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Based on observation, interview, and record review, the facility failed to ensure the safe transport and storage of clean linens; failed to ensure a sanitary environment was maintained in the kitchen; and, failed to ensure food was properly stored. This deficient practice had the potential to affect all residents who used the laundry and kitchen services. Findings include:

1. Clean Laundry Storage

During an observation on 9/25/19 at 10:48 a.m., the clean linens which were stored on a rack inside the clean linen closet were not covered. The cover for the clean linen rack was flipped over the top of the rack, and there were miscellaneous items piled on top of the flap.

During an observation and interview on 9/25/19 at 11:00 a.m., staff members D and E were transporting clean linen in a metal cart upstairs in an elevator. The cart was not covered. Staff member E stated they did not cover the clean linens when transporting.

During an interview on 9/25/19 at 1:00 p.m., staff member B stated it was the expectation that clean linen would be covered when transported and while being stored in the clean linen closets. She stated this was to reduce the spread of infection, and to prevent the contamination of clean laundry.

2. Kitchen Sanitation

During an observation of the kitchen on 9/25/19 at 11:10 a.m., the following items were found to be dirty:

- The top of the convection oven had a thin layer of sticky, greasy dust.
- The freezers and refrigerators had food debris and sticky finger prints on the outside of the appliances, as well as on the appliance handles.
- Inside the freezers and refrigerators, there was food debris on the bottom of the shelves.
- Inside the microwave was cooked on food splatter on the inside walls and on the inside cooking plate.

During an interview on 9/25/19 at 11:10 a.m., staff members F and G stated there was a weekly cleaning schedule which should be followed to clean the convection oven, microwave and appliances. They stated these were cleaned at least weekly.

During an observation on 9/25/19, at 11:10 a.m., the most current posted cleaning checklist, dated for the week of 9/15 through 9/22, showed the freezers and refrigerators, inside and out, were not cleaned. The ovens were not cleaned, and the microwave was last cleaned on 9/15/19.

During an observation and interview on 9/25/19 at 11:10 a.m., showed the daily cleaning, and weekly cleaning checklists, were for the week of 9/15/19 through 9/22/19. There was no posted daily or weekly cleaning checklist for the week of 9/23/19 through 9/29/19. Staff member G stated they followed the posted daily and weekly cleaning checklists to know when something was last cleaned. He stated the staff would mark the date on the checklist when they were done cleaning the required areas.

During an interview on 9/25/19 at 1:12 p.m., staff member H stated it was the expectation staff maintained a clean and sanitary environment in the kitchen. She stated they were to follow the daily, weekly, and monthly cleaning schedules which are posted on the wall. They were to sign off each area as it was completed.

Review of the facility's policy and procedure titled, Sanitation of Food Preparation Area, with an approval date of 4/19/19, showed, "The food preparation area is clean, sanitary, and safe... 11. Daily, weekly, and monthly cleaning is assigned".

3. Safe Food Storage

During an observation of the kitchen on 9/25/19 at 11:10 a.m., the following items were found to be incorrectly stored:

- There were two large white bins both with lids, one labeled flour, and the other labeled sugar. There was no UBD posted on the flour or sugar bins.
- There was a small white bin located next to a refrigerator, which was stored on the floor, and its lid was pushed sideways into the bin. In the bin was an opened bag of brown sugar.
- There were various beverages pre-poured into serving cups which were in the refrigerator and were not covered or dated.
- There was a granulated white powder which was stored in a small bin on the counter. The bin did not have a label to identify what was in the bin, and there was no UBD on the bin.
- There were plastic containers in the cupboard which contained a raisin bran cereal, crispy rice cereal, and oatmeal. The containers were not labeled with what was in them and they did not have UBD.
- There were various sandwiches in the refrigerator which were not labeled and did not have a UBD.
- There was a tray of cut brown cakes inside the refrigerator. These cakes were not covered or dated.
-There was a bag of bread crumbs, open to the air inside the pantry. The bread crumbs did not have an open date, and they were not sealed shut after the last use.

During an interview on 9/25/19 at 11:10 a.m., staff members F and G stated there was such a quick turnaround time on the flour and sugar they did not put a UBD on the bins. They stated they believed the flour and sugar had recently been replaced, but they could not say when that occurred. Staff member F stated the cakes and beverages were for that day's meal service and did not feel they needed to be covered since they were going to be served soon. Staff member F stated the various sandwiches were for the jail, so they did not need to label those items. Staff member G stated he believed the cereals were filled the previous week but was not certain. He stated the resident who used the rice cereal had recently passed away, and he was the only patient who ate the rice cereal. Staff member G stated he thought they could go ahead and toss out the rice cereal. He stated the white granulated powder in the unmarked bin on the counter was powdered milk. He stated he was not sure how long it had been in the container, but the resident which used the dried milk had recently passed away, and the staff member thought they could go ahead and dispose of the powdered milk.

During an interview on 9/25/19 at 1:12 p.m., staff member H stated it was the expectation that staff store food items up and off the floor. She stated any food being prepared in the kitchen, should be covered and dated when not being served, to prevent contamination of the food items. She stated any food items not being stored in their original containers should be dated with what it is and a UBD should be placed on the bins. She stated it was the expectation of staff to store and serve food in a sanitary manner.