service Director or designee. -3. Temperatures of all remaining food from a meal will be checked and recorded at the end of the meal services. Food that is outside of the accepted temperature range will be discarded. The cook will immediately notify the Food service Director or designee. -4. The Food Service Director or designee will in-service all dietary personnel that are currently working (8-12-2016) regarding food temperature safety and safe food handling. All other employees will be in-serviced prior to their next scheduled work day. An employee will not be allowed to work until they have received the training. The training will include when to take temperatures, acceptable temperature range for cold and hot food, documenting temperatures, what to do in the event the temperatures are out of range and safe food handling. The food Service Director or designee will in-service all new dietary staff regarding taking food temperatures and safe food handling. -5. The Food service Director or designee will review all temperature recording on a daily basis to ensure that staff are recording and reporting temperatures correctly. -6. The Food Service Director or designee will audit food handling and temperature monitoring at a minimum of weekly at varying times to ensure that staff are handling food correctly. If a discrepancy is noted, the auditor will intervene immediately. -7. The Food Service Director or designee will report to the QAPI (Quality Assurance Performance Improvement) Committee monthly regarding any temperature out of range and any mishandling of food and the corrective action taken. |
2019-08-01 |