HospitalInspections.org

Based on observation, staff interview and facility policy /record review, the management of dietary services failed to assure adherence to established policies for safety practices for food handling.
Potentially hazardous food was not maintained under time and temperature control to prevent bacterial growth; equipment and utensils were not maintained with clean and smooth cleanable surfaces, food was stored under unsanitary conditions, and food was not protected from contamination. All of which increase the risk of cross contamination and potential for food borne illness which have the potential to affect all patients and staff who ingest food from the kitchen.

The findings include:

1) A review of the Healthsouth Treasure Coast Rehabiltation Hospital Policy and Procedures revealed:
Subject: Infection Control. Department: Dietary SOP #400.1 dated 2/14.
D. Food preparation and service
3. Food is served with clean tongs, scoops, forks, spoons, spatulas, or other suitable implements so as to avoid manual contact
E. Ice
2. The outside of the ice machine are cleaned and sanitized daily
G. Cleaning
2. Ranges and grills are cleaned daily.
3. All work surfaces, utensils, and equipment are cleaned and sanitized after each use.
Subject: Ware Washing. Department: Dietary SOP #400.9 dated 2/14
C. Clean up
Clean top and side of dish machine.
Subject: Equipment care and cleaning. Department: Dietary SOP #400.11 (1) dated 2/14
Cleaning of Stainless steel- detailed instructions provided for various pieces of equipment.

On 09/21/2015 beginning at 9:47 AM accompanied by the Nutrition Services Manager, the following concerns were identified:
1) Sliced packaged turkey thawing under running water which measured 75 degrees with calibrated thermometer. Hazardous temperature range potentiating bacterial growth is 41 degrees to 135 degrees.
2) Rust colored rough surfaces on many areas including: hoods, Vulcan ovens, steel shelving for juice concentrates, plastic covered rack for lid storage, ice machine, dish machine exhaust vent, stainless steel utility carts, and interior of reach in refrigerator in cold preparation area.
3) Food equipment not clean including: the area above the bowl for 3 of 3 mixers; the knob on the meat slicer; the interior of the microwave and the toaster; a cracked plastic lid on the robo coup, and a small blender being set up for use with a wet interior.
4) Three of three Spatulas with melted degraded handles and one rust colored vegetable peeler.
5) Walk in refrigerator with split and blackened gaskets; dust coated fan grill with fan blowing over ready to eat food, and one case of cabbage stored directly on the floor
6) Three of 3 ceiling vents located over food preparation and food pathways heavily laden with dirt.
7) Dry goods stored on dusty shelving
8) The dishmachine exterior with gray encrusted area around temperature guages.
9) Tray Transport Carts have cracked and damaged gray colored bumpers that were not clean to sight.
At 11:30 AM, during the observation of luncheon trayline preparation, the Nutrition Services Manager obtained with a calibrated thermometer, a temperature of 120 degrees for the pureed veal placed in the food warmer for an undetermined amount of time. The pureed veal was discarded. A temperature of 120 degrees is within the hazardous temperature range of 41 degrees and 135 degrees, which allows bacterial growth to flourish. At that temperature the pureed veal is potentially contaminated.
The Nutrition Services Manager in an interview during the tour acknowledged the concerns and noted that the kitchen equipment is 25 years old.

A review of the U.S. Food and Drug Administration 2009 Food code reveals at:
3-501.13 Thawing.
Except as specified in ¶ (D) of this section, POTENTIALLY
HAZARDOUS FOOD (TIME/TEMPERATURE CONTROL FOR SAFETY FOOD)
shall be thawed:
(A) Under refrigeration that maintains the FOOD temperature at
5oC (41oF) or less; or
(B) Completely submerged under running water:
(1) At a water temperature of 21oC (70oF) or below

3-501.19 Time as a Public Health Control.
(1) The FOOD shall have an initial temperature of 5ºC (41ºF) or
less when removed from cold holding temperature control, or
57°C (135°F) or greater when removed from hot holding
temperature control; P

4-602.13 Nonfood-Contact Surfaces.
The presence of food debris or dirt on nonfood contact surfaces may provide a suitable environment for the growth of microorganisms which employees may inadvertently transfer to food. If these areas are not kept clean, they may also provide harborage for insects, rodents, and other pests.

4-601.11 Equipment, Food-Contact Surfaces, Nonfood-
Contact Surfaces, and Utensils.
(A) EQUIPMENT FOOD-CONTACT SURFACES and UTENSILS shall be
clean to sight and touch. Pf
(B) The FOOD-CONTACT SURFACES of cooking EQUIPMENT and
pans shall be kept free of encrusted grease deposits and other
soil accumulations.
(C) NonFOOD-CONTACT SURFACES of EQUIPMENT shall be kept free
of an accumulation of dust, dirt, FOOD residue, and other debris.
4-901.11 Equipment and Utensils, Air-Drying Required.
After cleaning and SANITIZING, EQUIPMENT and UTENSILS:
(A) Shall be air-dried or used after adequate draining as
specified in the first paragraph of 40 CFR 180.940 Tolerance
exemptions for active and inert ingredients for use in
antimicrobial formulations (food-contact surface SANITIZING
solutions), before contact with FOOD; and
(B) May not be cloth dried except that UTENSILS that have
been air-dried may be polished with cloths that are
maintained clean and dry.