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Based on observation, interview, and review of hospital records, the hospital failed to ensure all essential mechanical equipment was in operating condition when a hot water heater, that supplied hot water to the kitchen, was leaking into the emergency food storage area.

Findings:

During visit, on 3/11/13 at 5 p.m., of the hospital emergency food storage area, the floor surrounding a hot water heater was observed to be wet. The water, leaking from the hot water heater, left a dark circle on the concrete floor under the hot water heater that extended out about half a foot around the hot water heater.

Directly opposite the hot water heater, extending down the full length of the space, were large flattened cardboard boxes standing on edge, in front of the food storage shelving. Stored on the concrete floor were boxed canned food items and cleaning chemicals.

During an interview, on 3/11/13 at 5:10 p.m., the hospital Engineering Manager stated it was in the "works" to have the hot water heater replaced. The engineering Manager explained that replacing the hot water heater was not just an easy switch of equipment, a new hot water heater required that the flue to the outside be enclosed. The Engineering Manager stated he was working with the hospital architect, and the Office of State Wide Health Planning and Development, (OSHPD, reviews and inspects health care facility construction projects), to ensure the replacement hot water heater met all required building codes.

The Engineering Manager stated the architect had drawn up plans and the project was ready to start the next week.

At 5:30 p.m., on 3/11/13, the Engineering Manager provided copies of e-mail between the hospital and the architect. Review, of the e-mails indicated on 2/6/13, the hospital Director of Operations requested the architect's assistance in "planning a fix", to the water heater that served dietary and the hospital dishwasher as it was leaking.

The architect replied to the Operations Manager, on 2/7/13, with a list of questions: natural gas or propane, size of the gas line, etc.

A third e-mail, dated 2/26/13, was a forwarded copy of the prior e-mails to the Engineering Manager.

Based on observation and interview, the hospital failed to ensure food sanitation standards were met in dietary services when the hospital dishwasher lacked an air gap, a separation between food prep (sink) and the floor drain to prevent sewage backflow into the hospital dishwasher, with potential for food borne illness if clean dishes became contaminated with dirty water.

Findings:

During an observation, on 3/11/13 at 4:55 p.m., there was no visible air gap, (an unobstructed vertical separation between the water outlet and the flood rim of the receptacle to prevent backflow) located at the outflow drainage pipe area of the dishwasher.

During an interview, and concurrent interview, on 3/11/13 at 3:25 p.m., the Engineering Manager stated the "bell housing" had arrived for the air gap on the kitchen dishwasher. The Engineering Manager showed a large cup-shaped device with both ends open. The Engineering Manager showed how the bell housing would be connected to a back flow valve inside the pipe running to the sewage system.

The Engineering Manager stated he would do the work himself, and he had consulted with the Dietary Supervisor as to the best time to do the work on the dishwasher. The Engineering Manager stated he preferred to do the work during the week or on Saturday, because he may just need additional parts that he couldn't get on a Sunday. The Engineering Manager stated he and the Dietary Supervisor had also discussed the possibility of using paper products for food service if the air gap repair work took longer than anticipated.

It would be the standard of practice to ensure the presence of an air gap between the water supply inlet and the flood level rim of the plumbing fixture, equipment of nonfood equipment and shall be a least twice the diameter of the water supply inlet and may not be less than one inch. (Food Code, 2009).